Monday, April 10, 2017

Infant Mortality and Midwives

As many of you learned in my presentation, I wrote my final research paper on infant mortality in Tohono O'odham Nation. I concluded that the most compelling explanation for the high infant mortality rate of Tohono O'odham Nation is the prevalence of diabetes on the reservation. This remains a sound conclusion, but other information, which I have since gathered, could shed additional light on the problem.

In an entirely different class, my final research project analyzed the relation between infant health and proximity to various medical facilities in Ghana. As I established in my research paper, Tohono O'odham Nation actually shares many characteristics with underdeveloped countries such as Ghana. In my research project, I did not find a significant correlation between infant health in Ghana and proximity to hospitals, nurses, clinics, or maternity homes. But I did find that infant health is positively correlated with proximity to a midwife at the 1% level. In fact, proximity to a midwife was the single largest predictor of infant health outcomes included in our regression. Therefore, it follows that midwives could have the same positive affects on infant health outcomes in Tohono O'odham Nation.

If the tribal government pushes for more individuals to work as midwives on the reservation. They could also be investing in a solution which aligns closely with traditional tribal values. The midwives of Ghana, which were so effective, often did not use advanced medical technology and methods to safely care for and deliver infants. Instead, these midwives relied on traditional methods and many generations of accumulated information regarding child birth. It is likely that Tohono O'odham culture carries a similar knowledge of child birth and prenatal care. As we've discussed in this class, traditional routes of solving problems in native american nations are often times the most effective long term. My two recommendations for addressing infant mortalities both involve more traditional methods. First, as I discussed in my paper, confronting the type II diabetes epidemic in Tohono O'odham Nation is key. This can be done by movement toward a more traditional diet for Tohono O'odham tribal members as we have discussed in this class. Second, prenatal and infant care can be improved through traditional methods with midwives.

We have even seen midwives have similar success in the U.S.. I'll link a couple of articles here:

1 comment:

  1. Great footnote to your paper. I wonder to what extent the close relationship between midwife and mother explains their effectiveness. This quote from the vanderbilt article you linked to is suggestive:

    "She monitored Holloway throughout her pregnancy, explaining the process each step along the way and involving Holloway in planning the baby’s birth."

    Do OB/GYNs have caseloads that prevents them from spending too much time thinking about individual women?