*Trigger Warning – in speaking out against birth violence, this article contains an image and descriptions that may be highly distressing. Please exercise discretion before proceeding*
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Midwife Training Film – YouTube
Training in what NOT to do
As of July 2012, there have been over 11,000 hits on this 1989 “training” film made in Gambia, Africa.
Contrary to the captions in the film, this doctor did not save this baby’s life from umbilical cord strangulation.
The doctor, described as head of obstetrics, exposed this baby to the risk of an hypoxic-ischemic injury caused by pre-birth amputation from the placenta.
(hypoxia-ischemia = insufficient oxygen and blood supply)
Although this film was shot in 1989, pre-birth cord cutting is still being performed in many places and remains a preventable cause of death, brain damage, trauma and harm.
Despite the title, this film should never be used for training midwives or anyone else involved in birth.
Loose cord around the neck is not umbilical strangulation
The cord around the neck (nuchal cord) was loose – posing no interference to the birth or risk to the baby.
The film shows the baby shoulders were rotating easily when the doctor double clamped and cut the cord.
The baby girl was only seconds away from being born when her blood vessels were clamped off in the umbilical cord – removing her oxygen supply and ‘fixing’ her with an insufficient blood volume for a safe, normal transition at birth.
Due to his training, this medical practitioner subjected this vulnerable newborn to the potential risks of:
- fatal blood loss
- severe shock from blood loss
- hypoxic-ischemic brain damage
- cerebral palsy
- respiratory distress
- severe anaemia imposed at birth, in a country where maternal anaemia is high and infant anaemia is estimated 75% and a significant cause of mortality (Gambia, Africa)
- developmental delay and cognitive deficits
This “management” of the umbilical cord was unnecessary and lacks any basis in logic or scientific evidence.
(See here for a review of nuchal cord management and the lack of evidence for pulling, clamping or cutting a nuchal cord)
Assault instead of resuscitation and support
To add to insult, this training video shows the baby girl was unable to breathe for over 2 minutes and was not provided resuscitation (longer if you calculate from the moment the cord was clamped).
Instead, she was repeatedly smacked, painfully rubbed, held upside down, and actually dropped with her head titled backwards on one occasion.
This baby was suctioned so painfully she can be seen trying to push the suction bulb away. It was revolting to watch her retch and gag while struggling to even breathe.
Once this baby was able to breathe enough to cry, the doctor hit her again so hard she squealed in pain.
Yes, this birth occurred in a resource-poor setting in a developing country…but this assault on normal birth physiology and lack of care is not appropriate, not anywhere and not ever.
The knowledge that this baby’s condition at birth was iatrogenic (caused by the doctor) just makes this treatment even worse.
This is one of the most violent assaults on an infant by a practitioner I have ever watched- it is devastating to think how many infants have been treated this way!
A link to this video has not been included in this post – as stated above, it contains some of the most distressing images of birth I have seen captured on film.
In speaking out against the brutality and dangerous misinformation in this film, I must also acknowledge the mother’s trauma.
This women has been subjected to female genital mutilation and the premise of the film is she required an episiotomy in order to give birth. She was used for training purposes and it is possible (likely) she gave no consent to being filmed. Her baby was seriously mistreated and she witnessed this battery for minutes after the birth.
Wthin four minutes of birth, the doctor prematurely pulls the placenta from her body and starts to dig his fingers into her uterus, ignoring her pain.
I have to say how so sorry I am for their needless pain and suffering, caused by obstetric violence and absence of physiology in research and training.
For more information about Obstetric Violence, please read this article by New Zealand academic Sarah Stewart
To read about women-directed efforts to improve birth safety in West Africa, see African Birth Collective
For information and support regarding birth trauma, please check for organisations closest to you.
Examples of organisations where you can seek support, understanding and resources are: