Nine years after the birth of my daughter, I still vividly recall preparing for her arrival. There was a nursery to furnish, tons of stuff to buy, and it was finally time to replace my 13-year-old car with something that had AWD, airbags and antilock brakes. Most of all, there was the matter of selecting a perfect name. The first name chose itself; Liliena was named after my Tongan Peace Corps sister. Her middle name presented more of a challenge -- it had to be both beautiful and meaningful. After hours of poring through baby name books and speaking different combinations aloud, we finally chose Beatrice, "bringer of joy." A year later, we went through much the same process when I became pregnant with my son.
There are many places in the world where parents dare not select their babies' names in advance. It's not that these parents love their children less than we do, it's because they know there is a good chance their babies will die. I will never forget my recent visit to a referral hospital in East Africa. The head of pediatrics described the many foreign visitors who "came to help," made big promises and never returned. He then showed me their delivery room, a 6 x 12 foot alcove with two metal labor tables and a peeling tile floor. There was no running water, no stethoscope or simple suction equipment, and no blankets or towels to dry and warm newborns. Metal bins were set within easy reach; it was not unusual for the bodies of "stillborns," who had yet to utter a single cry, to be placed inside and left for dead. Physicians attend very few deliveries in developing countries and, tragically, many health workers don't realize that by simply suctioning a baby's mouth and nose, and rubbing his back and warming him, they could help him start to breathe.
It is sobering for me to contrast this with my own experience. My son Grayson was born 10 days after his due date, delivered by stat c-section when the fetal monitor showed dangerous drops in his heart rate. Within 10 minutes of the concerning tracing, I heard the beautiful sound of my son's first cry. He was perfect -- save for a dent in his lower lip, where his tiny hand had been pressed up against his sweet little face. I learned about this detail later; my blood pressure had dropped to 60/30 and my recollection of that night is somewhat vague. Gray has asked me several times what would have happened if he had been born in a place where they didn't have hospitals. I have replied, quite honestly, that we probably both would have died.
The reality is, unlike those of us fortunate enough to have ready access to skilled medical care; millions of women throughout the world DO die during childbirth, and go through their pregnancies knowing that their babies may also die before, during or shortly after birth.
Every mother deserves to deliver her baby safely, and to experience the immeasurable joy of hearing that first cry. Every baby deserves to have a skilled attendant who can keep them out of that metal bin, by helping them take their first breath. Now, thanks to Helping Babies Breathe®, newborns in resource- limited settings stand a much better chance of ending up in their mothers' arms, alive and well.
Helping Babies Breathe® (HBB) is a curriculum developed and being distributed by the American Academy of Pediatrics, in consultation with the World Health Organization (WHO), and in collaboration with the US Agency for International Development, Save the Children, NICHD, Laerdal Medical, Johnson & Johnson, and a number of other organizations.
HBB trains birth attendants in developing countries in the essential skills of newborn resuscitation. Our goal is to have at least one skilled attendant at the birth of every baby, armed with the simple, inexpensive equipment needed to help each baby breathe within the first minute after birth. HBB training has been introduced in 48 countries so far, but only 11 of these countries have sufficient resources to take this critically important program to scale.
This week at a panel about Front Line Health Workers hosted by Johnson & Johnson, Dr. Jon Klein from the AAP noted that "much more needs to be done to improve newborn survival to achieve the MDGs on a global scale." Helping Babies Breathe will be targeted to the 63 countries participating in Millennium Development Goal 4.
It is crucial that we find ways to increase support for HBB training in developing countries, so more birth attendants can be taught to evaluate newborns and stimulate their breathing. As this goal is achieved, more and more babies will survive and end up where they belong - not in those metal bins, but home with their families, where the fun of choosing their names can begin!
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