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Labour wards in Iran

I am working on the report for the Iranian Ministry of Health and Medical Education and the UNPFA following our mission to Iran. We will be making a number of recommendations and suggestions regarding the provision of maternity care that will include: ideas for further training for midwives and obstetricians; the development of new birth centres; the implementation of prenatal education programs; access to research evidence and more appropriate reference books; provision of simple equipment to better enable physiologic births to take place in the current labour wards; and ultimately the reconstruction of maternity hospitals.

This last goal is a long term one, but we have been told that new hospitals are being built now and we have been asked to provide some information on building guidelines and service provision in Australia to help shape thinking in Iran.

The photos below illustrate the urgency of the problem. Until conditions like these are improved, there is very little hope that normal physiological births will occur in current labour wards. The main issue is the complete lack of privacy, which affects both women and midwives alike. Everything being done is on view and while this is a major problem for the labouring woman, the midwives and obstetricians are also vulnerable to being watched over by their peers and supervisors.

The hospital in which these photos were taken is typical of labour wards in public hospitals across Iran.

This is the entrance to the labour ward area.

The nurses station in the centre of the unit. The first stage rooms are on the right and left with the second stage room on the right at the end.

There are five beds in this room. A woman is labouring in the bed on either side of the one shown, behind the curtain. There are two other similar rooms in this unit.

Once on second stage, the mother is moved to this room, where three beds, side by side, are used for managing second stage. In this hospital, which has 1,000 births per month, it is common for two or three women to be giving birth at the same time in this room.

Fathers and relatives wait in this area while the birth is in progress. It was a busy waiting room, opening directly onto the road at the entrance to the hospital. Fathers will see their new baby in the post-natal ward, where women stay for 24 hours (uncomplicated birth) or 36 hours (caesarean birth) before discharge home.

Posted by andrea at November 14, 2007 08:50 AM