Lao Birthwork

$3,686 of $10,000 goal

Raised by 49 people in 11 months

Dear friends,
With the help of your generous donations and gofundme,  we travelled to Laos in January this year to present a 5 day training to over 30 midwives, healthworkers, district trainers and obstetricians .

Laos is one of the poorest countries in the world, with a high maternal and infant mortality rate. Luang Prabang province is situated in the north of Laos where it is mountainous and populated with a great number of diverse ethnicities. Most villagers live at subsistence level.

The training was enthusiastically received, with heartfelt requests to return and do a follow up training in December this year.

The follow up would entail visiting Luang Prabang Province in Northern Laos once again, and each of the district hospitals at Chomphet & Phonesay, where we would facilitate a 3 day workshop with participants coming in from their outlying villages.

Afterwards, we will travel to the most remote villages within each district to gain better insight in to the way of life there, and the problems they face. (One young health worker who came from a remote outreach area, rode for 12 hours on a motorbike with her husband and baby to attend the workshop in Luang Prabang.)

So once again, we need your help to raise funds to be able to continue to do this work.

This time, we hope to raise $10,000.

This will cover bringing participants together and accommodating and feeding them for the duration of  training at a district level. We also have to  cover the cost of a Laos translator, buy supplies and relevant equipment and education materials, and cover our accommodation expenses. We are also in the process of publishing a booklet based on the posters we created for the initial training. This picture booklet with simple reminders and skills will become a template for use in any other culture.

We have also been invited to do further trainings within Laos, so we are seeing this project as a long term one .

Eating just 1 egg a day can make a significant difference to a woman and baby’s wellbeing in Laos. In our privileged culture, per week that’s the equivalent value of one cup of bought coffee.

This gofundme campaign is called ‘Lao Birthwork’. Please share as widely as you canand private donations and fundraising initiatives are also welcome.

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Over the course of our Birthwork Trainings in Laos we have handed out near to 100 Days for Girls Menstrual Hygiene Kits. A kit consists of a few pairs of undies, a face washer & soap & a collection of reusable (washable) cloth menstrual pads. The kit also comes with a couple of zip lock bags, one for washing in & one for pad storage, some easy to understand pictorial instructions & a calendar for charting ones cycle, all contained in a vibrant cloth bag.
These kits are sewn up and prepared by volunteers and are sent all around the world in large quantities.
Last night Jen & I had dinner with Sally Pippan. Sally is an English Nurse, working with a French NGO. After visiting Laos 7 years ago & being deeply moved by the many aspects of need she observed, she went home & completed a Masters in Community Health in The Developing World & went to Malawi, in African to complete a thesis on Menstrual Health & Education. Sally has since created a menstrual education program & with a team of Lao educators, educates school teachers & students throughout Northern Laos, in all aspect of Menstrual Health.
In her research she has found that 97% of girls & women in Laos were not aware of the menstrual cycle prior to their first cycle; never having received any education, preparation or support with how to manage their monthly bleeding.
In Laos village girls & women generally construct a nappy like wrap using old strips of their traditional skirts. These wraps can be cumbersome & ineffective & usually require a woman or girl to stay home during her bleeding days each month. While resting & altering ones level of exertion whilst bleeding is important it is also important to have choice in the matter. For many girls in the developing world it means staying home from school or work each month, which can have a big impact on their precious education & livelihood.
Sally had also written a beautiful book & designed her own reusable pad product, which she provides instructions for in her book.
Washing & drying ones pads is also a matter of challenge as in many ethnic minorities there are taboos about exposing under garments to the world or hanging things that we wear on our lower bodies up high. Pads can tend to be washed under the water in the river by a girl’s feet so that no one will see them & laid out, concealed under other garments to dry. They are often not washed or dried adequately.
Like all the issues we have faced in Laos this one is not easily remedied but the more education & support that can be given, through amazing people like Sally & her team of trainers & organisations like Days for Girls hopefully over time will make a difference & see girls & women cycling with greater comfort & awareness.

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For our final Laos Birthwork Training we crossed the Mekong once again & travelled further into Chompet District to the health centre at Nagiew, a Hmong/ Khmu village south west of Luang Prabang. Travelling on precarious roads, amidst the construction of the new Laos-Thailand Super Highway we travelled for several hours, passing riverside villages & dense jungle.
We had asked for pregnant women from any of the surrounding 14 villages, under the health centre’s care to join us for the day.
To our delight we were met by around 20 young women, most of who were teenage mothers and pregnant with their first babies.
A large percentage of women marry young in Laos, sometimes as early as 13. Babies generally come soon after, school education ceases, the instance of malnutrition, childbirth complications & domestic violence are common & the cycle of poverty perpetuates. Different initiatives are attempting to keep girls in school longer & discourage early marriage & pregnancy but economic & cultural factors make things difficult to change. So we have been told, the poorer families prioritise their son’s education over their daughters. Daughters are either required at home, needing to work to support their family or their brothers' education or married off. In some ethnic minorities the woman is required to live with her son's family. This may mean moving away from her family & community & system of support. We focused today's training on simple approaches to self-care & the precious nature of the pregnant, birthing & new mother. The Hmong & Khmu are two of the ethnic monitory groups known to practice the restrictive postnatal diet of rice & salt. Some families do it for a short time, others for up to 3 months. Nutritional deficiencies associated with this diet are thought to contribute to the instance of beriberi caused by thiamine (vitamin B1) deficiency. Beriberi is a cause of infant death in Laos. Knowing we were encroaching on sensitive cultural territory & belief systems we attempted to offer some very gentle & respectful guidance around the importance of good nutrition through pregnancy & whilst breastfeeding.
Most of these women will birth at home supported by their families & a village midwife or health worker. There are little options if a transfer is needed so their health & wellbeing is paramount.
We spoke about the importance of treating pregnant & breastfeeding mothers with respect & kindness & taught some simple breath & bodywork techniques that can bring relief & relaxation during pregnancy & birth. Each woman had the opportunity to receive some gentle bodywork. These hard worker women would get little if no nurturing in their lives. If nothing more it felt precious to be offering them a few moments to receive, to be touched gently & with kindness & reminded of the important work they are fulfilling for their families & communities.
We spoke about the importance of asking for family support & had a beautiful encounter with a pregnant women's brother who was willing to learn some practices to support his sister. There were also a collection of other brothers & partners who gathered to watch. It felt promising to be planting some tiny seeds that might in some small way inspire greater care & kindness for mothers.
We spoke about dynamics of the pelvis & the value of different positions & a willingness to be creative with what works best for each woman & each birth. While the local midwives were, once again taken a back by our proposals, the woman, who had birthed before took pride in using our charts to point out that they had birthed in squatting positions with the use of the traditional hanging rope. It was so beautiful to observe these culturally shy & reserved women coming out of their shells & sharing their stories with one another. Mixed community gatherings of pregnant women like this are not usual & it felt really special to be apart of such an event.
We had another vibrant opportunity to illustrate the possibilities of different active birth positions & baby catching in the health centres' birthing room. It was the narrowest bed yet but we made the most it & seemed to inspire some more creative possibilities & confidence in the midwives & health workers present.
One of local male midwives took us to his family's cafe for lunch. He shared that he was very challenged by his work, the many complex aspects of this professional responsibilities. He loved being a midwife & helping women & babies but there are many hardships.
Over lunch our beautiful translator, Phonesavan handed out Yahua vine to all the pregnant women. Yahua is used as a traditional remedy, drunk as a tea to support postnatal healing & milk production. Phonesavan was passionate about ensuring that the women had some on hand.
We finished the day handing out the last of our days for girls menstrual pad kits - quite remarkably we had exactly the right amount to go around!
Thank you all so much for following our adventures, for all your words of support & encouragement & to everyone who has offered financial assistance to make this trip possible. We are already dreaming into our next Birthwork Initative & feeling assured of the ongoing value of work of this nature both in Laos & other places of need the world round.

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Today we crossed the misty Mekong River & walked through a muddy roadside village to reach the Chompet District Hospital where the next 2 days of our Laos Birthwork Training will take place.
Once more we reunited with many of the participants from our January training with much warmth & welcoming.
Jenny began with a beautiful exploration into the essential qualities that we bring to our work with birth. For us it is Our Knowledge, Our Hands & Our Kindness. Once again she introduced the 3 Kindnesses & emphasised the exploration of the First Kindness; Kindness & Commitment To Ones Knowledge Base & in particular a kindness & willingness to share ones knowledge with the women, their families & the communities in our care. Having seen such vibrant & enthusiastic examples of community involvement in the postnatal visits we observed in the Phontong & Vengjeulan, Jen emphasised, specifically the importance of involving the greater community, their support & sense of responsibility in caring for pregnant, birthing & new mothers & babies. These occasions of community gathering appear to be such precious opportunities for community education, particularly around themes of nutrition, kindness & compassionate of care of the mother.
In a heart moving conversation with Piyanat, Red Cross Official & Midwifery Supervisor I leant more about the depth of exasperation she feels & the challenges of the circumstances she works within. Piyanat is a Thai midwife who been working with the Red Cross in Luang Prabang for many years. Implementing change & improving services has not been easy for her & her colleagues & they feel great stress & heartache in response to the continuing high rates of infant & maternal death in the districts that they cares for. During her years of service she has seen an improvement in physical conditions in many health centres. Many Health Centres have been upgraded & Midwives & Health Workers are putting in much effort maintaining cleanliness, hygiene, clinic finances & record taking but, in her perception, so much is still needed in the realms of quality of care. According to Piyanat, despite her & her colleague’s efforts there is still a lack of the kindness, compassion & thorough care that women require to ensure their wellbeing. Factors involving geographical isolation, lack of transport, poverty & malnutrition are also leading hindrances in the great task of effecting change.
Piyanat & her colleagues feel a great level of responsibility for the communities they care for & dearly long for different outcomes but this has not proved an easy task.
She has cared for us beautifully during our stay & provided us with comfort, warmth, welcoming, enthusiasm & encouragement for the teaching we are providing. We are very grateful for her care & very humbled by her on going commitment & devotion to support the communities she cares for.
Today we heard more stories of the tragic implications of geographical Isolation. One young midwife shared a story of a mother who gave birth at home in her village. Seeking help to address a retained placenta, the mother walked for 3 hours to reach the nearest health centre. Upon arrival, the mother was cold & profoundly compromised. Many unsuccessful efforts were made to assist the mother but the removal of the placenta was not possible. A tractor was arranged to transport the mother to the District hospital. The mothers passed away while being transported, leaving 3 children behind her.
Another midwife told of a mother with placenta previa who lived in a remote rubber plantation. Her bleeding began in the plantation & she travelled for 6 hours by tractor to reach the health centre but died en route.
Another midwife shared that she works in a health centre without electricity. It takes her up 4 hours travel by car, boat then tractor in order to access medical support.
These brave women work & birth in circumstances of isolation that we can barely fathom. We feel so moved by what they face & really pray that our offerings are of some service & most importantly that over time the outcomes of health, wellbeing & dignity can all be improved.
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This day’s training at Chompet District Hospital focused largely on emergency care skills; Postpartum Haemorrhage, Infant Resuscitation, Shoulder Dystocia & complex Breech Births. After such a big day of topics & the emotional content of some very confronting stories it felt good to lighted the mood & move into an exploration of pelvic anatomy & dynamics, active & opening birth positions, the importance of nurturing the mother & more creative ways of making space & relieving tension in the pelvis to support smooth birth or address a stuck situation.
The female pelvis really is amazing!!
Jen paints such a rich yet down to earth picture of what our beautiful bodies are capable; demonstrating the potential of pelvic mobility, the passage of the baby & just how much space & movement can be created through subtle positional changes & touch & bodywork techniques.
I have listened to her exploration of the dynamics of both the bony & the soft pelvis innumerable times over the last 15 years but I never cease to feel awed or glean new insights from her deeply informative & inspiring teachings.
It was really encouraging to see the enthusiasm that Bokaeo (one of the Red Cross Supervisors) responded to Jen's teaching with. She provided the group with an additional translation & demonstration of Jen's wonderful teachings appearing passionate to ensure that this common sense body wisdom had been adequately received.
Once again we offered a theatrical array of enactments of birth in different positions, both on the bed & on the floor & tried our best to further demystify the prospect of birthing other than on ones back.
It became apparent that alike to the midwives in Phonesay District these midwives have also felt to afraid to encourage mothers to birth in other positions or to offer assistance through touch & constructive or comforting forms of bodywork. While the district trainers & supervisors are very passionate about what we are teaching it is clearly a very big step to alter the status quo. We role played different scenarios that involved introducing the mother to different possibilities of touch & positional variations in an attempt to offer options that might may feel applicable in their care. Regardless of how far our teachings span we all had much fun & everyone gave themselves to our practices with much laughter & enthusiasm.
It was beautiful to see the very reserved, young male doctors joining in!
Our day finished with another exploration of kindness & the many opportunities we have as Birthworkers to foster trust & feelings of Nurturance in the woman we care for.
We finished with our vaginal examination roleplay hoping again to sow some seeds of change around how women's intimate bodies are touched. Around the world vaginal examinations & Pap smears are so often given without the gentility & kindness they warrant. So many women possess stories within which they feel they were touched clinically without the care & kindness they have needed. As all women know simple, respectful changes in communication, lubrication, pace & timing can make such a difference.
Today was our last day with beautiful Claire's invaluable presence in our team. Claire is an independent midwife in New Zealand & has been working with birth for 16 years. She holds a wealth of birthing knowledge. Her mastery of clinical skills, her clear, light hearted, playful & loving teaching style has brought so much our trainings - we don't know how we would have managed without her!
I can't wait til are next together again - hopefully with Fiona Hallinan as well who could not join us this time.
It is such a privilege to be working beside such amazing women!
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$3,686 of $10,000 goal

Raised by 49 people in 11 months
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