Birth in Belize [April 2008]
I’ve lived in Belize for over a year, however, I don’t like what I see. I have delivered four babies here in Belize. Since I am retired (sort of) all these couples have found me. Each of them wanted a natural birth.
From talking with other women here, I have learned that the c-section rate is rising, and for silly reasons. Like being overdue—when she was only 39 weeks by LMP and conception; and weak—she was told that because she was a vegetarian she could not handle the stress of labor.
Another did not want to be slapped in labor (they are supposed to be quiet) and also did not want an episiotomy. All first-time moms in Belize hospitals get an episiotomy, are required to use stirrups and no family members are allowed at hospital births. Also c-sections are given for progress that is too slow.
Women receive no childbirth education or dietary advice. Breastfeeding is supposed to be encouraged, but women are told routinely reasons they cannot: baby too small, baby needs food for the first few days because you have no milk, your nipples are too big. These are just things that I have been told personally.
Hospital staff are not motivated to change their behavior, as all are on salary and they get the same poor pay whether they are nice or not or whether anyone turns up to have the baby there or not. If staff are mean, then fewer patients come. Most ladies here go across the border to Mexico if they have the funds.
I have heard of a waterbirth being planned in a Mennonite community—but definitely not at the hospital. When I suggested to a hospital midwife that I thought the lady was overdue because the baby was posterior she ran for a doctor—she thought I meant breech! The lady was only at her due date.
The one thing that has changed here in Belize is more c-sections.
BELIZE CITY, Belize (WOMENSENEWS)--The young woman lying in the small, cheerfully decorated recovery room was still groggy, but she was fully aware of her new role: being a mother.
She had just delivered her first child at the Karl Heusner Memorial Hospital in Belize City, where she was encouraged and coached by a nurse to start breastfeeding her healthy, hours-old baby boy.
In Belize every woman's pregnancy and delivery is under the microscope of the Millennium Development Goals, U.N. anti-poverty pledges made by governments that are due in 2015.
"We had zero maternal deaths in 2011," said Dr. Natalia Largaespada-Beer, director of maternal and child health for Belize's Ministry of Health, in an email interview. "Every obstetric emergency is considered a national emergency."
To meet its goal of 10 maternal deaths for every 100,000 live births, the country with a population of only around 400,000 people--and just 7,000 women or so who give birth each year--will have to keep that up.
Amikole Aminata Maraesa, an American doctor of anthropology who lived in southern Belize in 2006, explains the math.
In 2009, she said, the country's maternal mortality ratio was 54 deaths per 100,000 live births. Sounds high, but in raw numbers it meant four deaths out of about 7,407 births.
Huge National Sway
With each woman's life and death holding huge sway over its national statistic, the country offers a snapshot of public health services that seem to be working, even during a hard economic downturn.
The poverty rate in Belize jumped to 15.8 percent in 2009 from 10.2 percent in 2002, a startling 46 percent increase that would presumably contribute to health deficits in both rural and urban areas.
Many doctors come from Cuba to work in hospitals and clinics and to help the government provide services.
Staffing and supply shortages plague hospitals and rural clinics, but many institutions are still making gains. Since 2008, for instance, a handful-- Karl Heusner Memorial Hospital in Belize City, Northern Regional Hospital in the northern part of the country and Corozal Community Hospital--have received a UNICEF "baby-friendly" designation showing their commitment to fostering breastfeeding.
Largaespada-Beer said some of the strategies Belize has implemented include distribution of iron and folic acid to females ages 10 to 49 to reduce anemia and the risk for postpartum hemorrhage.
The country provides mobile and community clinics that treat the leading causes of mortality in women, such as hypertension during pregnancy among women with hospital deliveries and postpartum hemorrhaging among those who deliver at home.
Dispensing Nourishment
The government dispenses prenatal and postnatal vitamins and fortified food for pregnant and postnatal moms who are at risk or undernourished.
The percentage of births attended by a skilled health professional rose to 94 percent in 2010, up from 79 percent in 1995, according to a report by the Ministry of Health.
Early initiation of breastfeeding increased by 51 percent between 2006 and 2010, according to a UNICEF report.
Among Belize's diverse population, those least likely to breastfeed exclusively for the crucial first three months were better-educated women, mostly from urban areas and with careers, and within the Creole community, the country's ministry reports. The highest rate of exclusive breastfeeding was among the Q'eqch'i Maya and women who gave birth at home.
While the benefits to infants are more commonly emphasized, studies have also shown that breastfeeding helps with postnatal weight loss and reduces the risk of postnatal hemorrhage and breast, ovarian and uterine cancers.
The government also promotes institutional--versus home--deliveries and more skilled birth attendants. Although many rural women prefer to give birth at home around their families, they can now also call an ambulance that arrives with a midwife in case of an en-route delivery.
Leah V. Bennett, a journalist for more than 16 years, lives in Staten Island, N.Y., and is currently an editor and Web producer for The Asbury Park Press in Neptune, N.J. She also volunteers with the International Health Professions Network, which has been bringing free health and dental care to developing countries for more than 20 years.
