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Human Story

"Japanese style" childbirth education for expecting mothers in Bangladesh

PhotoSatkhira District Hospital

Long-cherished proposal by Ms. Selina Akter, a nurse at Satkhira District Hospital

"What questions will we get today?" On one Sunday in April, Ms. Keiko Maruyama, a 31-year-old nurse was waiting for the expecting mothers at Satkhira District Hospital. Today is the day on which a regular childbirth education class for expecting mothers is held at this hospital. After returning from a training program in Japan, Ms. Selina Akter, 45 years old, a nurse at Satkhira District Hospital, was deeply impressed by the childbirth education class which she saw in Japan and asked Keiko for her support to organize the same class in Satkhira.

"Community clinics or MCWCs (Mother and Child Welfare Center) provide guidance and care to expecting mothers but not in Satkhira District Hospital so it is true that some kind of classes for pregnant women are required", thought Keiko. "But, would it continue if we start?", "Selina says she wants to provide the same services as those provided in Japan, which are maternity yoga class and individual consultation, but are they really needed in Bangladesh?", "I don't want Selina to think that just spending money will do good to this hospital", Keiko was not sure about this idea.

When Keiko first visited Satkhira District Hospital she was told "if you want to start new ideas that's great but you can do it by yourself" or "we know it is good for the patients but please don't put any more pressure on us, we are already busy" and was often asked "can you buy hi-tech machines from Japan?". Her anxiety was such that she had been forgetting her passion as a volunteer.

But Selina kept on expressing her enthusiasm and proposed ideas one after another.

Photo(From left) Mazeda, Keiko and Selina

OK, let's give it a try!

To begin with, Keiko informed Selina that this initiative was driven by the hospital and that JICA and JICA Volunteers would only support. It would have been easy for her to prepare and hold a class but JICA Volunteers stay in Bangladesh for only 2 years and she wanted them to keep this positive pursuit even after her return to Japan. Her passion was accepted and she received a positive "Yes, of course!".

Another nurse, Ms. Mazeda Khatun, 43 years old, joined the team and one other staff from Family Welfare Visitor offered her support.

First step was to determine what service was desired. Selina said "just like Japan" but inappropriate service would not be appreciated so they looked over their situation.

  • In Japan, many household works are done by machines and the number of family members is limited, not like in Bangladesh. Japanese housewives tend to stay at home quiet and sometimes insufficient exercise cause problems. Considering this difference, we decided to instruct the expecting mothers to first take a good rest after meals.
  • Keiko also explained that in Japan, mothers come to see doctors to ask about their individual condition, with quite enough knowledge already acquired from books and internet. As there are limited ways to learn about pregnancy in villages of Bangladesh, we decided to give general information on pregnancy, nutrition and warnings.
  • When Keiko told that in Japan normally mothers give birth at hospitals where doctors are ready to help them, they decided to guide the mothers to take regular check-ups, to go to medical institutions when giving birth and to secure a way to be carried to hospitals in case of emergency.

PhotoMaterials for the better understanding

The next step was to prepare posters and brochures to help mothers understand the information provided. As it was a new trial, they decided to make use of the materials distributed from NGOs and private companies.

Another point to discuss was who would make the presentation and how. The nurses were eager to talk by themselves, but Selina was the only one who actually participated in the childbirth education class in Japan. To learn how to hold classes, they asked the MCWC in Narsingdi district to videotape their classes and they discussed their plan based on it.

The preparations seemed to be going well, however, Keiko was yet to experience the difficulty of starting something new in Bangladesh. When she explained about their plan to the Resident Medical Officer (RMO) and other staffs in the hospital, she was told to "ask someone else" or "confirm with different position" or to "wait for a few more days".

PhotoSelina explaining to the expecting mothers

First childbirth education class

On September 11, 2013, the first class was held at Satkhira District Hospital and the RMO was very happy that he invited local media to deliver the news to people in other areas.

Many questions were asked related to diet during pregnancy and how to take rest. In local areas of Bangladesh, male family members start the meals and after they finish, ladies eat in the order of maturity. In this case, expecting mothers who tend to be the younger members of the family will eat last and sometimes it is doubtful if they take enough nutrition. The nurses reminded their family members who accompanied pregnant participants to let them eat well.

After 7 months, the class is held regularly on every 1st and 3rd Sunday of the month. They aim to expand the participants for safer delivery and at the same time they try to make improvements to their classes. The nurses have become confident in their explanations. Although sometimes Keiko encounters the difference of culture she never stops to think of the best way to improve their pursuit.


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