7:58 am - Sunday March 18, 2018

Doula activities increase danger of childbirth at home, particularly in high risk pregnancies


MO,13/3/2018, KUALA LUMPUR: Doula (childbirth helper) activities in Malaysia are extreme as they “advice” expectant mothers to deliver their baby at home without knowing the health history of the mothers, the Dewan Rakyat was told today. Deputy Health Minister Datuk Seri Dr Hilmi Yahya said doula in Greek means women’s slave and the purpose of doula was to assist expectant mothers in giving them advice and massages, not to assist in childbirth.

“If they want to help during the delivery process, they need to be registered to do so. Many expectant mothers nowadays are having high risk pregnancy and factors for high risk pregnancy includes diabetes, high blood pressure, placenta previa (placenta lying unusually low in the uterus, next to or covering the cervix) and many more. “If this happens, the nurses at the hospitals know what to do as high risk pregnancy can cause death,” said Dr Hilmi.

Dr Hilmi said the unsafe birth percentage had decreased from 7.1 per cent in 1990 to 1.3 per cent (6,020 birth) in 2012 and 0.42 per cent (1,949 birth) in 2016 compared to an average birth registered between 440,000 to 450,000 births a year. “Based on unsafe birth report analysis, three main factors contributing to unsafe births are transportation, long distance to health facilities and expenses.

“There is an increase in unsafe birth due to the influence of doula activities in 2014 and 2015. The figure increased to six births in 2016 and seven in 2017. Due to this, there were three cases of newborn deaths each in 2016, 2017 and 2018,” he said. Dr Hilmi was responding to a question by Shamsul Iskandar @ Yusre Mohd Akin (PKR-Bukit Katil) who had asked the minister to state the proactive measures and legal action that can be taken by the ministry to curb doula activities as they do not have medical training or skills especially to handle high risk childbirth cases at home and whether the percentage of unsafe delivery and infant mortality escalates due to this practice.

Dr Hilmi further said that under Section 14 (1) Midwives Act 1966 (Act 436) any person who, not being a midwife registered under this Act, practices midwifery, shall be guilty of an offence and shall be liable upon conviction to a fine not exceeding RM2,000 or imprisonment for a period not exceeding one year or to both.


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