1. Tracking shot, midwife crossing bridge as she heads to a patients home
2. Tracking shot, midwife arrives to patients home
3. Med shot, midwife enters patients home and greets her
4. SOUNDBITE (Lao) Nanglao, pregnant woman:
“The midwife told me I should take care of myself and eat well, so I will have enough blood when my baby comes. If I feel the baby is coming and I can’t get to the health centre, she said I should contact her.”
5. Various shot, midwife caring for patient in bed
6. Wide shot, midwife walking towards a patient’s home
7. Med shot, midwife enters patients home
8. Wide shot, midwife greets patient
9. Med shot, family outside home
10. Med shot, patient
11. Various shots, midwifery training seminar
12. Various shots, women giving birth and midwives around her in a clinic
13. SOUNDBITE (Lao) Somephet, midwife:
“I knew some things before I took the course, but my knowledge wasn’t very clear. For example, I didn’t know the danger signs. Now I can recognize a dangerous situation, and I can tell whether I will be able to cope with it or not.”
14. Med shot, midwife checking pregnant woman
15. Zoom in, patient waiting for midwife
16. Various shots, midwife with patient

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Storyline

Somephet is one of the first graduates of a new midwifery-training programme in the Lao People’s Democratic Republic. From her base in a rural health centre, she serves a dozen surrounding villages.

Nanglao’s village is one of them. During her last delivery, Nanglao almost bled to death. She had her baby at home without medical support. This time Somephet examines her and advises Nanglao to go to a health centre when she’s ready to give birth.

SOUNDBITE (Lao) Nanglao, pregnant woman:
“The midwife told me I should take care of myself and eat well, so I will have enough blood when my baby comes. If I feel the baby is coming and I can’t get to the health centre, she said I should contact her.”

Before Somephet was trained women here were on their own.

Experts say that some 350,000 mothers and millions of infants die worldwide each year from complications related to pregnancy and childbirth. Most of these deaths could be prevented with more skilled birth attendants and better access to emergency care.

Laos, a poor, mountainous Southeast Asian country with a severe shortage of skilled medical staff, has pledged to improve maternal and infant care as a commitment to the UN Secretary-General’s Global Strategy on Women’s and Children’s Health. Closing the personnel gap is the first priority.

With support from the UN Population Fund and donors, 140 students, mostly auxiliary nurses enrolled in a midwifery course.

Trainees honed their skills by delivering babies at a nearby hospital, under their teachers’ guidance.

Potentially life-threatening complications occur in about one in seven deliveries. Women giving birth need a skilled attendant who knows how to respond to obstructed labour, haemorrhage, shock and infection, and there needs to be an accessible referral facility.

Before her training, Somephet lacked these skills.

SOUNDBITE (Lao) Somephet, midwife:
“I knew some things before I took the course, but my knowledge wasn’t very clear. For example, I didn’t know the danger signs. Now I can recognize a dangerous situation, and I can tell whether I will be able to cope with it or not.”

Now she’s confident and there has been a steady increase in clients coming to her health centre. Somephet also provides family planning advice and child immunizations.

Reaching women in distant villages remains a challenge. But local health volunteers assist health centres in keeping track of pregnancies throughout their areas. And the midwives make house calls when they can.

Laos has a long way to go to ensure that all women can give birth in safe surroundings. But the country’s new midwives are an important start.