Childbirth in remote regions | |
Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Geneva: World Health Organization, 2003 (448 pp). ISBN 92 4 154587 9. |
If you are a doctor
or midwife about to go overseas to work in a remote or third world country, then this book is essential. Even as a practising obstetrician I would be taking it with me, as it contains vital information for managing obstetric emergencies in remote locations with minimal resources. In many parts of the world, the information contained in this book represents the best hope for medical care that women have when complications occur in their pregnancy or during childbirth.
This compact and exceedingly well-organised book has been put together by the World Health Organization’s Department of Reproductive Health and Research, Family and Community Health. For those with limited knowledge and experience in obstetrics, there are useful chapters to remind you of the common problems and their management. The book is organised in a manner that enables it to be used very efficiently under the pressure of an emergency. The details for administration of ketamine for anaesthesia, and technical instructions on how to perform a symphysiotomy, the correction of an inverted uterus and how to perform a craniotomy for the obstructed dead baby are all readily accessible in the procedures section. Likewise, it has a section on broad clinical principles and symptoms. Acknowledgement of the psychological needs of the woman and her family is also included. I was surprised to find no mention of management of women who have had a female circumcision or female genital mutilation, as this can pose additional problems for women in childbirth. For those health professionals who have never seen or encountered complications arising from this, a section on this would have been valuable. Although not a problem worldwide, it is still an issue in many regions. This is a valuable resource for those working in remote places or in third world countries. I would take it with me — although I would be hoping that I would not have to resort to using some of the information! Unfortunately, I suspect that for some health professionals it will be this very information that will be vital in saving women’s lives. Sonia R Grover
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