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Health Alliance International

Success Story: Case Study

Safe Places to Give Birth: Natalia

Posted: Jul 2009

Natalia's fourth child was born at a Birth-Friendly Facility (BFF).  HAI began working with the Ministry of Health to improve health outcomes for mothers and their newbornbabies.   During an initial assesment, community voices revealed some deeply entrenched traditional practices related to birthing.  Home births are important in Timorese tradition with many women delivering on specially prepared bamboo beds constructed by their husbands. There is a preference for an upright delivery position supported by a family member and a rope secured around roof rafters to support the woman during the last stages of labor.

HAI's community assessment also revealed a widespread lack of awareness of the benefits of delivering with a skilled birth attendant, and there were many negative associations with deliveries in a health facility. Negative associations included a lack of privacy provided to a birthing mother, lack of support for traditional birthing practices, such as upright positioning or use of hot compresses, and lack of space or permission for family members to attend the birth.

Natalia and her four kids at home

To address the traditional practices, increase delivery with a skilled birth attendant and create positive associations with deliveries in a health facility, we worked with the Timor-Leste Ministry of Health to develop the concept and build Birth-Friendly Facilities (BFFs).

Natalia, a 26-year old woman, has four children ages 8, 5, 3 and a three month year old. Her first three children were born in her simple home assisted only by her mother-in-law as they had always done in her family. Natalia went to the opening inauguration of the new Birth-Friendly Facility in her village and was able to tour the facility with the midwife. She saw the bamboo bed, the private rooms, the pretty curtains on the windows, and the kitchen facilitates.

During prenatal care visits, the midwife encouraged Natalia to use the facility and she was able to convince her family. Her fourth child, now a healthy three-month old, was born at the BFF:

"In the house I worried that there could be problem... and I was scared. At home family members get scared to help with the delivery, there are lots of people that are worried, not knowing what to do, and everyone giving advice. At the BFF, it was more peaceful, more organized. There was one person to help-the midwife knows what to do."


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Health Alliance International

We are a nongovernmental organization that supports governments in strengthening health systems and providing health care for all. We are affiliated with the University of Washington.


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