Risk and Recognition: The Traditional Midwives Who Filled the Gap in the Time of Ebola
The chapter focuses on vignettes of three traditional midwives who carried out deliveries in their community when the Ebola outbreak forced their local hospital to close its in-patient services. They operated with little equipment and scant information on infection control, often using plastic bags or rewashing black-market personal protective equipment (PPEs). They worked in an environment of great fear, rumor, and uncertainty, especially regarding the health status of delivering pregnant women. As facilities reopened for delivery, and traditional midwives were being told “no more home deliveries”, these women felt unrecognized by the formal health system and the Ministry of Health for the risks they took and the efforts they made. As influential figures in the community, this resentment can remain a barrier for pregnant women from going to the hospital. The chapter will explore how the system of facility deliveries quickly crumbled during the Ebola epidemic, and people reverted to traditional ways to deliver. It explores what makes these traditional supports able to operate during both the crisis points and the good times for the Liberian formal health system. It recommends greater two-way learning between different approaches to maternal health care, especially as the residual effects of Ebola make the need to work with community-based supporters greater than ever.
KeywordsTraditional Midwives Traditional birth attendants Ebola Pregnancy Delivery Obstetrical risk Health systems Liberia Midwives Maternal health Ebola virus disease
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