Trinidad and Tobago is the southernmost state in the West Indies; in 2013, the maternal mortality rate adjusted was 84 deaths per 100 000 women; these figures are adjusted for unreported and misclassified by the World Health Organization. The rate of contraception, the percentage of women in unions aged 15-49 years currently using contraception, is 42.5%. Fertility rate of 1.8 children per woman. Fourteen weeks maternity leave with allowances given by the government; women usually choose to take this leave after birth than before, to spend time with newborns.
Video Childbirth in Trinidad and Tobago
Perawatan pra-natal
95.7% of pregnant women have at least 1 pregnancy care visit. This visit is most common in women's local clinics. Diabetes and high blood pressure are two of the more serious conditions for pregnant women in Trinidad and Tobago. Often, if women do not have antenatal visits early enough in their pregnancies, this condition may be missed, leading to complications during delivery. The biggest challenge for prenatal health is to maintain a healthy diet. Caribbean cuisine is mostly spiced high, with high salt content, and, along with common practice of frying and high-saturated fats, it contributes to poor management of diabetes and an increased risk of high blood pressure.
For the treatment of diabetes and high blood pressure, during pregnancy or other, Trinidad and Tobagonian people often view traditional caribbean medicine as a complement to prescribed medications. For example, one study found the following plants were used among half Caribbean respondents for diabetes: cerasse/noni/wayili/pare ( Momordica charantia ), cinnamon bark and pills ( Cinnamomum verum ), mauby bark ( Colubrina arborescens ), aloe vera (Aloe vera , Aloe barbadensis ), tea shrubs (unspecified medicinal plants) and celery ( Apium graveolens ). Cucumber ( Cucumis sativus ), garlic ( Allium sativum ), and tamarind leaf ( Tamarindus indica ) are also used to control high blood pressure. This plant is crushed, melted, and consumed cold or soaked as a brewed tea. Momordica charantia is the most popular plant used by participants to treat type 2 diabetes.
Maps Childbirth in Trinidad and Tobago
Traditional medicine
Traditional medicine is also used for labor and infertility. One study, which conducted interviews with the citizens of Trinidad over a four-year period from 1996-2000, found the following use of crops for childbirth and infertility: Mimosa pudica , Ruta graveolens , Abelmoschus moschatus , Chamaesyce hirta , Cola nitida , cumanenesis Ambrosia , Pilea microphylla Aristolochia rugosa , Aristolochia trilobata i> Laportea aestuans and Vetiveria zizanioides .
Intercourse
The fertility rate of adolescents in Trinidad and Tobago, by 2013, is 35.5 births per 1,000 women aged 15-19 years. In 2007, a representative sample of all 13- to 15-year-olds in Trinidad and Tobago was surveyed about sexual health: 26.0% of students had sex during their lifetime and 13.2% of students had sexual intercourse for the first time before the age of 13. Male students were significantly more likely than female students to have sexual intercourse (32.0% of all males versus 20.2% of all females) and also had it for the first time before the age of 13 (19.9% ​​of all males versus 6.3% of all women). In total, 17.6% of students had sexual intercourse with two or more partners during their lifetime. Male students (23.9%) were significantly more likely than female students (11.4%) to have multiple partners. Among students who had sexual intercourse during the last 12 months, 59.1% used condoms when they last had sexual intercourse, but only 22.4% used condoms most of the time or always during the last 12 months.
Although the above surveys show early age of initiation of sexual activity and low use of contraceptive practices, a 2008 study of twin island states showed a decline in both teen and teenage fertility rates over the last decade.
Abortion
In Trinidad and Tobago, abortion rates are the same as birth rates; that there is about the same number of abortions per year at birth, about 19,000. However, in Trinidad and Tobago, abortion is illegal in cases of incest, rape, social and economic reasons and is only legal when the mother's life is in danger. Every year between 3000-4000 women are hospitalized for the consequences of unsafe termination; it is the main cause of maternal morbidity. Abortion is not openly discussed in Trinidad and Tobago. There is the impression that the citizens of Trinidad strongly opposed the law of abortion reform, in part because of certain vocal religious groups; however, a survey of 918 residents conducted in 2005 found that although nearly half of the participants had poor perception of abortion, more than half of them supported the expansion of the legal basis for access to termination.
HIV
The prevalence rate for sexually transmitted infections: 1.7% of adults aged 15-49 in Trinidad and Tobago have a human immunodeficiency virus (HIV) by 2013.
Labor and birth
From a recent study in 2012, 100% of births in Trinidad and Tobago were attended by a healthcare professional. 97.4% of total births occur in an institution. Of the total births in Trinidad and Tobago, about 2% occurred at home, 83% in public hospitals, 14.7% in private hospitals, and 0.0025% in the Birth Center of Mamatoto. Except in the case of the birth at home, after labor begins, the mother generally goes to the hospital or birth center as directed by the health worker, usually by telephone.
In public hospitals, as a standard of care, midwives attend infant delivery. Only in the case of complicated labor, for example requiring a cesarean or suture, an obstetrician will be called. Cesareans are not available on request and rates in most public hospitals vary from 10-14%, with higher rates occurring in hospitals that receive more referrals. There is a trend of high episiotomy rates in public hospitals, as high as 50%. The availability of limited epidurals in these hospitals is limited and most naturally deliver. Continuous fetal monitoring technology is not used.
Birth practice
Public hospitals
Public hospitals tend to abide by some old Western medical policies that are not based on current research or empirical evidence according to the Cochrane Library (systematic review database); for example, women who work continue to lie in bed and are not allowed to have a supportive person, or eat solid food, and delivery takes place with a woman's leg in the stirrups. Even when new policies are made, it does not need to be practiced, as is the case with the Mount Hope Medical facility which does have a more modern policy to align with baby-friendly status, but it is not well followed. In all public facilities, working women share the same space for the most part, on an open floor, non-air conditioned, with only screens separating them for privacy. Woman moved to separate room for delivery. A direct relative may be allowed for delivery but this person often has to fulfill a set of hospital specific requirements and can still be rejected at the wishes of the staff. For example, San Fernando General Hospital (serving the southern tip of the island) does not allow relatives in the delivery room; Sangre Grande Hospital (serving the eastern end) has a form with rules to be signed and followed by the couple; and the Spanish Port General Hospital (serving the western tip) require proof of birth grade along with other requirements. Doula (trained emotional support people) are not allowed to provide labor support. If the doula is a direct relative, he may accompany the mother for delivery as a permitted family member.
Private hospital
In private hospitals, babies are born only by obstetricians, and pregnant women are attended by nurses, midwives (who basically act as nursing and delivery nurses) and doula, if specifically employed by the mother. The total cost of vaginal delivery in the private sector is about $ 17,000-20,000 TTD (about $ 3000 USD) and double the price for a caesarean section. Certain entrepreneurs do provide private insurance, but do not cover most of these costs to make it an affordable option for most people. Private hospitals have the use of similar technologies, such as in hospitals in the US, for fetal monitoring and pain management. Unlike a public hospital, epidurals are warranted if desired. Cesarean section is performed in case of medical indication and can also be done on request, although it is rare. The rate of caesarean section in most private facilities is about 30%. Women working in private facilities often have more flexibility in what they can do: whether they eat during labor, move around, or have many supporters with them. In general, labor takes place in a private air-conditioned room with family members and doula if previously arranged by the family.
Home birth
The planned birth at home was attended by the midwife. In order to be eligible for home birth, midwives should approve of birth as a low risk without medical indications in advance for service needs that are not available in a home context. As part of midwife training in Trinidad and Tobago, all obstetric students must attend at least three home births before their certification is considered complete.
Birthplace of Mamatoto
At the Birth Center, Mamatoto, baby delivery is attended by midwives who follow the model of midwifery care. Mothers can work in whatever position they feel most comfortable, and water, massage, acupressure, and doula are available at every birth for pain management. Over 90% of births are natural vaginal births, requiring no intervention. The center has about 2% episiotomy rates and limited use of birth technology, although they are adequately prepared for emergencies, with ambulances being paid on retainers to transport mothers to the hospital if necessary. Obstetricians and pediatricians are members of the Birth Center board and while they are not usually present for birth, they offer advice when needed. This center attends about 50-70 births every year. Births in Mamatoto cost around $ 14,000 TTD but there is a cost reduction, based on family income, and pro bono services for unemployed or teenage women.
Maternal choice
In general, if a mother has the means, she will choose to give birth to her baby at a private facility rather than in a public place. This is partly due to the bad reputation of public hospitals because of media depictions of maternal deaths. Some mothers might even take out a loan, "baby loan," so they can deliver in private facilities, not public property.
Postpartum and newborn care
Birth or placenta in the hospital is disposed of as biological waste and no special rituals are observed in the country. Newborns, for the most part, remain on the mother's side after being examined by healthcare professionals. Public hospitals do a better job of preventing the separation of their mothers in the hours immediately after birth, in part because they do not have the usual breeding facilities as private hospitals do.
Women usually stay in a hospital, public or private, no later than 24 hours after birth. The trend is towards an early release due to density in public facilities, and because of the financial costs at private facilities. Most hospitals have policies that encourage initiation of breastfeeding before returning home. However, early initiation of breastfeeding rates in Trinidad and Tobago is only 41.2% in 2013; it is the percentage of babies who receive breast milk from their mother's breast within an hour of birth. Furthermore, by 2013, only 12.8% of newborns are exclusively breastfed in the first six months after birth and 83.4% are introduced in solid or semi-solid or soft foods within their first six to eight months. In part, this phenomenon may be caused by the often-spoken belief in Trinidad and Tobago that in order for a baby to sleep well at night, she should be given milk with cereal before bed.
The under-five mortality rate in Trinidad and Tobago is 21 deaths per 1,000 live births and infant mortality is 19 deaths per 1000 live births. The main cause of death is prematurity. There are only three Neonatal Intensive Care Units (NICUs) in the country; the three are in separate public health facilities in Trinidad: in Port of Spain, San Fernando and Mount Hope. If there is any suspicion that the baby will be born prematurely, the prospective mother will be referred to one of these hospitals for labor. Private facilities do not have Neonatal Intensive Care Units (NICU). If newborns are admitted to the NICU, mothers must adhere to hospital policies that do not allow them to stay with babies, and require pumping of breast milk for infants.
Postpartum depression is not carefully monitored or measured in this country. As part of the public health facility, there is a six-week postpartum examination, during which time this condition may be detectable, but there is little follow-up with the mother between the discharge and the examination. Although, if she chooses, she may visit a doctor at a local health clinic at any time. In private health facilities, mothers are given special pediatricians who check for newborns at birth; This personal doctor may be contacted by the mother if she chooses to do so, in connection with postpartum depression. At Mamatoto, disposal usually occurs four hours after birth, after which the health staff calls the mother every day for a week, and then once a week until the six-week postpartum visit. In this way, there is a lot of follow-up to provide health workers an opportunity to ensure mental health of the mother.
Home care
After mothers and babies return home, the family is core and extended and many community members become involved with the care of newborns and mothers. It is typical for a new mother to stay with a female relative for several weeks directly after being discharged, or a female relative moving with a new mother for several weeks to help cook, clean and care for the mother and baby. baby. Often, senior women in families and communities are very vocal with their opinions to care about, and their counsel is generally respected, though not always applicable. Their advice might take the form of traditional medicine and more folklore. The following are examples of some beliefs: The baby's mole should be covered with a hat especially at night, falling dew or rain, to prevent the baby from getting sick; coconut oil should be used to massage and stretch the limbs of newborns; talismans and certain jewelry should be placed on the newborn to ward off the "evil eye"; small amounts of breastmilk can be placed on the eyes of newborns to prevent infection; and soursop may be given to promote drowsiness in newborns. As for the mother, the skin beverage mauby ( Colubrina arborescens ) should be consumed to "cleanse" the body; vervine tea should be consumed to promote breastfeeding; and thick sheets can wrap around your mother's abdomen for weeks to help her get back to her original size. Some health experts have also noted that enema is proposed to mothers often by families and community members for various reasons.
Finally, newborns may be through certain rites according to their family religion. For example, most babies born in Christian homes have Baptism.
References
Source of the article : Wikipedia
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