Midwife saves child mother births in mountainous province

The 51-year-old head midwife said that the young woman, 33 weeks pregnant, had been treated for over two hours at a district medical center. However, severe bleeding, escalating blood pressure, and seizures had necessitated her transfer to the provincial hospital.

After more than four hours, the patient arrived unconscious. Following a swift consultation with a doctor on duty, Ha decided to proceed with emergency surgery.

The surgery was completed successfully that afternoon, and a 1.8 kg baby boy was delivered into this world.

The team, including Ha, were finally able to breathe a sigh of relief.

"I feel both joy and sorrow every time we help an underaged pregnant patient," she said, recalling the incident on April 18.

Head midwife Hoang Thi Thu Ha gives antenatal care to a mother in labor at the obstetrics department, Dien Bien Provincial General Hospital, April 2024. Photo by Thanh Nga

‘I had to comfort them’

Ha has spent decades helping teenagers, many of them from ethnic minority communities in the mountains, give birth.

Reflecting on her early career in 1994, Ha, then 21, was shocked to encounter pregnant girls as young as 14 and 15. She struggled to believe school-aged girls were becoming mothers before their bodies were fully developed.

Language barriers were a significant challenge for the midwife.

Whenever Ha examined a pregnant woman from a non-Vietnamese community, the patient was often afraid because they couldn’t speak the Vietnamese language.

The necessary translator summoned could then sometimes be seen as another burden by the inexperienced mothers who easily viewed them as just another stranger in a room observing her most vulnerable and private moments.

Many young pregnant women, unfamiliar with reproductive health care, refused hospital treatment and preferred home births.

"I had to comfort them on a daily basis so they would be more willing to undergo examinations. Ensuring they received adequate nutrition for childbirth was also a concern," Ha recalled.

Still troubled

The midwife said that when a pregnant woman under 18 years old is in labor, she must be taught endurance, how to breath properly and how to hold her hands and feet in the correct position. In the delivery room, Ha would encourage frail and unhealthy patients by promising them rewards if they helped facilitate safe labors and births.

Most pregnant women from remote ethnic groups also lacked postpartum preparation. Ha frequently used her salary to buy newborn supplies or solicited donations to ensure the babies had essential items.

Despite her 30 years of experience, Ha is still troubled by the high number of underage pregnancies. These young mothers face significant risks such as poor fetal development, the threat of miscarriage, premature births, pre-eclampsia, and difficult labor. Home births risk serious infections, retained placentas, torn perineum, and uterine infections.

Patient Vang Thi Mua, who gave birth prematurely at 33 weeks, exemplifies these challenges. Both mother and child required extended hospital stays after birth for intense monitoring. Ha not only provided postpartum care but also sought financial support for their hospital fees and meals.

17-year-old pregnant woman in Dien Bien City, Dien Bien Province and her husband after she gave birth, April 2024. Photo by Thanh Nga

Child brides

In 2023, the hospital received over 60 teenage pregnancy cases, primarily from the Thai and Mong ethnic communities. Statistics show that between 2021 and August 2023, Dien Bien experienced over 11,500 marriages, with 3,200 involving child brides. Dien Bien Dong District alone recorded 83 early marriages among 330 unions in 2023.

Tran Duc Trong, Head of the Ethnic Department of the district, said that child marriages contribute to poverty and inadequate medical, cultural and mental care for children. He emphasized the need to change the mindset and awareness of highland communities to eradicate ingrained outdated customs.

Unlike Vang Thi Mua, Giang Thi Di, 16, faced a tragic outcome. Hospitalized for premature labor at 22 weeks, her baby died 15 minutes after birth. Di and her 18-year-old husband were left devastated.

Ha noted that Di had only seen a doctor once during her pregnancy despite constant abdominal pain. When her condition worsened, she sought hospital care, but it was too late to prevent premature birth.

"These young mothers cannot care for themselves, let alone their babies," said Ha. "I hope for an end to child marriages so they can understand the sacredness of motherhood and take responsibility for themselves, their families, and society," she said.

*Names have been altered to maintain the anonymity of the interviewees.