Doulas cannot replace trained personnel in childbirths

PETALING JAYA: Doulas – whose role is to give emotional support to mothers – cannot replace trained midwives or doctors in childbirths, said the Malaysian Medical Association.

Its president Dr Ravindran R. Naidu said while some mothers opt to deliver at home in their belief that labour without medical intervention is a natural process, a birth is unsafe if it is not supervised and conducted by trained midwives or doctors.

“In Malaysia, home births are not supported by doctors, medical professional societies or the Health Ministry.

“If the delivery is conducted at home without trained midwives or doctors, the complications may be severe, irreversible and, on occasions, life threatening,” he said.

Among the complications to the mothers are severe bleeding, fits, ruptured uterus or infections.

Babies may suffer brain damage, fits, physical or nervous system injuries if the labour is not monitored and complications go undetected.

“In serious cases, both mother or baby may die as in some instances in the past,” he said.

Checks by The Star on several local doula websites show that a full service fee is about RM2,100.

Facebook account handler Medical Mythbusters Malaysia also issued an open letter asking for intervention to create awareness among the public on the issue.

The Health Ministry in a statement issued yesterday confirmed that the baby who died after undergoing an unsafe delivery in Johor Baru on Feb 4 passed away due to asphyxia after the baby’s head was stuck in the mother’s perineum during the breech deli­very.

Health Ministry director-general Datuk Dr Noor Hisham Abdullah said the delivery of the baby was assisted by a non-healthcare professional who is also not accredited to handle childbirth.

“The ministry expresses its condolences to the parents and relatives of the baby.

“We view this seriously and are saddened over the demise of the baby, especially when it is a case of avoidable infant mortality.

“The fast-growing pace of the health sector and the implementation of various maternal and child health initiatives especially during the post-Merdeka era has seen a sharp decline in maternal and infant mortality rates to a very low level, equivalent to that of developed countries,” he said.

For the whole of 2017 in Johor, there were 58 cases of unsafe deli­very where five were home births which were related to doulas and two of those deliveries were high-risk cases.

Statistics from the Health Ministry’s Family Health Development Division stated that there were two maternal deaths in 2013 and an infant death in 2016 due to unsafe deliveries related to doulas.

Federal Territories mufti Datuk Dr Zulkifli Mohamad Al-Bakri ruled that doula services are not allowed in the absence of a trained medical professional.

“After scrutinising the issue on top of seeking information from medical experts, we are of the opinion that engaging in the services of a doula is not allowed without the observation of a trained doctor or midwife,” Dr Zulkifli said in a statement.

He said refusing to give birth at the hospital due to the issue of aurat is not a valid reason as one’s life takes precedence.