On the 31st August Dr Lois McKellar, Academic and Lecturer of Midwifery at UniSA will present findings from the Safe Arrivals research at an International Midwifery Conference held at the University of Ulster, Ireland. The theme – ‘Safe Motherhood – Developing Partnerships with TBAs’.
Since well before travelling with a Safe Arrivals team in 2009 Dr McKellar had already become a keen advocate for the program. Now, in addition to sharing with others her concern for the TBAs of Cambodia she also offers her expertise and oversight to the development of the Safe Arrivals training.
But while the World Health Organisation recommends that every woman should have a skilled birth attendant attend her birth, there is a growing unease with Dr McKellar and others that the best of intentions might lead to the worst of outcomes – at least in the short term.
As Christine MacArthur Professor of Maternal and Child Epidemiology from the University of Birmingham observes, “Although a skilled birth attendant for all women is obviously the ideal, … it may be years before this is a feasible option”. MacArthur goes on to say, “In one trial, the most promising interventions for reducing perinatal mortality and morbidity were training traditional birth attendants …. and strengthening linkages”.
So this year, Safe Arrivals will pilot a referral element. The hypothesis of the research will be that training traditional birth attendants can lead to an increased number of pregnant mothers being referred to the government health centres – where skilled birth attendants are waiting!
As Dr McKellar notes, “If you lose the TBA you lose access to women. They are the link. Do away with the link and you do away with improving maternal health”.