Nepali Times
No home delivery


Despite war, poverty and political instability Nepal's maternal mortality rate has dropped from 800 per 100,000 live births 20 years ago to 280 today. Rising female literacy, later marriages and the spread of road access are regarded as factors.y

Still, less than a third of all mothers give birth in hospitals and only six out of ten deliveries are done by skilled birth attendants. And to reach the Millennium Development Goals, Nepal needs to reduce the maternal mortality rate further to 134 by 2015.

And despite the drop in under-five infant mortality figures from 237 per 1,000 live births in 1970 to 50 today, three-fourths of all baby deaths happen just after birth or before its first birthday.

This is why, besides encouraging mothers to seek skilled birth attendants the government is also spreading a campaign to care for new-born babies from 10 pilot districts to 15 more.

When 25-year-old Mayarani Chaudhari of Dodhari of Bardiya gave birth to a still-born baby girl, her family starting digging a hole in the ground to bury her. But they decided to call the skilled birth attendant, Pushpa Sigdel, to have a second look. Pushpa found that the baby had its windpipe squeezed by the umbilical chord. She gave artificial resuscitation and revived the baby. Last week, Mayarani posed with daughter, Shami, in her lap and her son, Samir. Pushpa (centre) and her assistant, Luna Rana Magar , are also in the picture. Says Mayarani: "Pushpa Didi is like a goddess to us, she brought my daughter back to life."

When Gita Gharti Magar got pregnant, she was determined to deliver in a hospital because her first baby died of jaundice soon after birth. "I am glad I went to a nursing home this time because my baby was premature and weighed only 1.5 kg," she says. Gita demonstrates the "love embrace" technique of holding her baby, Anis. Birth attendants recommend mothers use this method in places where there are no incubators.

When her labour pains started, Debimaya Pariyar hopped onto a bus by herself and headed to the nearest hospital in Nepalganj. It took her an hour to reach the city. Soon after being admitted into the maternity ward of the Bheri Zonal Hospital, Debimaya gave birth to twins. "I'm glad I listened to the skilled birth attendant in my village," she says, "she had warned me there could be complications if I gave birth at home." Here she is last week with her two other daughters, Subina and Khusi, and mother, Nainimaya.

Krishna Nepali gave birth to her first baby boy in a hospital in Gulariya of Bardiya because her mother-in-law Himkumari insisted on it. "We used to have babies at home, but now we know it is dangerous for both mothers and babies so we took my daughter-in-law to hospital," says Himkumari (right). Save the Children is helping the government with community-based newborn care for mothers and their babies in Bardiya. UNICEF and Plan Nepal are involved in other districts.

Read also:
Healthy progress
Nepal's maternal mortalityrate has dropped from 850 per 100,000 live births twenty years ago to 280 today.
A healthy majority, EDITORIAL
Birkha Dai's clinic, ABHAYA SHRESTHA in MUGU
Do hospitals have to be so expensive?, ELIPHA PRADHANANGA in DHULIKHEL
Dhulikhel and Chhetrapati hospitals show the way in making health care affordable to all Nepalis

1. Surendra Malla
Well achievement  towards  M D G. We must focus more on health sector and even on the slogan "No home delivery".

2. Sanjana
Lovely pictures. 
RE: second photograph: the technique is called "kangaroo mother care" to keep underweight babies warm helping them stay healthy and gain weight.

3. KiranL
Thanks to Dambar Shrestha for such an interesting and uplifting story about how much a difference training young midwives makes for the health of poor Nepalese people. Much more, it seems than, sending a doctor to a private medical school after paying Rs 25 lakhs in donation.

(11 JAN 2013 - 17 JAN 2013)