Maternity in Cuba

•GISELA Machado Valle watches the movements of her unborn son whose hand stirs in her belly. For more than eight years she has awaited this pregnancy in order to complete her family that already has one daughter. The father shares in his wife’s joy.

For the last ten days, leading up to her due date, Gisela has stayed in a maternal home in Sancti Spíritus, where she receives specialized medical attention for a blood pressure disorder. It could be temporary, since during pregnancy, afflictions occasionally appear that disappear after birth.

In the community where the mother lives, 30 tangled kilometers from the maternity hospital where she will give birth, Gisela received full prenatal care. This period passes through her memory: regular clinical check-ups, dental care, and nutrition.

Not even her husband could “escape” this routine, since in Cuba tests are done on the father as well to detect, in advance, any condition that could be detrimental to the life of the baby, such as those related to sexually transmitted diseases, especially HIV/AIDS. From these tests Ricardo Martínez, knows that he must take care of a liver ailment so that nothing affects the health of his son.

PREGNANCY RISKS

The aspiration of a woman to become a mother requires preparation. Dr. Elena Guerra, gyno-obstetrician at the Raúl González Coro Hospital in Havana, recommends that one first consults their family doctor, who knows how to avoid pre-conception risks.

Family planning services are also available to women between the ages of 18 and 38 in policlinics located in 169 municipalities of Cuba, where those who suffer chronic illnesses, have difficulty conceiving or have had several children are given care.

Expecting mothers who suffer heart problems, diabetes mellitus, chronic hypertension or bronchial asthma, must keep their condition well controlled and consult with their doctor before conception, in order to decrease risks during pregnancy, birth, and fetal development. According to the specialist, malnutrition and anemia in the mother are also hazards.

“When approaching the end of a pregnancy or when a woman shows symptoms of these problems, care is provided in specialized maternity hospitals, to monitor and control the health of the mother, which also implies that of the child,” she assures.

Cuba has developed a Mother and Child Program, which promotes the health of the mother and the child as well as the responsibility of the state and society in their protection. According to the 2004 UN Human Development report, the island is among the countries with the lowest maternal mortality in Latin America, and infant mortality in the world.

The causes of mortality in mothers are related to complications in childbirth, while that of infants under one year are linked to low birth weight and congenital malformations.

TO AVOID CONGENITAL MALFORMATIONS

The principal way to avoid congenital malformation is to know the risk factors present in each woman and couple. “Pregnancy cannot be a chance event, but instead a conscious one. The optimum moment must be determined, during which chronic illnesses are controlled, the diet contains sufficient levels of folic acid, and only the prescribed medications are ingested,” says geneticist Lidia Rodríguez.

“Secondary prevention is also important: a small number of genetic anomalies are possible to detect by various scientific methods (ultrasounds, alpha-fetoprotein, Down Syndrome).

“When the presence of abnormalities in the embryo or fetus are known soon enough, which in Cuba is always before 26 weeks, the pregnancy can be interrupted upon the request of the couple or, in some cases, the mother,” explains Lidia Rodríguez.

Infant mortality has decreased between three and four points over the last two decades with the prenatal detection of congenital afflictions, which are the second cause of death in children under five and the third leading cause in children between 5 and 15, according to the same source.

The universal, no-cost Cuban health care system, the preparation and human quality of Cuban doctors and nurses, and the social equality and political will, in contrast to the reality in the majority of the underdeveloped world, have resulted in the Cuban “miracle”.