The ‘mananabang’ killed (1st of 2 parts)

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Tuesday, July 29, 2014

THE term ‘mananabang,’ which is a Cebuano term, is used to identify people, mostly women who assist the delivery of births but without any formal training in the disciplines of midwifery, nursing or obstetrics.
In the Philippines, they are formally called the ‘Traditional Birth Attendants” (TBAs) in contrast to the Skilled Birth Attendants (SBAs), who may be a doctor, nurse, midwife or the specialized ‘nurse-midwives’ (health professionals who hold licenses both in nursing and midwifery as in R.N., R.M.).

On the other hand, the Tagalog regions in the country commonly address these TBAs as “hilot.”

Allow me to share a recent experience with what a ‘mananabang’ has done to a patient.


Last week, while supervising and coaching midwifery students in handling actual deliveries in a health facility in Tagoloan, Misamis Oriental, a ricocheting Multicab arrived at the main gate of the said facility.

At the back of the vehicle laid a woman wrapped in layers of blankets. She was pale, in pain and was in a delirious state of mind.

She was surrounded by two women and a man who were all her relatives.
One of her significant others said she was delivered by a ‘mananabang’ at home in their far-flung community.

The midwives and other health personnel of the facility responded promptly.

As we did our assessments and history taking, our initial findings revealed that the woman had delivered a stillborn and she was in active bleeding.

The dead newborn baby was lying flat on the cold metallic floor of the vehicle beside the hemorrhaging mother. It was a baby boy.

His dark blue color tells of his negative respirations. With no vital signs, his umbilical cord had yet to be cut and the placenta was still inside the woman’s body.

Upon inspection, there were multiple lacerations of various sizes scattered on his lower legs and one on the head.

Working collaboratively, we managed to expel the placenta out, controlled the bleeding and rendered post-mortem (after-death) care of the baby.
As we explored further the case of the rushed patient, we realized she was just 17 years old.

Her female companion confessed that they had seen the mananabang pulled the baby out.

And so based on our probing, we had arrived at the theory that maybe the baby had a breech presentation (the feet out first instead of the head).
The companion then narrated what she had seen which is paraphrased as follows: “The mananabang forcibly pulled the baby out of the mother’s vagina.”

After successfully doing so, “she turned the baby upside down with the umbilical cord dangling and harshly slapped the buttocks several times to stimulate the baby to cry.”

When all her efforts failed, she allegedly shook the baby many times and then turned and tossed the poor boy up and down for it to cry but to no success.

As the baby turned deeper blue, the mananabang allegedly fled, abandoning her patients at the mercy of the latters’ relatives who were present at home.

Thus, their last resort was the health facility.

According to the 2009 study of the United Nations Children’s Fund, the following are the plausible explanations why despite their lack of educational preparation and professional eligibility, some persist to avail the services of the pseudo-health practitioners:

(1) Distance of the patient to the health centers or stations especially those living in the hinterlands, mountains and those with unfavorable roads;

(2) The cost of SBAs’ services that usually plays around P10, 000 for doctors, P7, 000 for nurses and P2, 000 for midwives compared to the P1, 0000 charged by the mananabang; and (3) There is an empirical evidence that suggests that the mananabang is not only present during delivery but also stays after to feed the patient, wash the latters’ clothes and takes care of the baby like a nanny compared obviously to a doctor, nurse or midwifes who leave immediately upon stabilization of the patients’ vital signs.

(To be continued on Friday, August 1, 2014) [Email:]

Published in the Sun.Star Cagayan de Oro newspaper on July 30, 2014.


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