Mexico: Safe Childbirth – 1995-96

In a community medicine course taught by CIET staff, medical students carried out a study in indigenous communities of the risks to mother and infant of childbirth under local health conditions. Pregnant women in rural communities depend mainly on local midwives who have no medical training, to deliver their children. Teams of medical students, local midwives and indigenous interpreters were formed in eight rural communities. The teams visited households to discuss with women their prenatal care, delivery and postpartum their last pregnancy. The results of the survey were analyzed by the medical students and formed the basis of a dialogue with the midwives on the problems of childbirth in rural communities. Each of the midwives was given a baumanometer, a stethoscope and a thermometer and trained to measure blood pressure and temperature. The principal discussion with the group of midwives was the problem of retained placenta, the principal cause of maternal death in the area.

A study of 3,000 urban women in their reproductive years in a working class area of Acapulco revealed that women aged 15-19 years were twice as likely to suffer a complication at childbirth as older women, yet very few of them had received any antenatal advice or had been registered in any of the social security schemes. Overall, only three in every ten women had health care guaranteed by social security and, of these, only two actually received any sort of prenatal examination or advice. Yet the average wait during a prenatal visit was two hours. Caesarian section was common, particularly among women who relied on private practitioners (12.5%).

As the result of these studies, a new strategy was developed in collaboration with one of the four University Schools of Nursing, to provide free coverage with prenatal care as part of the training of nurses and medical students.