Deputy Health Minister Datuk Seri Dr Hilmi Yahya said doula in Greek means women’s slave and the purpose of doula was to assist expectant mothers in giving them advice and massages, not to assist in childbirth. NST FILE PIC

KUALA LUMPUR: The controversial practice of ‘doula’ (childbirth helpers) in Malaysia can deemed as extreme, with some expectant women even being advised to give birth at home despite not knowing the mothers’ medical history.

Deputy Health Minister, Datuk Seri Dr Hilmi Yahaya, said even in the United States, expectant women are not advised to deliver at home or placed in situations which could prove harmful to them or their babies.

He said there are still some parties who are even linking the practice to religion, such as by saying that even Maryam gave birth to the Prophet Isa without any aid.

“They are very convincing and in the end, the women are swayed into giving birth at home,” he said in response to a question by Shamsul Iskandar Mohd Akin (PKR-Bukit Katil) in the Dewan Rakyat yesterday.

Shamsul had asked the minister to state the proactive measures and legal action that can be taken by the ministry to curb doula activities, where most helpers have no medical training. He had also asked whether the percentage of unsafe deliveries and infant mortality has escalated due to this practice.

Dr Hilmi said the ministry fears that there may be a rise in deaths if more babies are delivered at home.

“In Greek, doula means a female slave whose original purpose was to aid pregnant women, such as by giving advice and massaging them, but they cannot deliver the babies.

“As such, those who want to aid in the childbirth process must be registered and certified,” he said.

He said Malaysia has nevertheless recorded a decline in the percentage of unsage deliveries - down from 7.1 per cent in 1990 to 1.3 per cent in 2012, and 0.42 per cent in 2016, compared to the average birth rate of between 440,000 to 450,000 annually.

He said analysis reports showed that there are three main factors which contribute to unsafe deliveries - lack of transport to a medical facility, the home located far away from medical facilities, and the large number of illegal immigrants who deliver at home.

“Since 2014, the percentage of unsafe deliveries due to the influence of doula is less than 0.5 per cent.

“However, there has been an increase in the number of unsafe deliveries via doula activities, where two births each were reported in 2014 and 2015.”

This figure, he said, rose to six in 2016 and seven in 2017.

“As a result of the doula practice, three newborn deaths were reported; one each in 2016, 2017 and the latest in January this year,” he said.

Responding to a supplementary question by Dr Mansor Abdul Rahman (BN-Sik) on whether the Health Ministry plans to recognise doula activities by imposing legal controls under Section 14(1) of the Midwives Act 1966, Dr Hilmi said the law is clear, whereby those who deliver babies must be certified.

“If they are not certified and registered, then it is wrong. The law is clear. It is only that some people take advantage of the situation by convincing these expectant women to deliver at home.

“It is fine if you want to deliver at home, but there must be a certified midwife present to handle the situation.

“What’s important here is that we must weigh the risks involved. Many expectant mothers nowadays have high-risk pregnancies. Factors includes diabetes, high blood pressure, placenta previa (placenta lying unusually low in the uterus, next to or covering the cervix) and many more.

“If there are high risks involved, then you have to go to a hospital. The doula should only act as a companion to the mothers,” he said.

Reporting by Mohd Anwar Patho Rohman, Idris Musa, Rizanizam Abdul Hamid, Luqman Arif Abdul Karim,Farhana Syed Nokman and Nor Ain Mohamed Radhi

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