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What it’s like to be a midwife in one of the most remote parts of Vietnam

BY   March 17, 2015 at 8:10 AM EDT
A medical center in Muong Ang District in northwestern Vietnam provides perinatal and HIV services. Photo by Larisa Epatko/PBS NewsHour

A medical center in Muong Ang District in northwestern Vietnam provides perinatal and HIV services. Photo by Larisa Epatko/PBS NewsHour

DIEN BIEN PHU, Vietnam — Quang Thi Un said she didn’t give much thought to becoming a midwife or really any line of work until her brother, a teacher, sent her to a new midwifery training program in Vietnam.

“When I watched babies being delivered, I started to love the job,” she said recently through an interpreter during a break at a clinic in the remote Muong Ang District in northwestern Vietnam where she now works. After completing two years of training, Quang, who is 29, returned to the small mountainous commune. Over the past four years, she’s delivered about 30 babies.

Most women prefer to deliver at home, where they are comfortable and among family, Quang said. If there are complications, such as the umbilical cord wrapped around a baby’s neck which can be detected through an ultrasound, the woman is sent to the nearest hospital, about 30 miles away.

Quang Thi Un is a midwife in Muong Ang District in rural Vietnam. Photo by Larisa Epatko/PBS NewsHour

Quang Thi Un is a midwife in Muong Ang District in rural Vietnam. Photo by Larisa Epatko/PBS NewsHour

Dr. Nguyen Duc, vice director of Vietnam’s Department of Maternal and Child Health, said there are “great discrepancies” between health services in big cities and remote mountainous regions. There’s a lack of health workers among rural populations, so patients have to travel long distances to get medical help. And among the more than 50 different ethnic groups living in rural areas, it’s tradition to give birth at home. So they need village health workers with proper medical training and knowledge of the local languages and customs, he said.

One of the statistics that illustrates the divide: The death rate of children under age 5 is 55 per 1,000 live births in the rural province of Dien Bien Phu, compared to 23 per 1,000 live births in all of Vietnam, according to the General Statistics Office of Vietnam’s figures for 2012. (For the United States it’s seven, according to the World Bank.)

To improve overall health in the country’s remote areas, the Vietnamese government has been building multi-purpose health centers that offer a range of pregnancy services, HIV testing and methadone treatment for heroin addicts.

The nursery at the National Hospital for Obstetrics and Gynecology in Hanoi, Vietnam, bustles with babies on Jan. 12, 2015. The National Hospital for Obstetrics and Gynecology in Hanoi handles 170,000 out-patients and 60,000 in-patients per year. Making health services readily available in rural areas would help ease overcrowded city hospitals. Photo by Larisa Epatko/PBS NewsHour

The nursery at the National Hospital for Obstetrics and Gynecology in Hanoi, Vietnam, bustles with babies on Jan. 12, 2015. The National Hospital for Obstetrics and Gynecology in Hanoi handles 170,000 out-patients and 60,000 in-patients per year. Making health services readily available in rural areas would help ease overcrowded city hospitals. Photo by Larisa Epatko/PBS NewsHour

In addition, the government started a midwifery education program for local residents to study at city hospitals, for which it pays about $30,000 per person for six months of training.

The midwives are seen as a temporary measure to fill in for more formalized medical treatment, according to Nguyen. “Overall, we have to reduce the development gap and have people go to health care centers rather than giving birth at home.”

Quang said she encourages women in her small community to go to medical facilities, but some are shy about delivering their babies in front of non-relatives and don’t know about the possible complications. Training more female village health attendants would help at least a little, she said. “Most are male, and young mothers are hesitant to contact them for midwifery services.”

“We still have a lot of difficulties and challenges to overcome,” said Duc. The midwives are helping for now. “Even one midwife can reduce maternal and child mortality.”

This report was produced from a trip to Vietnam arranged by the United Nations Foundation.

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