“Now I Use Contraception” – Oun Srey Leak’s Story

This is the third blog in a 4-part series sharing personal family planning stories from around the world – presented by CARE and Girls’ Globe in the lead up to the 2018 International Conference on Family Planning. Catch up on the whole series with stories from HawaParmila, and Olive.

Oun Srey Leak, a 26-year-old mother of one, navigates her way to work on a crowded street in Phnom Penh, Cambodia. She has worked in the Gladpeer garment factory for five years.

The garment industry is a huge part of Cambodia’s economy, employing over 700,000 workers. About 90% of these workers are women.

Srey Leak, like many of her colleagues, moved to Phnom Penh from a less populous area of Cambodia in search of job opportunities. She met her husband and shortly after became pregnant with their daughter.

Photo by GMB Films

“After I got married, I heard using contraception could stop us from being able to have children in the future. So, that’s why I decided to have a child soon after I got married. Two months after the wedding, I got pregnant,” Srey Leak explained.

Although half of female garment workers report being sexually active, less than a third of them use modern contraceptives.

Just as soon as Srey Leak became a new mom, she was faced with the demand to return to the garment factory. “After the birth, I needed to get back to work. So, I took my daughter to my mother back in the province. I am now far away from my child because I don’t have time to take care of her.”

Srey Leak’s story is not atypical. Most Cambodian garment factories operate six days a week, eight hours a day, and workers are often paid based on the outputs they produce, rather than the time they put in. Taking time off to go to the doctor may cost them more income than they can afford to lose, and there are limited health providers and pharmacies operating on Sundays when the factories are closed.

For the past five years, CARE has been working in garment factories to help women like Srey Leak make healthy decisions. Chat! is a package of activities that reaches women inside factories, where they spend most of their time. The innovative package includes sessions providing information on various sexual and reproductive health topics.

Srey Leak welcomed the opportunity to take control of her health. “One day, CARE came to invite workers to join a short training. They showed me short films about understanding the different types of contraception, safe abortion, and the ways in which we can avoid unplanned pregnancies.”

The sessions are paired with videos that feature fictional characters, in which the women can relate to and identify real health challenges. There is also an app that provides interactive quizzes and activities that are tailored specifically for garment workers, to facilitate ongoing learning.

After she learnt about the various modern contraceptive methods available to her, Srey Leak decided to start using oral contraceptives.

“I now take the contraceptive pill every day. If I’d known about this method before, I could have used it before falling pregnant,” she shared. “For me, after I joined CARE’s training, it changed my life. Now I use contraception and I have a greater understanding. So, it means I can have enough money for my next child.”

Chat! is supported by the Australian government’s Partnering to Save Lives (PSL) initiative and the Cambodian Ministry of Health in an alliance to reduce maternal and newborn mortality in Cambodia. Workers who participated are twice as likely to use modern family planning methods and health services. Factory managers have reported increased productivity and reduced absenteeism within their workers.

Learn more about CARE Cambodia’s garment factory work here, and read an interview with Chat! co-founders Maly Man and Julia Battle.

Forget the ‘Mommy Wars’ – Breastfeeding Inequality is the Real Issue

Too many heated words and firey tweets are being spent on the breastfeeding ‘mommy war’. It needs to stop.

Whether or not a well-educated and well-off mother chooses to breastfeed is not the big issue. The real problem – one impacting tens of thousands of lives – is breastfeeding inequality. Too many mothers are NOT getting equal opportunity to breastfeed.

Did you know that in the US, breastfeeding rates vary wildly from state to state? In Louisiana, 57% of infants are ever breastfed. In California, it’s 93%. That’s a huge difference.

It’s no surprise that Louisiana is one of the poorest states while California is one of the wealthiest. In fact, socioeconomic forces drastically affect breastfeeding rates. This visual guide by WeTheParents brings the shocking reality of breastfeeding inequality into focus.

Women born into socioeconomic hardship tend to have lower family income, lower level of education, and lower breastfeeding rates.

It’s not fair for the baby or the mother.

Some of the reasons for reduced breastfeeding are:

  • Less access to paid maternity leave
  • Lower paid jobs that are less likely to allow for pumping breaks
  • Inadequate maternity and lactation support in hospital
  • Less effective family and community support
  • A culture that doesn’t treat breastfeeding as a desirable status symbol (in contrast to the ‘crunchy mommies’).

The problem is intensified because babies born into conditions of hardship are less likely to receive adequate healthcare, parental involvement, and nutritious supplementary food once weaning begins.

This means that the babies who would benefit most from breastmilk are the ones least likely to get it.

Mothers Unite

This week is World Breastfeeding Week organized by World Alliance for Breastfeeding Action (WABA). It is the perfect opportunity to begin reframing the debate.

The mommy wars are a distraction. Let’s not waste valuable energy debating whether or not a well-off, middle-class mother is right to breastfeed her child. Yes, breast is best, but it’s likely her child will get a good start in life either way.

Mothers, let’s all come together and fight for breastfeeding equality. Surely we can all agree, that if a woman wants to breastfeed, she should be given the best possible chance to do so. The fact that less well-off mothers often don’t have the same knowledge or opportunities to breastfeed their babies is simply not right.

Instead of dividing along tribal lines, let’s unite and push for all mothers to have the same access to breastfeeding information, support, and workplace lactation programmes. It’s this that will really drive up breastfeeding rates and improve health outcomes for mothers and babies.

And so, the next time you find yourself caught up in breastfeeding guerrilla warfare taking place within the comments section of some blog, remember the real issue: breastfeeding inequality.

Neve is a mother of two, writer and breastfeeding advocate. You can find her trying to simplify parenting and empower new moms to meet their breastfeeding goals over at her blog WeTheParents.

 

Midwives Made Me Feel Like Not Going Home

I have met both considerate and not so considerate midwives. Without a doubt, the majority have belonged to the first category, and to those who haven’t been as caring – I don’t blame you. I admire the work that you do, the long hours you spend in the delivery rooms, the paperwork you need to put up with. I admire all of it.  

I have nothing but respect for midwives and I feel tremendously grateful to live in Sweden, a country where healthcare is equally accessible to all. Not once during my pregnancy nor the delivery did I feel fear, in fact I felt quite the opposite. I really did feel that I was in safe hands all the way through – from planning the pregnancy to the postpartum period.

I had quite an uncomplicated pregnancy and delivery, more or less, but I won’t deny that I was exhausted (to say the least) when our daughter was finally born.

The midwives made be feel so comfortable in the patient hotel right after delivery that I almost did not want to go home. Home – which is otherwise the only place I want to be in times of exhaustion, insecurity or stress.

Knowing that they were right there, only a few footsteps away, gave me a strong sense of security. When my husband left the patient hotel for the first time, I recall the feelings of nervousness and insecurity that started to creep up on me. I was carrying our daughter in my arms when suddenly one of her legs turned completely blue. I panicked. I ran out in the hallway and screamed for help, and a midwife in her late 50s quickly came up to me: “You’re just holding her a little bit too tight, dear. Don’t you worry, she’s perfectly fine.” Her humble smile and reassuring stroke on my shoulder calmed me down in an instant.

On our second (and last) night in the hotel, the breastfeeding marathon was real. My breasts were crazy swollen, lumpy and aching and my daughter did not want to latch on properly. It was the middle of the night, I hadn’t slept for 48 hours and the tears seemed unstoppable. I felt inadequate for not being able to calm my daughter down when she screamed as if I was hurting her, while all I was trying my hardest to do was to please her.

This time, another midwife came to our room and, again, told me not to worry so much. “Let me hold her for you, and just try to relax for a moment. It’ll be alright, this is absolutely normal.” Then she helped me finding a comfortable position for breastfeeding while lying down, and put my daughter to my breast. The screaming party was finally over, and at last I felt as if I was able to breathe properly again.

Midwives provided me with their invaluable knowledge, skills and help, and I am forever thankful for the time they spent taking care of me and my family.

Obviously, we did eventually leave the patient hotel, but I’ll admit that I would’ve gladly stayed longer – in the safe hands of the midwives there. 

Girls’ Globe will be present at the 31st International Confederation of Midwives Triennial Congress – bringing you live coverage from Toronto, Canada via our #ICMLive hub. To keep up to date with all the action, use #ICMLive to engage online. 

Raising Black Girls: an interview with Vanessa Stair

New York native Vanessa Stair’s experience as a woman of color, raising a child of color, in a non-traditional family is one not documented in the largely white, heterosexual context of the mommy blogger sphere. So she created her own space – www.ChocoLACTmilk.com is a testimony to the roses and thorns of colored parenting, being a feminist mother of a young girl, and raising our girls right.

Grace Wong: What inspired you to start chocoLACTmilk?

Vanessa Stair: My senior year I was pregnant with Peyton and wrote my senior thesis on breastfeeding in the black community. Since I was invested in the topic and was myself breastfeeding Peyton, I started inviting a small group of moms to come over once or twice a month to talk about their experiences of being black and breastfeeding. It naturally evolved to talking about other issues: how we felt as moms, some of us young mothers, our blackness, how we navigated our race and care for our children.

Life got in the way and some moms went back to work or moved, but I really held onto that space where women of color could talk about the intersectionality of being a mother of color to a child of color, and creating a space where we can talk about issues that uniquely affect us.

GW: You just mentioned that mothers of color face unique issues, what are some of the most challenging aspects of colored parenting?

VS:  I want to be unapologetic in my parenting. I want to live true to myself. But certain times navigating that space and respecting that can be very, very hard. I want Peyton to be a carefree black girl: do the things she wants, act the way she wants, and find her own voice, but often I find myself hesitant to do certain things because of the perceptions around children of color.

There are different life lessons that come with being a girl of color. I have to be very intentional about the kind of things I bring into her space so she sees positive representations of herself in various forms – not always the civil rights leader but a superhero or an astronaut. 

GW: You have been able to convey quite complex lessons like consent to Peyton. I feel like my peers, and even those older than me, don’t understand all of the nuances of consent. How have you been able to teach that to a five-year-old?

VS: To a three- or four-year-old consent can be taught very simply: no means no. When you say no I don’t currently want to be touched, that means no.

What has been more difficult for my partner and I is navigating Peyton’s ownership over her own body while also having the task of keeping her safe. For example, one thing we struggle with is crossing the street. Sometimes she does not want to hold our hand, and we have to say to her, “I understand that, but in this instance because there is a safety concern we need to hold your hand, and when we finish crossing the street and you don’t want to hold my hand anymore that is fine.”

As a four-year-old, Peyton has more awareness of her body than most kids and great at saying no to people. Peyton has an afro, and a lot of times people just want to touch it, and for us we say, every part of your body is your own – that includes your hair, your shoulders, your fingers – that is your body and the moment you feel uncomfortable you have right to say “no thank you.

Recently, we are walking down the street and this older woman puts her hand on Peyton’s hair and I am just about to go off at her and Peyton just goes, “Do not touch my hair” and the woman goes “Oh but I just wanted touch it,” and Peyton replies, “You wouldn’t touch my vagina, so don’t touch my hair.” This woman was mortified, but for me I was proud that Peyton recognized that every part of her body she has ownership. I think another part of the struggle is that it applies to everyone.

What is your hope for the chocoLACTmilk?

VS: Reaching a larger audience and creating a space where I can cathartically journal my experiences and create an outlet for other parents, with similar experiences, to have a dialogue. The dialogue is already out there so it is about harnessing that and bringing it to another, larger space, and creating community and support.

Celebrating Midwives & Partnerships that Matter

The lifetime risk of a woman dying from pregnancy and childbirth related complications in Kenya is high, at 1 in 55. According to latest data by UNICEF, the maternal mortality ratio in Kenya is 488 per 100,000 live births is unacceptably high. Only approximately 44 per cent of births are assisted by a skilled health worker, mainly a nurse or a midwife. Skilled attendance and particularly the role of the midwife continues to be advanced as a global priority and effective intervention for safer motherhood.

The IMG-20170503-WA0003International Day of the Midwife, May 5th, is a day to celebrate the wonderful work midwives are doing around the world. I, Felogene Anumo, a Girls Globe Blogger had the opportunity to speak to Rachel Odoro who has over sixteen years of midwifery practice and is currently the Assistant Chief Nurse at Kenyatta National Hospital (KNH). She shares the highs and lows of her career and offers crucial perspectives on this year’s theme Midwives, Mothers and Families: Partners for Life!

What inspired you to be a midwife?

If a midwife has the passion for midwifery and is empathetic, all they require are the capabilities, skills and competencies and they can perform in the utmost. Delivering quality care for the mother and her family is what matters most.

I developed my passion while I was still young in my career as a community health worker. I really love the mother and the child and it saddens me that so many mothers are dying from mostly preventable maternal-child related causes. I believe that midwives and midwifery skills are very important for preventing maternal, neonatal deaths, stillbirths and birth related complications. My experience has taught me that in order to increase the survival rates during birth, midwives require adequate support, proper infrastructure and up-to-date training.

What makes you proud of being a midwife?

There is something special about providing care for a mother during the journey of pregnancy and childbirth. Being a midwife is not only about clinical skills but being empathetic, passionate, respectful, culturally sensitive to a woman’s needs during pregnancy. I recall some of my trying moments at Pumwani Maternity Hospital, one of the largest maternity hospitals in the country, where we would handle up to 100 mothers delivering within 24 hours. These numbers would go up during the nights when up to 60 mothers would deliver. Needless to say that midwives do not only deliver babies, they significantly contribute to women’s sexual and reproductive health, through the prevention of unwanted pregnancies, pre- and post-natal care and health education. Midwifery is also equally important for newborns during the critical first few weeks of life.

What change do midwives make in the community?

Midwives are essential in the healthcare workforce. A mother who is delivering a baby is not something that can wait. Well-trained, well-equipped, well-supported and regulated midwives working in communities are uniquely positioned to save so many lives in their communities. Most maternal deaths are preventable as the health-care solutions to prevent or manage birth-related complications are well known.

However, we have to overcome certain challenges in order to work better with communities. More specifically, strengthening interpersonal relationships with mothers by improving attitude and practices when they seek care and working with Traditional Birth Attendants (TBA) to avoid mismanagement of mother and child. Other factors that prevent women from seeking or receiving care during pregnancy or childbirth include poverty, distance to health unit, lack of information, inadequate services and cultural practices. To improve maternal health outcomes, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system.

The Lancet maternal health series highlights that we will require more than 18 million additional health workers to meet targets set out in the Sustainable Development Goals by 2030. The series further highlights that Kenya is among the countries that has some of the lowest densities of midwives and obstetricians (WHO recommended one skilled birth attendant for every 175 pregnancies). What kind of partnerships are vital to support the work that you do?

  1. Families – Women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. This support can be provided by families or the community. Community support groups are able to identify expectant mothers, share their experience and intervene for example by providing transport during emergencies. telecommunication, transport during emergencies etc. The midwife in this case needs to form strong partnerships with the community so that emergencies can be referred on time
  2. Governments – To improve transport and telecommunication infrastructure. These would include proper road networks to health units as well availability of ambulances. The devolved system of governance in Kenya has enabled health units to be built in remote areas but a lot more still remains to be done. There is still a lot of congestion in the labor wards as a result of the free provision of maternal and child health care by government but our role is to reassure them that they will receive the highest form of care.
  3. Non Governmental Organizations (NGOs) – NGOs can partner with midwives to build competency and ensure that they are well-trained and well-supported especially for midwives working in low-resource settings. I have benefited from several trainings including by PRONTO International . There is no one who doesn’t require training. If I don’t read my books and update myself on the latest practices, I will decay.

We conclude this interview with a powerful reflection by Cathy Moore (in Sisters Singing). To all the Midwives at the frontlines, making motherhood safe – we love you, we appreciate you and we cherish you. Happy International Day of the Midwife.

“…As we ready ourselves to accept new life into our hands,
Let us be reminded of our place in the dance of creation.
Let us be protectors of courage.
Let us be observers of beauty.
Let us be guardians of the passage.
Let us be witnesses to the unfolding…”

Who Says I’m a Bad Mother?

Women may often be described as goddess-like, but perfect we are not. When my daughters were born I was ill-prepared and scared, and I momentarily felt like I lost a sense of myself.

Don’t get me wrong – my little miracles were precious to me from the first hint that I was pregnant, but it was a major life change. Sharing these mixed emotions seemed to perplex people, as though I should have been ever-joyous, selfless and nurturing, even despite sleep deprivation and my body being transformed beyond recognition.

I was a working mother who also attended school but I wanted to ensure the girls were my first priority. I made sure I was home most days after they were dismissed from school. We spent our afternoons doing homework, laughing and talking as they eagerly told stories of their day. Each night, I was thankful that I was able to read to them, pray with them and tuck them in. And as soon as they dozed off, I cracked my schoolbooks open.

Everyone familiar with my dreadful schedule would wonder, “You’re so hard working and brave. How do you do it?” I didn’t think I was either of those things. I just knew I wanted to show my children what determination looked like and how love felt.

The girls quickly moved into their teenage years, which brought on some unexpected challenges. I suppose that’s the art of being a teenager, doing the unexpected. And this is when everything shifted. I was no longer seen as hard working or brave.

Instead, people began to insinuate that maybe I had done something wrong. No one seemed to consider the neurological and hormonal changes all teenagers go through. No one seemed to remember how hard it was to navigate friendships and relationships in high school.

Well, maybe if I were around more, they’d hint, maybe if I didn’t go to school. Maybe I should have been a stay-at-home mother. Maybe I should have been more attentive, they’d imply, maybe more emotional. Some wondered whether I should have allowed the girls to have more freedom, while others said maybe I shouldn’t have allowed them to have so much. And slowly over time, I too began to question my abilities as a mother.

I also wondered why people judged me so harshly. Yet, in my heart, I knew the reason why. Society has developed an unattainable definition of the role of mothers: all sacrificial, never tiring, never stopping and relentlessly giving. We are supposed to raise our children perfectly, to get them through their many milestones seamlessly and to maintain composure gracefully, all the while pretending that none of this is detrimental to our own well-being.

There were times I locked myself in my bathroom and wept until my brown face turned a shade of deep red, wondering what I could’ve done to turn things around. I considered quitting school or sleeping less to get more done. Guilt rippled through my body, leaving knots in my stomach and tightly wound blood vessels throbbing in my temples.

Despite all of this, I knew that teenage hormones are powerful, that raising children isn’t linear, and that despite sometimes succumbing to guilt, everything wasn’t my fault. It wasn’t my fault that my children sometimes had a hard time in class or that boys were sometimes crass and girls were sometimes mean. It wasn’t my fault that they sometimes felt depressed, as heartbreaking as it was to witness.

My responsibility was to be there to help them when they fell, and sometimes even to catch them when I knew the fall would be too hard. It was my responsibility to listen, to love and to share my wisdom. And knowing this reassures me that although I’ve made mistakes, every imperfect thing in their lives was not due to my inadequacies, and things happen even despite my attempts to protect them. Being a mother is not about perfection. In fact, it is an imperfect art and a glorious blessing.