Mothers and Midwives in Syria

Sera Bond, founder of Circle of Health International (one of our grantees) is blown away by the bravery of Syrian women, especially the midwives who will take part in our grant-funded training program on advanced emergency obstetric skills.

Sera says, “This population of refugees and midwives is different from any other we work with and what makes them unique is also what makes them inspiring.”

Every Mother Counts: Sera, have seen what’s going on inside Syria?

Sera: We haven’t been able to travel there so we work from bordering countries and with local Syrian organizations to get supplies and equipment into Syria through Turkey, Jordan and Lebanon. We’ve also brought Syrian healthcare providers out of Syria for training. That’s how our EMC grant will work too — Syrian midwives will travel to Turkey in May for training.

EMC: What can you tell me about these midwives?

Sera: Other than they’re the bravest women alive? They’re a very different population of midwives than we’ve worked with before. EMC provided funding for six midwives and it was challenging to find six left in the country and we were lucky enough to find ten. This conflict has been going on for five years and more than 50% of Syrians have been forced to flee their homes. The rich people, many of whom were healthcare providers, were the first to leave. It’s surprising there are still midwives left in Syria and they’re doing this incredibly brave, important work in a country that everyone’s trying to get out of.

EMC: How are they different from other midwives you’ve worked with?

Sera: For one thing, they’re all nurse midwives. Syria had a great healthcare system prior to the conflict and many of these women were educated prior to the destruction of their healthcare system. Working in refugee situations is very different for them. They’re all pretty young, in their 20s and 30s, and unlike in many parts of the world where the midwifery profession is handed down through generations; these women actually chose this profession. Their decision was usually based on attending a female relative’s birth and then experiencing a “calling” or a feeling like this was the work that they were supposed to do.

EMC: Do these midwives function independently or do they work within a healthcare system?

Sera: They work with relief organizations. Most of the health facilities are operated by large regional NGOs, like Médecins Sans Frontières, Relief International or the Red Crescent. Imagine the level of bravery these women need just to go to work.

EMC: Where are women having their babies?

Sera Most Syrian women want to give birth in hospitals and they’re more comfortable with a medicalized version of birth. There are a few clinics and hospitals left standing but they’re badly staffed, there’s hardly any medicine and they don’t have power. Still, if they can get to a hospital, that’s where they want to deliver, even if they’re at risk of being bombed. But since many women can’t get to a facility, midwives make home visits. And I’m hearing anecdotal reports that Syrian midwives are crossing into Lebanon to deliver babies because when Syrian women get to refugee camps, they don’t know how to access services. So, the midwives cross the border, deliver their babies and go back home.

EMC: How do Syrian moms feel about delivering at home?

Sera: They’re shocked by it. Their own mothers delivered in hospitals and this generation is forced to give birth in places where they don’t feel safe, like in their homes or bunkers. Some of them deliver in caves or these underground dugouts people are living in. Syria was an upper middle class country. Most people had homes, cars and kids in college. For many refugees in other countries, they dream of a life that’s better than what they have, but they’ve never actually known anything better. They’ve never had a middle-class existence like Syrians had. That’s part of the trauma Syria is facing, Syria had great medical providers and strong hospitals. Then they got bombed into the Stone Age.

EMC: What else is unique about Syrian mothers?

Sera: The fact that they still want to have babies. In other refugee and war-torn populations, women are very hesitant to get pregnant. They don’t know where they’re going to live and whether there’s going to be food or healthcare. But Syrian women want to have more babies because they’re concerned about Syrians dying out. Women say they can’t wait to have another baby to replace a relative who died. It speaks to their cultural commitments and the number of people who are dying.

EMC: If a midwife runs into complications during a delivery, does she have any resources?

Sera: No, she doesn’t. Most of them are doing their best with almost nothing to work with. That’s why they’ve requested deeper training around postpartum hemorrhage and neonatal resuscitation. What’s frustrating though is that to really manage a hemorrhage or neonatal resuscitation you need a considerable amount of equipment they don’t have. We’re going to train them the best we can and then hopefully, send them back in with a lot of ambu-bags (breathing bags for resuscitations) and skills.

EMC: You can do a lot with that.

Sera: You really can, but we all know it’s not enough.

EMC: Why are these midwives staying in Syria?

Sera: Because they’re Syrians and they don’t want to leave. As long as there are women having babies, they’ll stay and help them out. Their bravery is that profound.

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