The excited voice at the other end of the phone was my son Zach: Our daughter-in-law was pregnant. We were over the moon with this happy news. Visions of grandparenthood flashed before me, but I also knew I was in for some jarring contrasts.
During Becca’s pregnancy, I was holed up writing my book “100 Under $100: One Hundred Tools for Empowering Global Women,” featuring affordable solutions for helping the world’s poorest women work their way out of extreme poverty. In many regions of the world, birthing mothers and their babies routinely die from complications that can be prevented with tools that cost less than a latte. Joyfully tracking a North American pregnancy while writing about women and newborns denied even the basics of prenatal and newborn care certainly highlights the inequity of the global birth lottery.
Becca and Zach explored the many birthing options available to them, eventually choosing a university hospital midwifery practice. To them this was the best of both worlds: lower-tech midwifery combined with hospital back-up. They also engaged a doula for labor support. Contrast that with the over 60 million women in the world who give birth at home, usually with no trained health worker present. Global health advocates are working hard to create safer birthing venues and to train more skilled birth attendants to bring down maternal and infant death rates, so many times higher in the developing world than in places like Washington, DC, where Becca and Zach live.
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Giving birth in dirt-floor huts is high-risk for both mother and baby. About 10% of the world’s annual 360,000 maternal deaths are due to infection; countless more women survive infections but suffer permanent injury. Clean Birth Kits provide a sterile environment for birthing, decreasing infections of mother and baby. They’ve been around for decades. Obviously our distribution systems suck, given all those deaths from infection.
Clean Birth Kits are a ziplock bag of single-use, inexpensive equipment to guarantee clean hands, perineum (the birth canal), birthing surface, umbilical cord cutter, and cord care. These kits include pictorial directions for non-literate mothers. Add-ons include plastic gloves, a sanitary pad for post-partum use, and a towel, blanket, and/or onesie for the newborn. Where they are subsidized, health care workers distribute them.
Women planning to deliver in hospitals in low resource countries are also instructed to bring a Clean Birth Kit, since sterile conditions are far from the norm. Entrepreneur Zubaida Bai has launched a social business, ayzh, marketing a stylish Clean Birth Kit tucked in a purse. The back story? She herself, a well-educated engineer, acquired an infection in the hospital after the birth of her child, resulting in years of pain and ultimate infertility. She is harnessing market forces to help others avoid this burden.
In each of my book’s 100 entries, I include an actionable item. CleanBirth.org focuses on Laos, a country with very high maternal death rates. For a $10 contribution, donors underwrite the cost of two Clean Birth Kits, provided to a nurse who both educates her pregnant patients and provides them with kits. CleanBirth offers attractive gift cards, making it easy to extend the blessings of the safe childbirth we take for granted to places where something as simple as a birth kit can save lives. The also sell Birth Provider Thank-You Cards for expressing gratitude to the doula, midwife, labor nurse, Ob-Gyn, and pediatrician.
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Ultimately, Becca was a rockstar. After a very hard and long labor assisted by a doula, midwife, and dad-to-be, their healthy baby girl entered the world.
When we arrived at the hospital to meet her, she was snuggled up against her papa’s chest, “skin-to-skin.” I was thrilled to witness this: It is Tool #2 in my book, “Kangaroo Care.” The practice was developed (or, perhaps more accurately, rediscovered and tested) by Colombian neonatologists frustrated by their lack of working equipment to save preemies. Through this natural incubation process babies were able to regulate their temperature and cried less, using their energy for stabilizing and growing. Fathers can provide the same support. Kangaroo caring is now standard protocol in the industrialized world, too. In many places, full-term babies are also held skin-to-skin, bridging their journey from womb to world. I love that this practice, so low-tech, was standardized in a low resource country and exported to rich countries. We have a lot to unlearn.
Becca and Zach dutifully followed their pediatrician’s instructions to let their baby’s umbilical cord dry naturally. It turns out this medical approach is counter to folkways. People intuitively sense the vulnerability of the cord and really, really, really want to do something proactive. Unfortunately common applications like mud or turmeric can introduce infection. CHX, a cheap antiseptic, is proving its mettle as a cord gel. It gives families something to apply to the cord, more in keeping with human instincts. And it saves babies’ lives. Babies 4 Babies, a mission-driven business, sells high-end American-made swaddles. Each sale provides four doses of CHX through their NGO-partner Saving Mothers, pairing up nicely with the mitzvah of pikuah nefesh, potentially saving a life. Or, in this case, four lives.
My children are now parents, the biggest shehecheyanu imaginable. Their daughter is thriving. May she grow up in a world that is better at extending the blessings of safe births and happy outcomes to all.
