Birthrights - The Mountain Midwives of Vietnam

Summary

In the rural far north of Vietnam, a battle between modernity and tradition unfolds, with high maternal mortality rates due to home births. Ying, a 20-year-old from the Mong ethnic group, graduates from a program aimed at improving maternal and infant health. She faces the challenge of overcoming cultural traditions, politics, remoteness, and poverty to convince women to give birth at health centers. Ying navigates the delicate balance between respecting her culture and promoting modern healthcare, helping to reduce maternal deaths in her community.

Takeaways

• 🏞️ The script discusses a battle between modernity and tradition in a mountainous region with high maternal mortality rates.
• 🎓 20-year-old Ying, from the Mong ethnic group, is a recent graduate of a program aimed at improving maternal and infant health.
• 🚑 Ying faces challenges such as cultural traditions, politics, remoteness, and poverty in her work as a midwife.
• 🏠 Ying's home, Chica Commune, has a basic health center serving 22,000 locals, but most women prefer traditional home births.
• 🤰 Ethnic minority women, particularly those under 18, are at a higher risk of death during childbirth in the Mong society.
• 🌱 Traditions and rituals are significant reasons why women prefer home births, making it difficult for Ying to promote health center births.
• 🛣️ The journey to the health center involves a 7 km trek and potential dangers, including the risk of kidnapping by human traffickers.
• 🏥 There is a history of tension between the Mong community and the Vietnamese state, affecting trust in government-run health centers.
• 🌐 Ying acts as a translator to ease the tension between Mong women and Vietnamese health workers.
• 👶 Despite the risks, Ying helps deliver a baby safely at the Chica Health Center, but the mother faces complications.
• 🌟 Ying's efforts contribute to a reduction in maternal deaths and she continues to navigate the balance between tradition and modern healthcare.

Q & A

What is the primary conflict depicted in the script?

The script depicts a conflict between modernity and tradition, particularly in the context of maternal and infant health practices in a rural area.

What is the maternal mortality rate in the region mentioned in the script?

The maternal mortality rate in the region is up to 10 times higher than other parts of the country.

Who is Ying and what is her role in the community?

Ying is a 20-year-old from the Mong ethnic group and a recent graduate from a program targeting maternal and infant health. She works as a midwife and aims to reduce maternal and infant mortality rates.

What obstacles does Ying face in her work as a midwife?

Ying faces obstacles such as cultural tradition, politics, remoteness, and poverty in her efforts to improve maternal and infant health.

Why do many women in the Mong community prefer home births?

Many women in the Mong community prefer home births because they can perform an important and ancient ritual, which is deeply rooted in their cultural practices.

What is the significance of the Chica Health Center in the script?

The Chica Health Center is the only place to get medical attention for the 22,000 locals in Chica commune, as the District Hospital is a 3-hour drive away.

What is the impact of home births on newborn mortality rates in the rural mountains?

Newborns in the rural mountains are 50% more likely to die if born at home compared to those born in the city.

What is the historical context that contributes to the tension between the Mong community and the Vietnamese State?

A communist policy of assimilation in the 1970s and 80s has left a mark on the Mong community, leading to a distrust of the government and tension with Vietnamese health workers.

What role does Ying play in bridging the gap between the Mong women and Vietnamese health workers?

Ying acts as a translator and mediator between the Mong women and Vietnamese health workers, easing the tension and helping to facilitate better healthcare practices.

What challenges does Ying face in convincing women like Sa to give birth at the health center?

Ying must convince women to overcome their fear of the government-run health center while respecting the traditional values of their own culture.

What is the significance of the journey to the Chica Health Center for Pang and Sa?

The journey to the Chica Health Center is significant as it represents a break from centuries of cultural practice and a step towards modern healthcare, despite the risks and challenges involved.

Outlines

00:00

🏞️ Struggle Between Modernity and Tradition

The script introduces a conflict between modern healthcare practices and traditional birthing customs in a rural mountainous region. The area has a significantly higher maternal mortality rate, prompting a need for change. It highlights the story of Ying, a 20-year-old from the Mong ethnic group, who has graduated from a program aimed at improving maternal and infant health. Ying faces challenges such as cultural traditions, political issues, remoteness, and poverty as she attempts to implement modern midwifery practices. The narrative also reveals that most women in Ying's community prefer traditional home births, which are riskier, and that the local health center is underutilized due to these cultural preferences.

05:02

👶 High Maternal Mortality Among Ethnic Minorities

This paragraph delves into the specific risks faced by ethnic minority women, such as Sar, who is under 18 and part of the Mong society. The script notes that women marrying at a young age, sometimes as early as 14, face higher mortality rates during childbirth. Ying's mission is complicated by the fact that home births are preferred for cultural reasons, including the performance of ancient rituals. The narrative follows Ying as she tries to convince Sar's family to allow her to take Sar to the health center for a safer birth, navigating through the challenges of tradition and family influence.

10:06

🚶‍♀️ Journey to Modern Healthcare Amidst Dangers

The script describes the difficult journey Ying undertakes with Sar and Pang, another pregnant woman, to reach the Chica Health Center. The journey is fraught with danger, including the risk of kidnapping by human traffickers along the border of Vietnam and China. Once at the health center, the women's unease is palpable due to historical tensions between the Mong community and the Vietnamese government. Ying serves as a bridge, translating for the Mong women and Vietnamese health workers, and facilitating trust. Despite the need for further medical attention at the District Hospital, the women must stay with relatives near the health center for the time being.

15:25

🌙 Labor and Delivery in the Face of Risk

The narrative continues with the imminent birth of Pang's child. Pang has to return to her mother's house due to the lack of medical facilities at the health center. The script highlights the risks associated with home births, especially in remote areas without immediate access to medical care. When Pang goes into labor, she must walk in the dark to reach the health center, a journey that could prove fatal. The tension builds as the audience is left to wonder about the outcome of her labor.

20:27

🤱 Safe Delivery and Cultural Compromise

The script concludes with Ying successfully assisting in the delivery of Pang's baby after a long labor. However, complications arise when Pang experiences uterine inertia, a leading cause of maternal death in Vietnam. Fortunately, the placenta is eventually delivered, and Pang survives. Ying's efforts lead to a compromise between tradition and modern healthcare, as the Vietnamese doctors allow a modified version of a traditional Mong birthright to be performed. The narrative also touches on the broader issue of maternal mortality worldwide and Ying's role in helping to reduce it. The story ends with a personal note, as Sar decides to return to her village and give birth at home, despite the risks.

Keywords

💡Modernity

Modernity refers to the state of being up-to-date or contemporary, often characterized by technological advancements and social changes. In the video, modernity is juxtaposed with tradition, particularly in the context of maternal health practices. The script discusses the need for ancient birthing practices to give way to modern healthcare to save lives, illustrating the tension between embracing modernity for improved health outcomes and preserving traditional customs.

💡Maternal Mortality Rate

Maternal mortality rate is a measure of the number of women who die due to complications related to pregnancy or childbirth, relative to the number of live births. The script highlights that the area depicted has a maternal mortality rate up to 10 times higher than other parts of the country, emphasizing the urgency of improving maternal healthcare in this region.

💡Ethnic Minority Women

Ethnic minority women are individuals belonging to a group that is smaller in number compared to the dominant ethnic group in a region. The video script mentions Ying, a 20-year-old from the Mong ethnic group, as one of the minority women trained to address maternal and infant health issues. This points to the specific challenges faced by ethnic minority women in accessing healthcare and the importance of culturally sensitive approaches.

💡Cultural Tradition

Cultural tradition refers to the customs, beliefs, and practices that are passed down within a culture or society. The script discusses how cultural traditions, such as home births and certain rituals, can be barriers to accessing modern healthcare. Ying's role is to navigate these traditions and encourage women to use the health center, showing the interplay between cultural practices and health outcomes.

💡Remoteness

Remoteness is the state of being far away from populated areas or services. The script describes the location of Ying's home, Chica Commune, as being in the rural far north, which is a 3-hour drive from the District Hospital. This remoteness contributes to the challenges faced by local women in accessing healthcare services, particularly during childbirth.

💡Poverty

Poverty is the state of being extremely poor, lacking the means to meet basic needs. The video script mentions poverty as one of the obstacles Ying must overcome in her work as a midwife. Poverty can exacerbate health issues by limiting access to healthcare and nutritious food, which is a significant factor in the high maternal mortality rate in the region.

💡Midwife

A midwife is a trained healthcare professional who provides care and support to women during pregnancy, childbirth, and after birth. Ying, as a recently graduated midwife, is central to the video's narrative. Her role is to help bridge the gap between traditional practices and modern healthcare, aiming to reduce maternal and infant mortality rates.

💡Home Births

Home births are childbirths that occur outside of a hospital setting, typically in the mother's home. The script notes that 70% of women in Chica choose home births due to cultural preferences and fears of the government-run health center. This preference increases the risk of complications and contributes to the higher infant mortality rate in rural areas.

💡Health Center

A health center is a facility that provides various healthcare services to the community. In the video, the Chica Health Center is the only place for locals to get medical attention, but it is underutilized due to cultural distrust and fear. The script shows Ying working to change this by encouraging women to give birth at the health center for safer conditions.

💡Assimilation Policy

Assimilation policy refers to government policies aimed at integrating minority groups into the dominant culture. The script mentions a communist policy of assimilation in the 1970s and 80s that has left a lasting impact on the Mong community. This policy has contributed to the distrust of the government and the health system, making Ying's work as a bridge between the community and modern healthcare even more challenging.

💡Childbirth

Childbirth is the process of giving birth to a child. The video script discusses the risks associated with childbirth, particularly in the context of home births versus giving birth at a health center. The narrative follows Ying's efforts to convince women of the safety and benefits of giving birth at the health center, which is crucial for reducing maternal and infant mortality.

Highlights

The battle between modernity and tradition in maternal health practices.

Maternal mortality rate in the area is up to 10 times higher than other parts of the country.

Introduction of a program targeting maternal and infant health in ethnic minority regions.

Ying, a 20-year-old from the Mong ethnic group, graduates from a midwife program.

Challenges faced by Ying include cultural tradition, politics, remoteness, and poverty.

Chica Commune's basic health center is the only medical facility for 22,000 locals.

70% of women in Chica prefer traditional home births, increasing newborn mortality rates.

Ying's dual identity as an ethnic Mong and a trained midwife.

The preference for home births to perform ancient rituals.

Ying's mission to convince women to give birth at the health center.

The journey of Ying and pregnant women towards the Chica Health Center.

Risks of giving birth along the Vietnam-China border due to human trafficking.

Tension between the Vietnamese State and the Mong community due to past assimilation policies.

Ying's role as a translator to ease tension between Mong women and Vietnamese health workers.

Pang's 6-hour journey for an ultrasound at the district hospital.

Pang's labor and the potential dangers of giving birth at home.

Ying's successful delivery of Pang's baby despite complications.

The cultural practice of allowing the husband to perform a birthright ritual post-delivery.

The global statistic of over 300,000 women dying in childbirth annually.

Ying's contribution to reducing maternal mortality and the ongoing challenge of balancing tradition with modernity.

Transcripts

[Music]

[Music]

behind the beauty of these mountains a

battle is being fought between modernity

and tradition

[Music]

this area has a maternal mortality rate

of up to 10 times higher than other

parts of the

country in order to save lives ancient

birthing practices must give

way 20-year-old Ying is from the Mong

ethnic group she is one of 49 ethnic

minority women who have recently

graduated from a program targeting

maternal and infant Health in the

region

[Music]

but for Ying to succeed in her work as a

midwife she must overcome the obstacles

of cultural tradition politics

remoteness and

[Music]

poverty

foree

fore

[Music]

fore

foree

[Music]

foree

spee

[Music]

Ying's home is chica commune a group of

villages in the rural far north of the

country mostly populated by the

[Applause]

Mong The District Hospital is a 3-hour

driveway this means for the 22,000

locals chica's basic health center is

the only place to get medical

attention over the last year only a very

small number of women in chica gave

birth at the local Health Center whilst

70% of women chose a traditional birth

at

home because ethnic women are much more

likely to have home births newborns in

the rural mountains are 50% more likely

to die than in the

city Ying is herself an ethnic Mong and

is caught between these two worlds in

order to reduce deaths she must convince

chica's women to overcome their fear of

the government run Health Center yet

respect the traditional values of her

own

[Music]

culture

[Music]

fore

foreign

[Music]

spee

fore

[Music]

foree

Ying arrives at sar's Village s lives

with her husband and his family who are

on a break from working in the

field in Vietnam ethnic minority women

are four times more likely to die during

childb

birth this figure Rises amongst women

like s who are under the age of

18 in Mong Society women marrying as

young as 14 is

[Music]

spe

[Music]

for forign

[Laughter]

[Music]

spee

one of the many reasons among women

prefer home births is so they can

perform an important and ancient

ritual

for these Customs make it difficult for

y to convince women to give birth at the

health

center

the next day Ying returns to s's village

now she must get past s's husband and

father in order to take her back to

chica

fore

having convinced the family ying and sa

begin their Journey back to chica but on

their way must stop at another

[Music]

Village

foree

[Music]

[Applause]

[Music]

foree

[Music]

sister-in-law 22-year-old Pang is also 9

months pregnant Pang chose to give birth

to her first two children at

[Music]

home

fore

fore

[Music]

fore

Ying guides Pang and sa on a 7 kmet

Journey towards the Chica Health

[Music]

Center there is a high chance that one

of them could give birth at any

time and there is an added

danger the height takes them along the

borderline of Vietnam and

China

in recent years this area has seen a

massive rise in the kidnapping of M

women by Chinese sex

[Music]

traffickers

at the Chica Health Center Pang and sa

nervously await their

checkups their unease stems from a

history of tension between the

Vietnamese State and a 700,000 strong

Mong

Community a communist policy of

assimilation in the 1970s and 80s has

left its Mark and a distrust of the

government remains

[Music]

as part of her job Ying must ease this

tension by acting as a translator

between M women and Vietnamese health

[Music]

[Music]

workers

the health center can't give Pang the

full examination she needs so tomorrow

she will have to make a 6-hour return

Journey to the district Hospital for an

ultrasound but for now she'll stay at

her parents home near the health center

whilst s also goes to stay with

relatives

nearby

[Applause]

[Music]

[Applause]

[Music]

spee

for

[Music]

fore

the next day Pang returns from her trip

to The District

[Music]

Hospital

[Music]

[Music]

foree

[Music]

with a birth imminent there is no choice

now but for Pang to return to her

mother's house and

[Music]

wait

10 hours later and Pang is now in labor

she must walk for 30 minutes in the dark

to get to the Health Center if Pang

gives birth now it could be

[Music]

fatal

foree

[Music]

speech

spee

[Music]

[Music]

for

[Music]

spee

[Music]

foree

[Music]

speee

[Music]

fore

speee

[Laughter]

[Music]

[Applause]

[Music]

foree

[Music]

[Music]

for

speee

after 4 hours of Labor Ying has helped

safely deliver the baby but the danger

remains for

Pang in a condition known as uterine

inertia her uterus is failing to

contract normally causing a delay in the

delivery of her

placenta this is Vietnam's number one

cause of maternal

death

[Music]

for

speech

[Music]

speee

spe

[Music]

for but this time Pang is

lucky finally the placenta is

delivered

fore

spee

fore

[Music]

foreign

[Music]

for by not having a home birth Ying has

convinced the family to break with

centuries of cultural practice

even so the Vietnamese doctors allow

pang's husband to carry out a modified

version of the most important M

Birthright

[Music]

hang named her newborn daughter after

ying a few days later s decided to

return to her Village and assisted by

her mother-in-law gave birth to a boy at

[Applause]

home

[Music]

[Music]

across the globe over 300,000 women die

each year in child birth 99% in

developing countries like

Vietnam Ying has played her own small

part in reducing that figure and in

order to save more lives she must

continue to walk the fine line between

tradition and

modernity for Ying the challenge

[Music]

continues