Canadian midwife Jennica Rawstron saw life and death unfold before her during what was at times a difficult and eye-opening experience in Ethiopia.
For the 32-year-old Rawstron, who grew up in Fort Langley, the moments that stand out from her recent placement with Cuso International as a volunteer midwife supervisor in Ethiopia include working alongside local midwives, who were helping women through difficult deliveries – often in situations that most Canadian women would never face.
Cuso International is a a charity that places skilled Canadian volunteers around the world.
Rawstron recently returned from a six-month volunteer placement in the African nation. She will be featured in an upcoming campaign and TV advertisement from Cuso International, which launches on Nov. 20, to raise awareness and funds to support midwives in countries like Ethiopia.
“I always enjoyed travelling but I also wanted to give back,” Rawstron said, about her motivation for going to Africa.
“It’s definitely something I wanted to do. That was what I grew up with in my family. My dad’s done a lot of work overseas and I’ve been to Africa before, 10 years ago, and that was really life-changing for me in terms of how I chose to live in Canada.”
While in Ethiopia, Rawstron was tasked with training her Ethiopian counterparts at a hospital.
While most of the ‘baby-catching’ was done by the local midwives, Rawstron did attend several deliveries.
In one of those first deliveries, the baby was breech.
“This baby was unresponsive at birth. It was a difficult delivery. We tried to resuscitate, but it was obvious the baby would die,” Rawstron said.
“It really had an impact on me because I’ve never had a stillbirth in Canada. Vaginal breech deliveries are not common in Canada because most women in that situation would have a scheduled C-section.”
Rawstron said it was interesting to see how the people in Ethiopia deal with stillbirths. “It’s so common there.”
A week later, it happened again that Rawstron was at the hospital for the delivery of another breech baby. This time, when the baby was born, she resuscitated him, and the baby survived.
“Ethiopian mothers do not have the opportunity for the same kind of health care that women in Canada have, so there are more of these high-risk births happening,” she said.
In Canada, most mothers and babies have access to the care they need in hospitals, or at home through the services of midwives. But in Ethiopia there are fewer qualified health workers. As a result, Ethiopian mothers and babies are far more likely to lose their lives from causes that are easily preventable with the basic healthcare and resources.
“I wasn’t in a primary role of catching babies, so as a result I would just be around,” Rawstron elaborated. “If the baby was born and the baby wasn’t breathing it was kind of mixed in terms of their preparedness for that kind of situation, which is kind of common. It was a bit surprising to me that there wasn’t more comfort with that.”
To support mothers and children in Ethiopia, Cuso International is currently raising funds to send more skilled healthcare workers, like Rawstron, to the east African country.
The volunteers are tasked with working alongside Ethiopian midwives and other healthcare providers to help them improve their skills – and potentially save more lives.
During her six-month placement, Rawstron could see that the Ethiopian midwives needed more training on emergency situations. Newborn resuscitation is a skill that midwives in Canada are required to learn and update their training on annually, but in Ethiopia, despite the frequency of these high-risk situations, Rawstron could see the midwives were not confident in their skills.
“Working in a low-resource setting is more difficult. Even when things are normal, you always have to prepared to resuscitate a newborn.
“I tried to discuss it and practise it with the students, and shared with them that even in Canada, we do this kind of training. I tried to teach them to practice more so that if it happens, they will be calm and able to do it.”
Rawstron also taught the students and care providers about the importance of compassionate and respectful care for the mothers. In many situations after a baby was born, the mother received very little, to no follow-up care. She taught them the importance of skin-to-skin contact when a baby is born, which most Ethiopian midwives are trained to do, but were not putting into practice.
“I realized that working alongside the midwives was more beneficial than I had imagined. Through trust and relationship building with the local staff, I got the sense that new suggestions were better received.
“Role modeling also played a big part in any impact I could have because simply being a Canadian-trained midwife meant a certain standard of care that was different from what I witnessed. I am extremely grateful to return to work in Canada and be a part of this healthcare system. Not only as a care provider, but as a patient. We are very lucky.”
Now home, Rawstron said her experiences in Ethiopia re-affirms her desire to continue on her career path.
“I was like, ‘I can’t wait to be back and providing the care that I do in Canada,’” she said.
“My capacity as a midwife, obviously, is greater here because there I couldn’t speak the language and all of these things. The things that I was really passionate about, like providing women-centred care and providing choice is virtually impossible there, and not part of their basic medical care. It’s exciting to be able to provide that again.”
A midwife cares for a woman and her family throughout the pregnancy journey, Rawstron explained.
“I would say it’s like comprehensive care,” she said. “It’s like having your nurse and doctor in one, because when you have your baby, your midwife does the nursing care but is also there doing the delivery and all of your pregnancy care and all of your nursing care, postpartum.”