When Home Birth Is Not a Choice

first_img ShareEmailPrint To learn more, read: Posted on April 20, 2018April 20, 2018By: Sarah Hodin, Project Coordinator II, Women and Health Initiative, Harvard T.H. Chan School of Public HealthClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)The topic of home birth is often a contentious one, sometimes causing heated debates among researchers, clinicians and advocates. While advocacy efforts around home birth—typically in high-income countries—tend to center on women’s rights to choose where they will have their babies, it is important to remember that home birth is not always a choice. Particularly in low-resource settings, women sometimes deliver at home not because they want to, but because they have to.Several studies have examined barriers to facility-based delivery. The groundbreaking “three delays” model proposed by Thaddeus and Maine in 1994 provided a framework for understanding why women may not deliver at a health facility. Geographic and socioeconomic inequities in access to facility-based delivery exist across the globe, reflecting the reality that some women are more likely to have a skilled birth attendant and essential supplies when they give birth than others.A recent paper that was published in the MHTF-PLOS Collection, “Neglected Populations: Decreasing Inequalities & Improving Measurement in Maternal Health,” presented perspectives from women in rural West Bengal, India who delivered either at home or in a health facility. Researchers conducted twelve focus groups with nearly 100 women in an effort to understand the factors influencing delivery location.Among the 55 women who delivered at home, 33 (60%) said that they had preferred to do so in a health facility. One of the barriers discussed was the unwillingness of family members to accompany women to the health facility.“My parents-in-law were reluctant to take me to the hospital. So I was forced to stay at home. I wanted to go to the hospital but it did not happen.”This finding is consistent with previous research that has identified inadequate social support from family and spouses as a challenge in this context. Other research from India has illustrated a connection between women’s lack of decision-making autonomy and a higher likelihood of home birth. Poor knowledge and understanding about reproductive and maternal health among men is another critical barrier to facility-based delivery in India.Eighteen women who gave birth at home reported that they were not able to get to a health facility to deliver because the vehicle did not arrive in time. One of the issues that arose in relation to transport was a woman’s lack of education about estimated delivery dates and average labor durations, which hinders women’s ability to prepare a birth plan.Based on these findings, the authors conclude with recommendations for research and practice:Researchers should collect data on women’s preferences for delivery location when examining determinants of home birth.India’s Accredited Social Health Activists (ASHAs) could play an important role in educating women and families at the community level on birth preparedness to increase facility-based delivery.Quality, equity and dignity should be a central focus in efforts to increase facility-based delivery to ensure that women in India and beyond receive timely, high quality, respectful care when they arrive at a health facility.—Explore other open access papers in the MHTF-PLOS Collection, “Neglected Populations: Decreasing Inequalities & Improving Measurement in Maternal Health.”Learn about distance as a barrier to facility-based delivery.Share this:last_img read more

FWS builds case against those suspected in walrus deaths

first_imgFederal authorities say the death of some of the walruses at a haul-out site in northwest Alaska were caused by humans, and the U.S. Fish and Wildlife Service believes it has identified those responsible.Walrus found dead and decapitated near Cape Lisburne. Photo: U.S. Fish and Wildlife Service.However, the U.S. attorney’s office, in a statement Friday afternoon, said charges have not been filed so far and the investigation continues. The statement said no further information on the investigation would be released at this time.Last month, federal authorities said they were investigating a report that about 25 walrus had been killed near Cape Lisburne and that some were missing tusks. Cape Lisburne is home to an Air Force radar station with few personnel.A message was left for an assistant U.S. attorney in Anchorage.last_img read more

International Womens Day

first_imgNo related posts. Luisa Nelson, from Limón province, was the first female mechanic to work at the Limón port, in 1978. She received a recognition during the groundbreaking ceremony for the new Moín port on Sunday, International Women’s Day. Facebook Commentslast_img

Segment the developers of this weeks highlighted

first_imgSegment, the developers of this week’s highlighted open-source project Evergreen, had a core set of beliefs in mind when they set out to design their robust framework of flexible and enterprise-ready React components. According to the project’s GitHub:“Evergreen is built on the belief that you can never predict all future requirements, only prepare for it. Instead of creating fixed configurations that work today, Evergreen promotes building systems that anticipate new and changing design requirements.Evergreen is built on the belief that things should work out of the box with smart defaults, but also offer full control when needed. For example, Evergreen uses CSS-in-JS and builds on top of the Box component in ui-box.Evergreen is built on the belief that using Evergreen and contributing to Evergreen should be a pleasant experience. We prioritize documentation and all the tools for a solid developer experience. We advocate respect and inclusivity in our writings and interactions.”Jeroen Ransijn, product designer at Segment, laid out in a blog post the value of having an intuitive design system at your disposal as a web developer. After numerous prototypes over the course of two years at Segment, Ransijn said that he found it absolutely necessary to streamline some of the design processes.“The prototypes I wanted to develop would live outside of our Segment application and would have no access to the application codebase,” Ransijn wrote. “This means that I didn’t have access to the components already in the application — I had to create everything from scratch. Most advice online talks about starting with a UI audit or trying to get executive buy-in. Those are all part of the long journey of a design system, but there are many ways to get started. If you set out to solve all of the problems in your product, you might be taking on too much at once. Instead, build something small and useful, provide value quickly, and iterate on what works.” Ransijn explained that Segment chose React when designing Evergreen because the company already used the popular JavaScript library in its daily operations. By starting from the React UI Primitive level, that the Evergreen team was able to design UI-BOX, which exports a single React Box component “that allows you to use React props for CSS properties,” according to Ransijn.Though altering CSS styling in Evergreen is still “complex,” according to Segment, a new branch allows developers to tool around with it.“It is important to note that UI-BOX only solves some of the problems,” Ransijn wrote in the post. “A class is still needed to control the appearance of a component. For example, a button can add dimensions and spacing with UI-BOX, but a class defines the appearance: background color, box shadows, color as well as the hover, active and focus states.”But Ransijn said the Segment team has gotten a lot of use out of the streamlined styling that Evergreen provides.last_img read more