America, Auto Bulk, Canada, Community, Culture, Development, Donna Luangmany, Education, Health, History, History, Immigration, Interviews, Lao, Lao American, Lao Canadian, Lao Diaspora, Laos, Lifestyle, Medical, Refugee, Southeast Asian, United States
comment 1

Maternal Health Care: A Midwife’s Tale

This is the second part in a series exploring the profession of a midwife and their value at birth. You can find more information about the profession and the first piece here.

The phone rings, rousing her from a slumber. On the other end of the line, a pregnant woman is deep in the throes of labour. It’s the height of the night. But as the new mother is about to discover, babies have no regard for schedules. The rhythm and regularity of her contractions suggests that birth is imminent. The freshly woken woman heads out to attend the delivery. For Bounmy Inthavong, it’s just another day on the job.

Bounmy is a midwife practicing in Peterborough, Ontario, Canada. Though she’s been catching babies since 2015, her interest in women’s health has been a lifelong passion. The daughter of Lao refugees, she discovered the value of patient-centered care at an early age.

“My brother and I were born in refugee camps. My dad had to deliver us because the births went so fast and crazy. My parents speak very highly of those experiences. There was such a sense of success. My sister’s birth in Waterloo (Canada) in 1991 was different. Doctors found tumours and cysts, and wanted my mom to terminate.

How do you make decisions like that when you don’t speak the language and have two young children? She was so stressed and afraid. After the birth, she was rushed away. It was such a whirlwind. Suddenly my dad was alone with this newborn.”

Because her sister was born in perfect health, it was an idealized western birth. But the experience was marred by the barriers her parents encountered. Something as basic and simple as a consent form is daunting when you don’t understand the language it’s written in. Bounmy imagined how she could have helped in this situation. “Had I been her care provider, I would have been able to help her understand, and give her agency.”

Bounmy was inspired to pursue a medical career. Many encouraged her to become a doctor, but it didn’t fit with her desire to work in women-centered health. Specifically, she wanted a role that allowed her to support vulnerable populations. It wasn’t until she headed abroad that she found the direction she’d been looking for.

Study trips offered a glimpse of maternal care across the globe. Bounmy traveled to South Africa and the UK during high school and university. While on exchange at Leeds University, she was given a hands-on introduction to midwifery. Her interest was sparked. After returning home, she applied to the 4-year midwifery program at McMaster University.

Bounmy’s training and work have taken her all over Ontario. She’s assisted women from Windsor to Peterborough, and in between. While practicing in Canada, she’s continued to make international connections.

In early 2017, a LinkedIn invitation landed in her mailbox. It was from Anna Af Ugglas, a Swedish midwife who had worked in Laos through the United Nations Population Fund (UNFPA). The two found common ground over a shared profession and a country that, funnily enough, neither of them were currently living in. Bounmy accepted her request, unaware of the journey they were about to set in motion.

Their conversation eventually turned to the International Confederation of Midwives (ICM), a global organization uniting midwives from around the world. With ICM’s triennial congress approaching, Anna was preparing a presentation on midwifery in Laos. She was well-versed on the latest developments. But having a Lao representative in attendance would connect the country onto the international playing field. Anna even had the perfect candidate.

Phouthone Chanthalansy has a long history of bringing babies into the world. In her youth, she attended labours and deliveries with her mother, a traditional birth attendant. The two worked with few supplies, often times without electricity. Despite meagre resources, they were a valuable asset to a community that had no other options. As she grew, Phouthone decided to add official training to the repertoire of self-taught skills her mother had passed on. Her schooling led her to work as a hospital midwife before moving onto teaching. Phouthone currently trains students at the University of Health Sciences in Vientiane. She’s also set to become president of the currently-forming Lao Association of Midwives (LAM).

Phouthone wanted to make the trip, but traveling to Toronto, Ontario was financially out of reach. Bounmy organized a fundraising project to cover the cost of travel and the congress registration fee. The venture drew international support from countries like Sweden and Amsterdam. In about 5 months, she raised over $5,200. Not only did it cover Phouthone’s expenses, but there were also leftover funds to donate to LAM. The trip was a once-in-a-lifetime experience for the Vientiane midwife. And for Bounmy? She discovered that women’s health carries universal themes no matter the location.

~~

We recently spoke with Bounmy about her fundraiser, and the growth of midwifery in Canada and Laos.

Why is women-centered care so important?

I don’t think women in society get enough voice. Labour and delivery are something that only we can do. People who birth here see it as a chore instead of sacred. Birth is rooted in tradition in lots of cultures. But once you get into an institution, it’s controlled and regulated. It’s seen as systematic.

What happened to my mom [nearly 30 years ago] still happens today. Women shouldn’t be in situations like that.

In a recent conversation with Siriphone Sakulku, the program coordinator for UNPFA, she said that pregnant women don’t need much to be cared for. What do you think the most important part of pre-natal care is?

I think we pretty much need to be heard, and not forgotten. Just taking the time to ask, “Are you okay? Do you have any questions?” can make a world of difference.

What else inspires you and your work?

Like most immigrants, my parents are my biggest inspiration. My parents met and decided to come to Canada. They ventured to a refugee camp and had two kids there. When we came to Montreal in 1990, there wasn’t much family support. My parents had to find their own way.

My dad doesn’t speak English well. But he’s had a job basically the whole time he’s been here and made sure there’s always food on the table. My mom is outgoing and very giving to the community. They worked so hard to keep their identity and get to where they wanted to be.

To see two people who can’t really merge fully into society [because of language barriers] but still have children who are all educated and established is inspiring. Their resilience and love for their family motivated me to become who I am today.

What does being Lao Canadian mean to you?

Family means everything to me. My parents taught us to be patient, mindful, kind, and generous. As a Lao Canadian, I think it’s important to take the opportunities this country has given us [and do some good]. I took my skills and proficiencies in the English language and used them to help those who can’t navigate the system.

What do you enjoy about your job?

I love educating women to be their own agents, establishing trust so that people feel they are part of their care, and not just a number. I especially like working with immigrants. Seeing women make their own decisions, instead of doing things because they feel like they need to, is empowering.

The connection between mom and baby at birth is amazing. My mom says to me, what she misses from pregnancy, is that it’s this little secret you have for nine months. And all of a sudden this secret comes to life. As a midwife, I get an incredible glimpse into the life of a family. To see the moment mom, dad, and baby fall in love. It’s a miracle to witness. And I get to help with that journey, to advocate for it.

It’s not just a North American thing. Birth is universal. It’s beautiful, powerful, and sacred.

Let’s talk about the ICM fundraiser. What was your favourite memory from that, and bringing Phouthone to Toronto?

Getting her connected to the Lao community in Southwestern Ontario was beautiful. Phouthone met people everywhere, and she was just amazed at how Lao people still appreciate each other. Phouthone got so much joy from spending time with Lao people from Canada. She talked about the hospitality and friendship she experienced. She really felt loved. I was happy to give that to her.

What did you learn about midwifery in Laos and Canada. How are they connected?

The biggest thing that we sometimes don’t see is the parallels in the two places. There are big differences between the high and low resources. But there are similarities, too.

Here, we have centralized care in Ottawa and Toronto. It’s difficult to reach people in rural and remote areas. The Aboriginal communities have different cultures, languages, and stigmas. All of these sacred things have to be met in birth.

It’s the same in Laos. Some women have to leave in order to get adequate care. But sometimes people want to stay in their villages. So there’s an increased rate of mortality and morbidity. We face very similar challenges in Canada and often take for granted what we have here. There are still people living in remote areas in Canada who have the same situation.

Things are happening in both countries and there are ways we can work towards improvement. Midwifery is still growing – it’s only 10 years old in Laos. They’re trying. There’s a lot of government agency and UN support that’s needed. The balance needs to come. You have to be able to show that you’re not stepping on their culture or tradition. Midwifery is moving towards culturally sensitive care in both countries.

Speaking of the future, where do you see yourself in the next five or ten years?

I might end up possibly teaching clinical skills, whether in Canada or internationally. If you produce good students, then you’ll produce good professionals.

I’d love to work internationally, providing emergency skills and women-centered care. A lot of the world hasn’t moved towards that yet. In Ontario, we are still trying to grow. Not that many people know about midwifery. But they will.

What else do you want people to know? What would you tell other refugees and immigrants?

If you find yourself without personalized care, or if you know someone who might benefit from that advocacy and time, then midwifery is for them. That personal touch – some jobs don’t have much time, but we do. We are funded for longer appointments. Sometimes it’s all someone needs when coming from trauma, or if English isn’t their first language.

For everyone: take the time to talk to your parents. Your birth is something they will never forget. That joy – it’s a memory that isn’t clouded.

Ask them what they went through to get here. I think that’s the biggest thing.

We always hear whispers when we’re younger. But stories from your parents will grow louder as you grow. When you’re younger, you only know what’s glamorous, instead of what’s truthful. You realize the extent of the vulnerability, the turmoil, and the risks that were taken by your family when you ask as adults.

Write those stories down. It’s so important. One day they won’t be here, and neither will those tales unless you record them. History is going to go the second our parents and families pass away. I always want children of immigrants to realize that, and to appreciate it.

– Donna Luangmany, dluangmany@gmail.com

1 Comment

  1. Awesome article. The biggest challenge I always saw regarding anything medical was communication. I consider myself a fairly good speaker of the Lao language however certain medical words and concepts were very difficult to carry over into our language. My question is has the medical section of the Lao language evolved in Lao PDR since the late 70’s and is there a medical dictionary available. I’ve also been in the presence of court or hospital appointed interpreters both Lao and Hmong (Lao speaking). I found most were serviceable but they struggled as well.

Leave a Reply

Your email address will not be published.