While it is true that hospital birth is safer than home delivery, it may not entirely be the preferred method of the marginalized sector, too. If they were well-informed, had the financial means and accessibility, do you think they will choose to give birth at home?
Working in a government hospital in the Philippines, I found out that the minority group called Mangyan, live in the mountains. It may take a few days to a week going to the nearest hospital or clinic. Besides the fact that they are poor, they are uneducated, too. It is icing on cake to put the blame to them in giving birth at home--if they have one. I also think that it is unfair to single out the traditional birth attendants for the three-digits maternal mortality rate.
The health care system in the Philippines should be re-evaluated and strengthened in order to improve the health of mothers and their newborns. The poor health indices reflect not only the management in the local areas but the entire management system, budget allocation, and overall political will of the government.
Cabral: Giving birth at home can be dangerous to mothers
By Julie Alipala
Philippine Daily Inquirer, 26 Mar 2010
ZAMBOANGA CITY, Philippines—Health Secretary Esperanza Cabral warned women about the greater risks in home birthing compared to giving birth to babies in hospitals or clinics.
"We don't encourage birth at homes because it is dangerous for mothers," Cabral said during a visit here Thursday.
Cabral said "hilots" (traditional birth attendants) were ill-equipped in handling complicated maternal cases.
Cabral was reacting to reports that home birthing was becoming more popular in many parts of the country.
"Women have to utilize (certified health) facilities for child birth. They will be better cared of than if they deliver at home because traditional birth attendants are not equipped to deal with complicated pregnancies," she said.
Cabral also blamed "hilots" for the rising incidence of maternal deaths—now at 132 per 100,000 live births—in the country.
The failure of traditional birth attendants to cope with and handle complicated pregnancy cases contributed to the increase, she said.
Cabral said the health department was trying its best to lower the mortality rate to 52 deaths per 100,000 live births, and patronizing "hilots" would not help in this objective.
She said there was no more reason to tap "hilots" because the government has been putting up Basic Emergency Maternal and New Born Care and Comprehensive Maternal and New Born Care facilities all throughout the country.
"We may not be able to beat the target but at least, there will be an assurance we will be able to reduce maternal deaths if more women will avail of government health services instead of tapping ‘hilots’," she said.
Dr. Ceferino Lustre II, a government doctor assigned to La Libertad, Zamboanga del Norte, said convincing expectant mothers to give birth in certified health facilities was the greatest challenge for rural doctors like him.
"In La Libertad, a lot of pregnant women prefer to deliver at home attended by hilots," Lustre said.
He said families would always consider the economics of birthing in deciding in favor of the "hilots."
"They always claim that it's cheaper to give birth at home. We always tell them that birthing is for free in barangay health centers," Lustre said.
He admitted that accessibility might be one reason women prefer to give birth at home than in health facilities, which are normally located far from where they live.
Dr. Zaida Aminulla, who is assigned to Sergio Osmeña town, also in Zamboanga del Norte, said what she did was to befriend the hilots in the town.
"We encourage them to assist us, serve as our guides and assist us in delivery. We also consult with them so they can bring pregnant women or patients to the health centers," Aminulla said.
She admitted that "in the community, hilots are still the most sought after."