Only 19% of women in Karamoja in North Eastern region of Uganda deliver in Health Centers. Traditionally, majority of the pregnant women deliver at home in kneel down or squatting position. Hence to meet the traditional practices of the women, the birth cushion was designed to offer a modified squatting position while ensuring the mother is comfortable. In this way mothers have the option to either use the delivery bed or the birth cushion.
Most women are choosing to use the birth cushion by choice versus the lithotomy position that is practiced at the health centers in Uganda. UNICEF’s effort to bring in an innovation at health facilities (birth cushion) that is culturally accepted by the women has paid off.
Modified squatting position is being practiced at Nadunget HC III in Moroto by the use of a birth cushion that was introduced in the month of July by Health Section, UNICEF Uganda. What is being pretested is the second version of the birth cushion and that has been placed at the health centre for two months. So far 20 mothers have delivered using it and feedback from them indicated that they are comfortable since it is firm and offers support as the mother is pushing the baby.
“I am excited, I liked the birth cushion” said Nakiru, a Mother who was delivering the previous night on the birth cushion. “I am going to encourage mothers in my village to deliver in the health facility because the position that we prefer is now used”, she goes on to say.
The midwives have reported that the deliveries at the facility have increased by three folds in the last two months after the introduction of the birth cushion. This innovation is likely to increase registration of antenatal mothers and also facilitate testing for HIV & AIDS. The midwife (Ms. Jane Atim) reported that it is a better option than having the mother squatting or kneeling. It is easy for her to view the perineum while the mother is seated on the birth cushion.
Modifications have been made on this second version by providing a soft cushion on the ground to receive the baby when being born. A wider cushion to receive the baby is being made so that it provides enough space to tie the cord.
The birth cushion has been put to use in other health centers also, advantages of this position are initiation of immediate breast-feeding, practice of the Kangaroo method for the new-born and immediate expulsion of placenta. This position may also help to cut down the vertical transmission of the mother to child transmission of HIV & AIDS.