"Guatemala has one of the highest maternal mortality rates in Latin America. Due to lack of access to quality maternity care and discrimination,
Indigenous Mayan women are
TWICE AS LIKELY TO DIE
from pregnancy and childbirth-related complications than non-Indigenous women."(1)
This striking inequity in maternal mortality hit close to home recently when a family member of one our coworkers died due to complications shortly after giving birth to her second child.
Jesus, a member of our clinic team since we opened our doors nearly a decade ago, is originally from the department of Quiché. Most of his family still resides in that region, which is several hours from our site. One of his cousins was a fledgling Christian artist. Her lone YouTube video features her singing "Tu Eres la Luz" ("You Are the Light").
She delivered at home, experienced significant postpartum hemorrhage, and was transferred to a nearby hospital for further evaluation and treatment.
She did not survive.
Her spouse became a widower with two young children one of whom was just a few hours old.
We cannot amend the above tragic history. However, our center certainly possesses the capacity and resources to intervene in similar scenarios and dramatically alter the ending.
With your help, we can rewrite the stories of mothers and families so that childbirth is a joyous celebration of life rather than a heartbreaking destruction of a young family.
Per the World Health Organization, "postpartum hemorrhage... affects millions of women annually and is the world’s leading cause of maternal deaths.... Despite being preventable and treatable."(2)
Preventable and treatable... but, how? It is not complicated. As Paul Farmer said, “what you really need are the staff, stuff, space, and systems.”
Staff, stuff, space, and systems.
Here's a quick evaluation of our center using those buckets.
Staff. We have a lean capable team, BUT we need to roughly double the number of our staff in order to sustainably provide our marginalized patient population with access to high quality 24/7/365 healthcare- including maternal care.
Stuff. This is a strength of our center. We are arguably one of the best, if not the best, equipped center in our region to be able to rapidly intervene in the event of postpartum hemorrhage. We already have on hand potentially life-saving medications and supplies such as: oxytocin, misoprostol, tranexamic acid, intrauterine postpartum hemorrhage control devices (such as the Bakri ball), kits for fresh whole blood transfusion, and even... REBOA?! (3).
Space. The second floor of our facility currently offers outpatient clinic space. The first floor includes an inpatient/resus area as well as one operating room. We could use more space. And... we are already working on that.
Recently, our designing architect and long-time Wachalal board member, Taylor Simpson, began to put together plans for a possible clinic expansion. In its current form, the proposed expansion would double our outpatient clinic capacity and provide a large flexible open space on the ground floor that could house additional inpatient beds and/or a dedicated labor and delivery area in the not-too-distant future.
Early floor plans for first and second floor of proposed expansion are included here.
Plus, a 3D walkthrough of proposed clinic expansion.
Systems. This is another area with room for growth. Ideally, we would form and strengthen connections with larger referral centers for cases that require interventions not immediately available at our center. We would also love to work with and support a network of local midwives. With whom those connections will be made and the nature of those relationships requires further investigation and refining. However, we are very much open to pursuing whatever connections afford us the ability to provide our patients with the care they deserve.
Much has been done, but the horizon holds even greater possibilities. Join us in making those possibilities a reality for our patients and their families.
Giving birth should NOT be deadly.
Top Photo by Dan Kirk Formentera on Unsplash
https://everymothercounts.org/guatemala/
https://www.who.int/news/item/11-10-2023-who-issues-global-plan-to-tackle-leading-cause-of-death-in-childbirth#:~:text=WHO%20today%20released%20its%20first,70%20000%20deaths%20every%20year.
Stensæth KH, Carlsen MIS, Løvvik TS, Uleberg O, Brede JR, Søvik E. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as adjunct treatment in life threatening postpartum hemorrhage: Fourteen years' experience from a single Norwegian center. Acta Obstet Gynecol Scand. 2024 May;103(5):965-969. doi: 10.1111/aogs.14767. Epub 2024 Jan 10. PMID: 38197478; PMCID: PMC11019522.