Training of Roma Health Mediators in Reproductive Health

Trainer document
CASE STUDIES
Elena is a 26-year old woman who has 5 children and lives in the countryside. She is six
months pregnant and she has visited the family doctor in the village only once. He told
her that she should come back after she has had some laboratory tests and he advised her
to quit smoking. Elena had neither time nor money to spend on traveling to town for
analysis and she continued to smoke as she did during her previous pregnancies. Now she
is not feeling very well but she does not want to return to the family doctor because she is
afraid that he will reprimand her for not respecting her scheduled visits and for
continuing to smoke.
Mira is a 20-year old woman and is four months pregnant for the first time. She and the
family members (her husband and mother-in-law) have ignored her needs related to her
pregnancy. Mira does not know anything about her special needs. She has not attended a
clinic for a check-up. Her life is like everybody else’s and nothing has changed: she
continues to do her housework, to carry water from the fountain and to take care of the
garden just like before her pregnancy. Several days ago, she started to have some pains in
her belly. Her mother-in-law calmed her telling that is normal, especially during the first
pregnancy. Two hours ago, Mira started to bleed.
Gheorghe’s wife, Andreea, became pregnant for the fourth time at 34-years of age. Like
previous times, both husband and wife thought that there was nothing to worry about, as
the new baby would arrive without any problem in due course like the others: without
any intervention from any doctor. She noticed a persistent headache during the last month
but didn’t pay much attention because she knew that all pregnant women have some
discomfort during pregnancies. Andreea died during the 8th month of pregnancy.
Maria is a 20-year and she is giving birth to her second baby. She delivered her first baby
at the hospital, everything was well, and she gave birth in only a few hours.
This time, the water broke during the night and her husband called the traditional birth
attendant early in the morning to assist Maria. She delivered a healthy baby and
everything looked fine, but after 1 hour she had not yet eliminated the placenta. The
traditional birth attendant gave her to drink (a plant infusion) but nothing changed. After
another hour, they called the ambulance. At 3 hours after the childbirth, Maria arrived to
the hospital, loosing blood. The doctors gave her a blood transfusion but unfortunately,
Maria died in 30 minutes.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 6: Pregnancy