The birth process that Jordan explains in her article is much different than what it is like to give birth in Malawi. In Jordans article she mentions many different medical personal and technologies in the room with the mother, what is interesting is that even with all the different people and equipment in the room the final decision on when the mother is ready to give birth is left up to the physician. This is extremely different from how births happen in Malawi. A midwife trainer leads a class to about 25 volunteers and after this class they are considered Skilled Birth Attendants.
The difference between births in Malawi and in the United States is schooking, this may be one of the reasons why the number of maternal deaths per 100,000 live births in Malawi is 634 as opposed to the United States where the number of maternal deaths per 100,000 live births is 23.8. The volunteers in Malawi are not only trained in becoming SBAs but also help women and families with family planning, HIV testing, planning for delivery, care for newborns, and contraception and basic healthcare. 90 percent of the time a birth happens in Malawi a skilled birth attendant is present, however as we know their skills are limited because they had only attended a training session. Having a SBA present is better than not having anyone at all but it is very different from the United States where even the nurse who went through years of school still could not make any final decisions about the birthing process.
Not having a skilled physician present is very important because 32 percent of all births in Malawi have preterm birth complications. A SBA is not skilled or knowledgeable enough to help the mother or the child with these kinds of problems. Another statistic is that for every 100 births in Malawi 11 are preterm. The United States takes great care of preterm infants, they require much more care than a full term infant, this may include things like feeding tubes. Malawi is not prepared to care for preterm infants when only an SBA is present at the birth.
More than half the people living in southern Malawi are 18 years old or younger. This is important because it means that many young girls are giving birth. The difference between young girls of 18 years old or younger and women of 25 years and older is in both mentality and body composition. Young girls are still getting used to their adult bodies and having a baby can create symptoms of depression because of how their body is changing so rapidly. Younger girls do not have as many years of education which can cause problems for both them and their newborn babies. Younger girls also do not have as much body fat as older women, this means that they need to gain much more weight during pregnancy inorder to support the baby. This can be difficult because they are still focused on looking a certain way and gaining so much weight in a short period of time can also lead to postpartum depression.
Brigitte, Jordan. (1992). Technology and Social Interaction: Notes on the achievement of
authoritative knowledge in complex settings. Institute for research on learning
“Malawi.” Healthy Newborn Network, www.healthynewbornnetwork.org/country/malawi/.
“Malawi.” Maternity Worldwide, www.maternityworldwide.org/what-we-do/malawi/.