CITY OF MALOLOS—About 75,000 licensed private practicing midwives in the country who were also front liners during the COVID-19 pandemic after they catered to pregnant women and their new born babies, now have expressed sentiments they are being treated less and are being discriminated.
Dionica Saquilon, National President of Integrated Midwives Association of the Philippines (IMAP) joined by other national and regional midwives groups presented to media on Tuesday in Angeles City their position letter addressed to Department of Health (DOH) Secretary Teodoro asking for review on the Department Circular N0.2021-005, otherwise known as the Adherence to the Definition of Low Risk and High Risk Pregnancy in the Implementation of Administrative Order No.2012-0012 – Rules and Regulations Governing the New Classification of Hospitals and other Health Facilities in the Philippines.
“We wanted to convey our sentiments during the time of the Covid Pandemic, wherein birthing homes and lying-in clinics cater on the maternal need of pregnant women, practicing strict infection control measures. Our contribution during the pandemic addresses these needs and lessens the chance of spreading the virus among pregnant women and unborn children. That up to these days, we are a contributory factor in decongestant of hospitals, particularly government owned hospitals in decreasing non complicated normal deliveries,” Saquilon added.
According to her, the circular is discriminatory because it limits the midwives to only handle low risk pregnancy cases contrary to earlier circulars that allow birthing stations to handle low risk cases. “Whereas, the Department Circular 2021-0005 specifies the operational definition of low risk pregnancy and that of high risk pregnancy. Stating that birthing homes and the like are allowed to cater low risk pregnant or women who are low risk of complications during pregnancy among others; Whereas, the issuance of Department Circular 2021-005 supplements Department Order 2021-0012, wherein the said administrative order did not specify nor mentioned in any of its provisions and sections stating that birthing homes and the like to cater only low risk pregnancy”.
Saquilon and her group also assails as unacceptable a provision in the said circular that states that “pregnancy among women who are more than 35 years old regardless of parity is considered as High Risk and are not allowed to give birth to birthing stations”.
There are 547 birthing centers all over the country.
However, Saquilon reiterates that all of them about 75,000 midwives in the country observes, respect and are long compliant to the DOH rule that high risk pregnancy cases must be handled by licensed obstetricians in the hospitals.
“Whereas, these birthing clinics have been consistently compliant with different DOH administrative issuance on facility standards and required equipment’s to ensure that there will be no maternal and infant morbidity and deaths because the undersigned believed that these are predictable, preventable and treatable if the facility is compliant with the licensing standards and training requirements”.
The position paper was duly signed by Saquilon, National Executive Director, Amethyst Castro, President IMAP/PPMA – Region 3, Lany Manaloto, President, IMAP, Region 3, Nely Cuenca,1st Vice President, Bulacan Chapter, Corazon Dela Cruz, 2nd Vice President, Nueva Ecija Chapter, Cecilia Paguio, Bataan Chapter, Zenaida Ferrer, Auditor,Tarlac Chapter, Gwendolyn Tungol, Board of Director, Pampanga Chapter,a nd Flocerfida De Castro, Board Director, Olongapo Chapter.
According to the midwives, the DOH order will not address the maternal and neonatal deaths but rather worsen its number because instead of having delivery in a midwife-owned birthing clinics with skilled birth attendant, they might avail home deliveries under the services of “hilots”, that are now happening on some parts of the region.
They added that the midwife-owned birthing clinics are manned with skilled birth personnel (midwives, nurses and physicians) who are equipped with the competencies on basic emergency obstetrics and new born care and are compliant to the minimum facility standards set by the DOH.
They also said the circular is in “contrary to Republic Act 10354 (Responsible Parenthood and Reproductive Health Act of 2012) which eradicate discriminatory practices, laws and policies that infringe on a person’s exercise of reproductive health rights which guarantees universal access to medically-safe, non-abortifacient, effective, legal, affordable and quality reproductive health care services. As this policy inhibits the freedom and right of choice of the primigravid and multigravid women to access quality maternal and neonatal services which are holistically given by a midwife-owned birthing clinics”.
“That, this administrative order will not address the maternal and neonatal deaths but rather worsen its number because instead of having delivery in a midwife-owned birthing clinics with skilled birth attendant, they might avail home deliveries under the services of hilots, that are now happening on some parts of the region. Their decisions might be influenced by their experiences in the hospitals: rejection for admission, poor delivery services, un-therapeutic approaches of government hospital personnel, unfavorable and overcrowded hospital environment and unexplained hospital bills. The growing number of cases of a Cesarian section also attributes the referrals of the primigravid and multigravid cases”.
“That, the Department Circular will never help us address the call of the government sector and will just worsen the need for additional bed capacity in the hospital settings. We will never achieved our vision to heal as one if we will not work as one”.
“We therefore ask your good office for a review regarding this issuance’s and to clarify matters on the specific provisions of the clarification circular in order for us to have comprehensive partnership with all the concerned professionals, government agencies and other partners in the care of mother and child,” the position paper further stated.