The practising midwife
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Midwifery practice in rural central Africa is full of joys (an abundance of twins, births by candlelight and resilience and stoicism that would leave even the very experienced birth practitioner speechless), but also a lot of challenges (every obstetric emergency in your wildest nightmares and worse) that are compounded by a lack of access to a skilled birth attendant. Women here have a strong culture of traditional practices and remedies, and hospital is often not the first port of call. Caring for women who cannot, themselves, consent to emergency life-saving caesarean sections, is a cultural aspect that we accept and respect as medical professionals working in the Democratic Republic of Congo (DRC). In a busy maternity ward in a low-resource setting, in a hospital supported by emergency humanitarian medical organisation Médecins sans Frontières (MSF), just how are obstetric emergencies managed--and are the outcomes what you would expect?
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The challenges faced by birthing women and maternity healthcare professionals in developing countries cannot not be over estimated. The experience of a midwife in a rural Tanzanian hospital described in this article gives a small insight into these challenges. ⋯ Conversely, where monitoring is minimalistic and time limits are not applied, 'normal birth' is truly the norm and the trust in women to grow and birth their babies is consistent and commendable. Reflection upon midwifery in developing countries can help inform attitudes and practice in the UK.