Skip to main content

Unintended Consequences of Policy Decisions to Reduce Maternal Mortality in the Asia Pacific

Buy Article:

$32.00 plus tax (Refund Policy)

OBJECTIVES: To describe the role of midwives and maternity care in three low resource settings and to challenge some policy options introduced to reduce maternal mortality for women residing in rural and remote areas.

APPROACH: A series of retrospective analyses were undertaken drawing on work the authors have conducted in rural and remote China, Timor-Leste, and Samoa over the past 5–20 years. Sources include our own empirical research, grey literature, as well as published secondary sources.

FINDINGS: In China, hospital birthing is promoted as a major strategy in reducing maternal mortality. This has greatly increased financial burdens for women and their families. In Samoa, traditional birth attendants (TBAs) are integrated into Samoa's health system alongside midwives and other health professionals, and they play a critical role in providing support for pregnant and birthing women. In Timor-Leste, the government has moved away from training TBAs and has shifted the focus from skilled attendance to facility-based delivery. Evaluation of a national maternity waiting home strategy, designed to improve access to facility-based delivery, did not improve access for women in remote areas.

CONCLUSIONS: Low-income countries need to be cautious when adopting global solutions, such as facility-based delivery, to tackle maternal deaths. Women-centered and cost-effective care should be provided locally. Culturally compatible maternity care can be achieved in concert with safety and emergency obstetric care. Midwives can create the bridges between social and professional systems that allow this to happen.
No Reference information available - sign in for access.
No Citation information available - sign in for access.
No Supplementary Data.
No Data/Media
No Metrics


Document Type: Research Article

Publication date: 2012-12-01

More about this publication?
  • The International Journal of Childbirth is a peer-reviewed, quarterly journal publishing original research, reviews, and case studies concerned with the practice of midwifery, women's health, prenatal care, and the birth process. The journal encourages the exploration of the complex and contextual issues surrounding childbirth provision and outcomes and invites manuscripts from a wide range of clinical, theoretical, political, methodological, psychological, public health, policy, and multicultural and interdisciplinary perspectives.
  • Information for Authors
  • Subscribe to this Title
  • Information for Advertisers
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more