Timor-Leste Health Care Seeking Behaviour Study - Secretaria de ...

Appendix 3 – Difficult birth; extract from FGDThe sequence of responses in this FGD discussion illustrates several aspects related to difficult birth.The TBA is unable to assist with retained placenta and it is imperative to urgently get the woman to ahospital. In this case, this requires the assistance of the local authority. There is recognition of theneed for a trained midwife or doctor to assist.Timor-Leste Health Care Seeking Behaviour Study | 2009I ask you again, at the time of delivery what was the problem that caused you to call a vehiclefrom the hospital?#1. Delivery is a problem when women give birth for example after giving birth the previousnight a woman may be affected by two things: sometimes she gives birth but not completely, likethe baby’s objects [sasan] from the mother’s stomach are delivered but probably not completely,for example the baby has come but the placenta like the string of the placenta or it can be saidthat the placenta does not come. If a TBA holds on but still [the placenta] does not come we willgo quickly to the hospital as the hospital knows how to handle it, the doctor is the one whoknows the gravity of this.#2. Here like my brother in-law said, [after] the baby has been delivered, and the cord cut, then ifthe placenta is very delayed in coming it obliges us to cut the cord and then clean the baby thencover her vagina [fatin lulik] because the placenta has not yet come out. We should take themother quickly to hospital because the TBA is not able [to assist] because it is complicated. Anambulance should be called to take the woman to the hospital so that the doctor can determinewhether to perform surgery or remove the placenta.Whom is involved in the decision making?#1. Because in the hamlet, the hamlet head has the following motivation: he does not wantsomeone to die in his hamlet. Because of this he has the right to be involved and give his opinionto the child’s father [woman’s husband]. So, the hamlet head also has a right … to go to hospital,to call a car to transport the woman to hospital … because the TBA is unable [to assist] … thedoctor knows whether [the difficulty] is severe or minor.When you went to the hospital what was the outcome?#1. [We] went to the hospital because TBAs have faith in their medicine [or technique] that theyapply to the [woman’s] stomach but if it is not effective then the TBA’s capacity is only to thisstage, so it’s better to go to hospital. It is not that we are Timorese that we consider ourtraditional medicine to be good, but we were born from there [traditional medicine]. Nowadaysbecause various illnesses exist, upon delivery a baby can get a fever immediately, in this [case]the doctor is knowledgeable. When the child is born the doctor can give an injection immediatelybecause they are knowledgeable about this. We should go to hospital - if people from ahousehold don’t move themselves to go [to hospital], the hamlet head may also take thatdecision [for them]. If you do not decide to take [the person] to hospital, if the person dies youare the one who will be responsible. We are also fearful of this so we take them to hospital.Two married men, FGD, Bobonaro63