“She Learned it from her Mother and Grandmother”: Women’s Experiences with Delivery and Post-partum Practices in Peri-urban Yangon, Myanmar
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Background Every year in Myanmar more than one million women give birth. Although births in hospitals and those attended by skilled birth attendants have increased considerably, the majority of women continue to give birth at home. Our needs assessment explored women’s reproductive health in peri-urban Yangon, a rapidly growing area characterized by poor infrastructure, slum settlements and a mobile, migrant population. In this article, we focus specifically on the perceptions and experiences of adult women, key informants, and health care providers regarding delivery and post-partum care. Methods Our study team conducted a systematic literature review, 18 key informant interviews, 27 facility surveys, a survey with 147 adult women, and seven focus group discussions with women and health care providers over the summer of 2014. We analyzed these data for content and themes using deductive and inductive techniques and used descriptive statistics to analyze the survey results. Results Women in peri-urban Yangon are increasingly choosing to give birth in hospitals; however public hospitals are often inaccessible due to financial constraints and lack of transportation. Further, sociocultural and financial considerations continue to make deliveries with a traditional birth attendant an appealing option for some women and potentially harmful traditional post-partum practices remain common. Conclusions Peri-urban populations face competing influences that guide decision-making surrounding delivery. Efforts to address the barriers to accessing hospital-based maternity services and trained providers appear warranted. The development of culturally-relevant resources that seek to raise awareness of the potential risks of traditional post-partum practices may also be of use.
KeywordsBurma Reproductive health Childbirth Traditional birth attendants
This project was supported by a trainee grant from the Society of Family Planning, an Ontario Graduate Scholarship, and a travel scholarship from the University of Ottawa. Dr. Foster’s Endowed Chair is funded by the Ministry of Health and Long-Term Care in Ontario and we appreciate the general support for her time that made this project possible. Finally, Cambridge Reproductive Health Consultants’ work in Thailand and Myanmar has long been supported by an anonymous donor to whom we are grateful. We would like to express our thanks to the National YWCA of Myanmar, as well as the Yangon YWCA, for their support of the project and assistance with recruitment, facilitation, and translation. We also thank Dr. Raywat Deonandan, Dr. Shoshana Magnet, and Cari Sietstra for their feedback on and contributions to earlier phases of this project. The conclusions and opinions expressed in this article are those of the authors and do not necessarily represent the views of the organizations with which the authors are affiliated or the funders.
- 1.Singh, S., Darroch, J. E., & Ashford, L. S. (2014). Adding it up 2014: The costs and benefits of investing in sexual and reproductive health. Retrieved from http://www.unfpa.org/sites/default/files/pub-pdf/Adding%20It%20Up-Final-11.18.14.pdf.
- 3.Dennis, C.-L., et al. (2007). Traditional post-partum practices and rituals: A qualitative systematic review. Womens Health, 3, 487–502.Google Scholar
- 4.UNFPA. (2010). Report on situation analysis of population and development, reproductive health and gender in Myanmar. Myanmar. UNFPA. Retrieved from http://yangon.sites.unicnetwork.org/files/2013/05/july-2010-Report-on-Situation-AnalysisUNFPA.pdf.
- 5.UNICEF. (2013). Snapshot of social sector public budget allocations and spending in Myanmar. Yangon, Myanmar.Google Scholar
- 6.Ministry of Health, UNICEF. (2011). Myanmar multiple indicator cluster survey 2009–2010. Nay Pyi Taw: Ministry of National Planning and Economic Development and Ministry of Health, Myanmar. Retrieved from http://www.childinfo.org/files/MICS3_Myanmar_FinalReport.pdf.
- 7.WHO, UNICEF, UNFPA, the World Bank, and the United Nations Population Division. (2014). Trends in maternal mortality: 1990 to 2013. Geneva, World Health Organization. Retrieved from http://data.worldbank.org/indicator/SH.STA.MMRT.
- 8.Hobstetter, M., Walsh, M., Leigh, J., Lee, C., Sietstra, C., & Foster, A. (2012). Separated by borders, united in need: An assessment of reproductive health on the Thailand–Burma border. Cambridge, MA: Ibis Reproductive Health. Retrieved from http://www.ibisreproductivehealth.org/sites/default/files/files/publications/separatedbyborders-English.pdf.
- 9.Sein, K. K. (2013). Beliefs and practices surrounding post-partum period among Myanmar women. Midwifery, 29(11). Retrieved from http://www.sciencedirect.com.proxy.bib.uottawa.ca/science/article/pii/S0266613812002197.
- 10.Ministry of Immigration and Population, UNFPA. (2009). Country report on 2007 Fertility and Reproductive Health Survey. Nay Pyi Taw: Ministry of Immigration and Population, Myanmar.Google Scholar
- 11.UNFPA. (2007). State of world population, 2007: Unleashing the potential of urban growth. UNFPA. Retrieved from http://www.unfpa.org/sites/default/files/pub-pdf/695_filename_sowp2007_eng.pdf.
- 12.Department of Population. (2014). Population and housing census of Myanmar, 2014: Provisional results. Nay Pyi Taw. Retrieved from http://unstats.un.org/unsd/demographic/sources/census/2010_phc/Myanmar/MMR2014-08-28-provres.pdf.
- 13.Sheehy, G., Aung, Y., Sietstra, C., & Foster, A. (2015a). Near the city but hard to reach: Results from a reproductive health needs assessment in peri-urban Yangon. Cambridge Reproductive Health Consultants (CRHC): Cambridge, MA. Retrieved from http://www.cambridgereproductivehealthconsultants.org/#!reports/c1b3f.
- 16.Deniz, N., & Lincoln, Y. (Eds.). (2005). The Sage handbook of qualitative research. Thousand Oaks, CA: Sage Publications.Google Scholar