Labour services have not always been up to the standards needed for expectant mothers, but significant improvements are being made in low- and middle-income countries (LMICs).
The safe delivery of newborns is of great importance. Too many women have not received quality labour services, but the functionality of labour rooms is improving in some low- and middle-income countries (LMICs). Developing infrastructure, installing more labour rooms and using safe birth checklists are all proving to be important measures in improving labour services for mothers.
Functional labour rooms
Health facility labour rooms are functioning at a poor level in some LMICs. But some countries are making significant strides in improving labour room services. Recent developments in Sindh, Pakistan, reveal the extent of these improvements. Within just a year, between late 2022 and late 2023, the number of health facilities with functional labour rooms increased by 48%.
To achieve these outcomes, the government was directly involved in fixing infrastructural gaps, with district heads directing the Buildings Department to carry out repairs. District heads also engaged with local NGOs and reviewed data with district health officers, in order to identify changes in need of making.
Labour services have also improved for women in Punjab, Pakistan. The number of health facilities offering 24/7 labour services increased from 1,200 in 2020 to 1,685 in 2023. While increasing the number of health facilities with labour services is an important step, ensuring that women can access these health facilities is equally important. This is why a dedicated ambulance service has been introduced, to ensure that women going into labour can safely reach these facilities.
Safe birth checklists
In Punjab, the government has launched a safe birth checklist as well, to ensure that women can safely deliver at health facilities. These checklists identify risk factors by reviewing the mother's medical history, monitoring blood pressure and temperature, ensuring that essential supplies for mothers and the baby are in place — such as oxytocin, gloves, a sterile blade and clamps — and counselling mothers before they return home.
Thousands of patient feedback phone calls for deliveries show that safe birth checklists have led to improvements. In April 2023, prior to the introduction of checklists, 87% of mothers had their vitals regularly monitored by staff before and after delivery. By June 2023, after the introduction of checklists, this figure had risen to 96%. Mothers who received counselling on breastfeeding, family planning, and danger signs to watch out for regarding the mother and baby, all increased during this time too.
While there is still room for improvement, it is encouraging to see labour services reaching new heights in some LMICs. Especially with populations increasing quickly, it is essential that high-quality labour services are in place for women. Scaling the number of functional labour rooms, and utilising safe birth checklists that identify and limit risks the mother or baby may face during or after labour, are some key ways to develop labour services.
