Alimaa with her healthy baby girl ©UNICEF/2014/Victoria Colamarco
Alimaa is leaning over and cooing at her newborn baby daughter. The baby is swaddled and wrapped tightly in a blanket. Alimaa has her hair covered, as is the Mongolian tradition. The bond between them is obvious, as is the love Alimaa has for her new child.
“We wanted her so much and have waited for her so long,” Alimaa says. “She is my last baby, as now I have two girls and two boys”.
Alimaa, 39, her husband Boldsihkan 39, sons Amgalanbaatar, 16 and Enkhbaatar, 6, and daughter Anungoo, 12 live in Uvurkangai Aimag (Province) 200 kilometers from Mongolia’s capital city, Ulaanbaatar. The family are nomadic herders and live 27 kilometers from the nearest town. When Alimaa returns, she will take her newborn daughter with her.
For Alimaa this birth was very different her previous three experiences. Firstly it was in Ulaanbaatar, but more importantly the hospital where she gave birth, the National Maternal and Child Health Center is piloting a new birthing practice that will be introduced across the country.
The new practice sees babies after being born placed immediately on their mother’s chest in skin-to-skin contact for the first two hours. This time allows the mother and baby to bond, and allows the baby to initiate breastfeeding in their own time.
Alimaa really liked the new practice. “When the baby was delivered, they put her on my chest and I could feel her on my skin,” she says. “It was so nice. When they did the skin-to-skin contact I loved it. I was really close to my baby. I could talk to here and really bond with her”.
“When I had my other babies, it was in the aimag hospital,” she explained. “After they were born, they took my babies away without asking. I didn’t know where they were taken or why. I was very worried about them and wanted to see them. I didn’t know if something was wrong with my babies”.
But this time it is different. “I don’t have to worry because she is right here”.
Alimaa believes the practice reduced the stress on her daughter. “She is very calm and not crying,” she says. “My other children cried all the time. They were not calm and didn’t sleep well. I am worried that she is not normal, because she is so quiet. But she is very alert and active. She eats and sleeps well”.
And it is not just Alimaa’s baby that is very calm and quiet. In Alimaa’s room there are three other mothers, each with their newborn baby. The room is quiet and calm. All the mothers looked relaxed and well rested, even though just hours earlier they had given birth to their babies.
Improving newborn care
Just a few hours old, Alimaa’s fourth child ©UNICEF/2014/Victoria Colamarco
Alimaa experienced a new birthing practice that is being piloted in the four maternal hospitals in Ulaanbaatar, and will later be introduced across the country. The new practice moves away from harmful and outdate practices, to simple steps that have a major impact on improving the survival and health of newborns.
The new practice includes immediate drying of the baby followed by sustained skin-to-skin contact, delayed cord clamping and early initiation of exclusive breastfeeding.
Dr Oyunbileg, a UNICEF consultant at the National Maternal and Child Health Centre is working to introduce the new practice to all maternal hospitals in Ulaanbaatar. She says the response from the hospital staff has been great.
“A quarter of the scheduled trainings have been carried out, training nurses, midwives, doctors and specialist in the new procedure,” she says. “After the trainings, I regularly visit the maternal hospitals to observe the practices and to provide advice and feedback on how staff can improve it.”
“I also talk to the mothers and I ask them what they think. They are very positive about the new practice and encourage us to continue”.
Dr Oyunbileg explained that the plan was to expand the practice nationwide. “Once we perfect the model, we can scale it up and implemented it in other parts of the country.”
Turning the trend around
UNICEF Health Specialist Dr Surenchimeg Vanchinkhuu says children under five were most likely to die during the first 28 days of life. “Of the 2,000 under five deaths in Mongolia each year, 42 per cent occur during the first 28 days of life,” she says.
“We need promote high impact, lifesaving interventions in delivery rooms that will improve child survival during this very vulnerable stage of their life,” Surenchimeg explains. “The new practice, was developed based on evidence, incorporates simple procedures that will significantly improve a child’s chance of survival past the first 28 days of life”.
“The new practices helps to keep babies warm, improves their breathing and circulation and establishes early breastfeeding which is key to developing their immune systems,” Dr Surenchimeg says. “They are simple interventions, but very effective.”
“Instituting a nationwide process, that is the same wherever you go, that uses these best practices will help children survive past the first 28 days of life, and improve Mongolia’s child mortality rate”.
For Alimaa, she isn’t worried the reasons why the new practice has been introduced. “I wouldn’t want to change this experience, with the skin-to-skin contact for anything,” she says. “Every mother should have the opportunity to experience this”.
Zetty Brake is the Communications and External Relations Officer at UNICEF in Mongolia