Intervention Needed For Asian Mothers, Babies

The study  shows that while some best care practices have been implemented in hospitals in South-East Asia, a number of worrying practices remain and more needs to be done to improve mothers' and babies' health.

For women in Asia, the lifetime risk of dying during or shortly after a pregnancy is one in 65 compared with one in 1800 for women in developed countries. For newborns, mortality rates are almost 10 times greater in South-East Asia than in developed countries.

For the study, researchers in Australia and South-East Asia conducted an audit of medical records of 9550 women and their infants who were admitted to the labor wards of nine hospitals across Indonesia, Malaysia, the Philippines and Thailand throughout 2005.

"The audit found that many professional health care workers in South-East Asia had implemented best practice for pregnant women and their babies prior to and immediately after birth, but there were also many cases that diverged from recommended practice," says one of the Chief Investigators of the study, Professor Caroline Crowther from the University of Adelaide's Discipline of Obstetrics & Gynecology.

"These practices included: not administering appropriate antibiotics to protect against infection during cesarean section; too liberal use of episiotomy (surgical incision through the perineum) for women having a vaginal birth and the use of enemas during labor, both of which were often inappropriately practiced."

The audit has been conducted as part of a major international research effort called SEA-ORCHID (South East Asia Optimizing Reproductive and Child Health In Developing countries Project). 

Funded by an International Collaborative Research Grant from the National Health and Medical Research Council of Australia (NHMRC) and Wellcome Trust, United Kingdom, the study group comprises three Australian universities (University of Adelaide, Monash and Sydney) as well as Gadjah Mada University, Indonesia, the Royal College of Medicine Perak, Malaysia, the University of the Philippines and Khon Kaen University, Thailand.

Professor Crowther says the SEA-ORCHID Group hopes to improve health outcomes for mothers and their babies in the region by building research capacity and applying research evidence into clinical practice.

"By identifying gaps in knowledge needing further research and implementing effective interventions, our SEA-ORCHID research group hopes to save many lives throughout the South-East Asian region. Based on this audit, it's clear that some intervention is required," she says.

The full audit - "Use of Evidence-based Practices in Pregnancy and Childbirth" - can be found online at: http://www.plosone.org/doi/pone.0002646