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A Look Inside Maternal Waiting Homes » Women's Courage

A Look Inside Maternal Waiting Homes

January 31st, 2013 by amanorot Leave a reply »

Maternal waiting homes are residential facilities built with the intent on improving access to skilled birth attendants and emergency obstetric care for women living in remote areas.  These homes are within easy reach of a hospital or health center equipped with medical supplies and trained staff that can give antenatal and emergency obstetric care. The homes are especially useful for women identified with a high-risk pregnancy as it allows them to be near life-saving services they may need. In some locations, women can access a nearby maternal waiting home up to three weeks before her expected due date. At the home traditional birth attendants will provide education on health, family planning, and breastfeeding (1). Once a woman goes into labor and should complications arise she can be promptly transported to a nearby hospital for delivery.

This concept of a maternal waiting home has been documented in the literature since the 1960s and in 1991 the World Health Organization highlighted the potential advantages of implementing these homes as a part of addressing high rates of maternal mortality in the developing world (2). Since maternal waiting homes have become a popular strategy in health systems in developing nations and have received support from large donors and the United Nations. Maternal waiting homes are based on the premise of identifying pregnancies that may result in complications. Women defined as ‘high risk’ include those expecting their first delivery, with many previous births, very young women, and older women with pre-eclampsia (high blood pressure). These homes do not require high technology and rely on resources within the community.

As maternal waiting homes are a large investment in terms of infrastructure, their efficacy is often questioned and little research has been done to assess if they increase the number of women in remote areas to use hospital services to deliver (2). There are also barriers that prevent women from using maternity waiting homes. Various barriers are listed as follows:

  • The cost of staying in a maternity waiting home may exceed costs of home delivery.
  • If homes are crowded, poorly staffed, unsafe at night, or lack water and food
  • Lack of transportation to the facility
  • Lack of respect from staff
  • Home locations may still be far from a hospital that provides emergency obstetric care.   (3)

Cost is at the top of the list of barriers preventing women from using maternity waiting homes. Women are expected to pay for their meals and make voluntary financial donations. The staff may not speak indigenous languages and some homes do not allow women to have family stay with them making them feel isolated. Traditionally many cultures have women give birth in a kneeling position so when women are brought to the hospital and required to lie down they are made uncomfortable. Strategies to make maternal waiting homes more attractive for women are to provide birthing chairs which allow women to deliver in a sitting position, providing more well equipped maternity waiting homes, developing a standardized protocol of services, providing more sexual health/prenatal education, and culturally acceptable care (4).

  1. http://www.womendeliver.org/updates/entry/celebrate-solutions-maternity-waiting-homes-in-liberia/
  2. http://www.who.int/bulletin/volumes/90/2/11-088955.pdf
  3. http://supportsummaries.org/support-summaries/show/do-maternity-waiting-homes-improve-maternal-and-neonatal-outcomes-in-low-resource-settingsa
  4. http://www.pahef.org/en/successtories/39/23-maternity-waiting-homes-.html
  5. http://www.nyasatimes.com/wp-content/uploads/2012/11/inside-the-shelter.jpg (photo)
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2 comments

  1. Magali says:

    I wonder how women are screened as “high risk”. I’d really like to know how useful the maternal homes are in attracting women who will have complications at birth. To me, it seems like in rural areas, only women who are actively involved in their pregnancy and have regular check ups will know enough about the complications of birth to seek these services to begin with. It’d be interesting to know who these maternal homes cater to (especially after mentioning those barriers), and how they can be re-structured to include more women who don’t know complications can arise until it’s too late.

  2. crennels says:

    I didn’t know much about maternal waiting homes in developing countries, so I was interested to read this post. I appreciated that you highlighted the importance of the homes being targeted and shaped to the future mothers. With something as intimate as childbirth, it is important that these women feel comfortable and at home. Increasing affordability and cultural sensitivity will make this resource, which sounds so helpful in theory, an unquestioned benefit for these women.

    It seems that making some of the shifts you suggest costs very little relative to the financial commitment of building the homes in the first place; for instance, providing birthing chairs seems a very cost-effective way of making women feel more comfortable as they give birth. It will be interesting to see how maternal waiting homes change in years to come, and if the focus on cultural sensitivity leads to meaningful improvement of experience for these women.

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