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Working in Tanzania: Giving Birth to Families

Part five of a small series: how families are born at FAME.

For me, guiding labor is key to the outcome, which means that I don’t like to leave a woman in active labor alone. I need to be able to read the labor. That way, I will understand the condition of mother and child and the progress better than any monitor can tell me. Sometimes, I will just observe the woman from the corner of my eyes, at other times I will be more actively involved in standing by her while she is going through contractions. I like to advocate for the creation of an atmosphere of harmony in the labor ward, which involves reduced lights, reduced noise, respecting the woman’s privacy and allowing a relative or her partner into the room at any moment if that is what the she wants and needs. I like to involve the partner, if present, as much as possible, during labor but also after birth.

I know that in Tanzania the role of the husband in childbirth is generally different from that in the West, in the sense that giving birth is basically a women’s affair. However, I remember two occasions at FAME when a husband really wanted to be involved, and it is our job as staff to give husbands all the space and opportunity to find their own role in the birth process. This also involves updating them on the progress (or lack thereof) so that they can mentally adjust when the labor suddenly turns into an emergency and they need to give permission for interventions. It can be very frightening and intimidating for a husband to give up control of a situation and hand over the destiny of his wife and future child into the hands of others. Especially since for most of them all they know about the process of childbirth is that it can be life-threatening. Communication with the husband is important and should not be overlooked through medical staff basically focusing on the woman alone.

After a caesarean, it is also important to make the husband part of what is happening, especially as it often takes quite some time before the woman is ready to leave the theatre. As medical staff, you can involve the newborn father. For instance, there was a case in which I noticed a father anxiously waiting in the ward for his wife to return from the theatre. I was doing the first care of the baby in the open incubator. Since the baby had a perfect start and was visibly thriving, I didn’t consider doing endless vital signs of any additional value. Instead of keeping the baby on the table, deprived of being cuddled, I decided to wrap it up and bring it to the father to see, hold and meet. Even though he was shy to hold his baby in the beginning, I could see he started to grow proud and felt way more involved in what was going on. It also gave me the opportunity to give him some explanation on observing the baby and answer some of his questions on breastfeeding.

As medical staff, we have a role in giving birth to a family, which means actively involving the father, even when he is a bit hesitant in the beginning. When a child is born, a mother and a father are born. As medical staff, we need to pay attention to guiding three births.

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Want to know more about my journey to Tanzania and the Foundation for African Medicine? Check my travel diary.

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