18 year old and pregnant Ma Htet Htet Win attended the antenatal clinic in Kwan Tar sub rural area in December 2016 with her husband U Tun Aye, a farmer. They arrived by bullock cart which they borrowed from a friend. The journey took 1.5 hours as the health centre is 5 miles from their village. This was Ma Htet Htet Win’s first pregnancy and she was 38 weeks along as she was examined by the midwife.
Like in most normal pregnancies, the babies head faces down towards the mothers cervix, however Ma Htet Htet Win’s babies head was facing up. When going into labour, the position of the baby is very important and it is far too risky to deliver a breech baby without harmful complications or even death. The placenta was unable to be pulled away from the wall of the uterus necessitating an emergency cesarean section. The midwife explained the situation and advised Ma Htet Htet Win to deliver in hospital.
Two weeks later, she started getting labor pain. They called on a Traditional Birth Attendant (TBA) who gave the same advice as the midwife to go to the hospital for an emergency C section. Ma Htet Htet Win was worried as they did not have the money needed for transportation to the hospital and to cover the charges associated with delivery. The nearest township hospital was a 30 minute car ride from their village.
Still in distress and refusing to go to hospital due to lack of finance, they called on the previous midwife once more. When the midwife arrived, Ma Htet Htet Win asked to deliver the baby at home. The midwife further explained and encouraged the young mother saying that a breech is a life threatening condition and it is necessary to go to hospital. The midwife explained about an ADRA Myanmar project called EMBRACE that supports referral patients, especially those in need of emergency obstetrics, by providing transportation costs and meals for the pregnant mother and accompanying person. On hearing this, Ma Htet Htet Win agreed to go to hospital.
Ma Htet Htet Win was accompanied to the hospital by the midwife, auxiliary midwife, traditional birth attendant and family members. The EMBRACE project had established referral systems in project villages, so the auxiliary midwife called on the village leader, MCHG (Mother and Child Group) leader and members to assist in getting Ma Htet Htet Win to the local township hospital.
The operation proved a success with a baby delivered by emergency C section weighing in at 3.8 kgs. Further complications saw the baby unable to breastfeed due to a yellow colouration in the eye. The baby was treated with antibiotics and phototherapy. After 10 days, both Ma Htet Htet Win and her healthy baby were discharged from hospital. EMBRACE project staff provided transportation costing 10,000 kyats and food at 42,000 kyats. Ma Htet Htet Win was so greatful for the assistance that she invited the staff to her house for lunch in appreciation.
The EMBRACE project, funded and supported by ADRA Canada and Global Affairs Canada, works in 27 villages within Hlaing Bwe township in Myanmar’s South Eastern Kayin State. Kwan Tar village is one of the targeted project villages and is included in Kwan Tar village tract which has 9 villages in total. Kwan Tar village has 132 households with a population of 798, 5 of which are recorded as pregnant. It is located 3 miles from the township hospital and has one sub rural health centre. Although the village is close to the hospital, the villagers are reluctant to go for various reasons. The EMBRACE project is working with volunteers from villages, such as auxiliary midwifes and community health workers to assist pregnant women in visiting antenatal clinics, refer emergency obstetric patients to hospital and organise health activities within the community. In return, the volunteers are supported with top up credit for their phones, transportation costs and accessories.
*Original Story By: EMBRACE Project Staff
Written By: Emma McCrow, Communications Officer
Photo: © 2017 ADRA Myanmar
