Responsible motherhood

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Saturday, August 23, 2014

NO MATTER how vital their roles are in child-bearing and child-rearing, some mothers are still not keen in first keeping themselves healthy to carry out their daunting tasks and responsibilities.

In highly-urbanized Davao City, City Health Office chief Dr. Josephine J. Villafuerte said among pregnant women, there are still morbidity cases due to bleeding, hypertension and pre-eclempsia, among others.

Thyroid cases related to pregnancy have also been recorded.

"These morbidity cases are all over the city, it's not only in urban or rural. So far hindi naman tumataas. Meron naman tayong services for pregnant women in our health centers. We really encourage for a pregnant woman to avail of pre-natal check-up at least five times during the nine months of pregnancy. However, most do so only for the first pregnancy. Pagkahuman dili na sila muadto para sa sunod na pregnancy kay huna-huna nila parehas lang (After the first pregnancy they no longer have themselves checked thinking it's all but the same just like the last time)," Villafuerte said in an interview at her office Wednesday, August 20.

She said there is no such thing as similar pregnancy that's why complications mostly occur to those who don't avail of pre-natal check-ups for the second pregnancy and others that follow it.

Aside from free pre-natal check-ups, Villafuerte said barangay health centers also provide free breast examination, cervical screening and papsmear to help early diagnosis of killer diseases like breast and cervical cancers that are prevalent on women.

"Sa health centers natin, kumpleto. May mga family planning methods din tayo, ine-educate natin sila. Walang rason na hindi mag-avail kasi libre naman ang mga services," she said.

It's unfortunate, however, that even if midwives or health personnel go to the communities, "Dili lang gihapon sila muadto para mag pa screening. Maayo unta mag-avail sila samga services kay aron mapangalagaan nila ilang mga sarili. Kay kung unsa may findings, ato man dayon na ginapa-screen (They still don't avail for the free screening. It would be best for them to avail of the free services to better take care of their health. Whatever results, we have it screened immediately)."

Ideals, regrets A girl as young as 12 years old can get pregnant as long as she has been through her first menstrual period. But OB-Gyne Dr. Yolanda Angel Tuason said it's not healthy and beneficial for a 12 year old or a teenager to get pregnant. "Pwedeng magbuntis ang sinumang nagka-mens na kahit 12 palang siya. Pero dahil hindi pa kumpleto ang reproductive system nya at hindi parin siya fully-developed mahihirapan siya. How can one so young and still very much a child care for another baby? Hindi siya ideal at hindi namin ini-encourage iyan," Tuason said in a conversation at her clinic at UM Multitest recently.

Tuason said even an 18-year-old is too young, adding that pregnancy is best to start at 20. Dr. Villafuerte shared the same convictions, "You can get pregnant as long as your reproductive system is already fully developed. For a teenager to get pregnant, most likely she wouldn't know how to care kasi bata pa rin siya. She might just be producing another street child. It's not healthy for her and her baby at all."

Davao City Councilor Berino L. Mambo-o Sr., who is the representative of the Indigenous Peoples (IPs) to the City Council, admitted in a separate interview that most IPs marry at a young age and their girls usually get pregnant while on their teenage years.

"Kabalo man ang mga ginikanan nga dili mayo nga mag-asawa ilang mga anak nga mga bata pa. Pero wala man silay laing buhaton sa bukid labaw na tong mga panahon nga wala pay eskwelahan. Ang among kabatan-onan walay laing kabisihan (The parents know it's not good for their children to marry at a young age but the kids have nothing else to do particularly those times when there are no schools in their areas. Our youth had nothing else to do)," Mambo-o said.

He also shared that their child also married young but as parents they can only guide, saying, "Unsa paman among mahimo, naa naman na. Amoa nalang silang tabangan (It's already there. We will just help them)."

Mambo-o, however, said they have been campaigning in their communities, educating them and encouraging their youth to go to school and engage in other activities like tribal sports to keep them busy.

Agnes, a lumad from Davao del Sur, left their home on the mountains and came to Davao City to work as a house help. She said her parents wanted her to get married at age 16. "Dili ko gusto maparehas sa akong mga igsoon, ang isa 14 pa lang naa nay anak (I didn't want to be like my siblings, my sister already has a child at age 14)."

After working for over a year as a house help, she met and fell in love with her textmate who works as a part-time ‘kargador’ in Sasa. She often stayed overnight at her boyfriend's boarding house during her day-off but not too long she got pregnant at 18. Her parents decided that she marries her boyfriend. Agnes was forced to stop working and relied on the meager income of her husband. "Pait man diay magminyo ug sayo. Wala koy trabaho dili na ko mapalit ako kinahanglan ug kinahanglan sa akong anak. Di ko katrabaho kay walay laing mubantay sa akong anak (It's tough to get married young. I have no work, I can't buy my needs and the needs of my child. I can't work because nobody else can take care of my child)," she said.

For already mothers, Dr. Tuason encourages birth spacing. "We really promote birth spacing for the welfare of the mother and the child. But it's still the decision of the couple if they want to have another baby once their first child has reached one year old or two years old. It's up to the mother if she's psychologically ready to care for another child when she still has an infant or a toddler to care for."

Dr. Villafuerte also said it's the mother's decision when to have another pregnancy, "pero kung ang imong anak three years old pa o wala pa mag-eskwela, unsaon nimo pag-atiman sa duha nga puro gagmay pa. Usually ang uban mag-rest usa for three years usa mag buntis usab (If your first child is three years old or is not yet going to school, how can you attend to two small children. Others usually rest for three years before getting pregnant again)."

The CHO chief added, "Kung sunod-sunod man gud imong pagbuntis wala pa makabalik ang nutrients nimo sa imong first nga pagbuntis kay diba samtang dala-dala pa nimo ang bata, shared na ninyo tanang nutrients. Murag ma-deplete sya after giving birth. Usahay ubang nanganak malnourished unya malagas ang ngipon kay kulang man ang nutrients. Wala pa maka-recover ang lawas (If you have consecutive pregnancies most likely you have not yet recovered the nutrients you lost during your first pregnancy as you shared all nutrients with your baby while still in the womb. It's depleted. Others get malnourished after giving birth that's why they lose teeth because of insufficient nutrients in the body that has not yet fully recovered)."

Mambo-o, meanwhile, said they have other means of birth control. Their women don't use pills or injectibles but use herbs instead. "Kanang dahon sa makahiya, pait man na. Mao na ilang usapon epektibo man pud. Halamang gamut raman ang ginagamit sa among mga babaye dili sila anang mga tusok-tusok (They munch on the makahiya leaves, which are bitter, and are effective. Our women only use medicinal herbs, they don't want any insertion or injection)."

Benefits Since August is breastfeeding month, Hakab Na 2 was held on August 2 at Stockbridge International School in Davao City for The Global Big Latch On, an international synchronized breastfeeding celebration, for the World Breastfeeding Week. Hakab Na 2 organizer Toni Guiani Fuentes of Breastfeeding Pinays said 35 breastfeeding moms in Davao joined the one-minute synchronized breastfeeding event that was also held in 825 other locations registered in 31 countries.

In the final count of The Global Big Latch On, a total of 13,798 children breastfed during the one-minute count with 14,173 breastfeeding women attended and 23,906 people attended. Though the 2013 record of 14,536 was not surpassed, global organizers still congratulated participants as the event has grown to include more countries. “We look forward to next year with excitement and we know that numbers are not the whole story. This event builds communities one latch at a time, increases support for all families and helps to change global culture around breastfeeding. It is really important that we continue to make breastfeeding in public a normal and supported part of having a child,” a statement on the www.biglatchon.org website was released August 5.

Fuentes, mother of six-year-old Danielle and 17-month-old Frederico, said Hakab Na 2 aimed to let breastfeeding moms in Davao City know that they have a support group. "Breastfeeding is a choice. Marami tayong nagbi-breastfeed. We are increasing in number. If we have difficulty, we are here to help you continue breastfeed. We are here to promote support and protect breastfeeding," Fuentes said in an interview with Sun.Star Davao during the event.

Fuentes regretted how her lack of knowledge deprived her first-born the benefits of her breast milk. "I breast fed my first-born only for a few days. I didn't have knowledge and support. My second child I breastfed for one year and five months. My first baby suffered skin allergies for six months, it was difficult for me emotionally as I was always crying. It was tearing me apart. Had I known then that breastfeeding her would have made a lot of difference...My second child is healthy and I have nothing to worry with him. He was never constipated unlike my first child."

"I love the joys of breastfeeding. It's an achievement of a lifetime that can never be surpassed by anything. I'm more conscious now to live a healthy lifestyle for my children," Fuentes added.

Sharmila Barreto Ong exclusively breastfed her four children - Liane, 14; Paulo 10; Krischnan, 5; and Stellan, 1. Her first three kids were breastfed until three years.

"They said you can only breastfeed your child up to two years. But for me, I let them wean on their own. Even if they already have teeth, at first they will try to bite, but once they know it hurts you, they will stop and not do it again. The kids will learn to respect your body," Barreto said.

During the Hakab 2, Latch Davao officers and members under its president Alex Hao shared their experiences in exclusively breastfeeding their respective children.

While Latch Davao just started this year, L.A.T.C.H. started in the Philippines in 2006. Latch Davao is a non-profit organization that offers quality lactation education and peer counseling services to mothers who wish to breastfeed.

Hao said Mommy Sense had also been into such advocacy since 10 years ago.

Hao said, "We at Latch Davao gives breastfeeding lectures and child birth class at The Pod. We have regular talks on what mothers can do and hospital practices every first, second and third Saturdays at Brokenshire Women's Center."

Last July 31, Latch Davao held a lecture in Barangay 76-A where pregnant mothers were oriented on the myths and truths about breastfeeding.

"May nagsabi kasi kailangan daw ipalipat-lipat ang pag breastfeed kasi angi sang breast parang kanin then ang kabila parang ulam (laughs). Meron ding nagsabi na hindi raw kasi magpantay ang boobs kung hindi ilipat-lipat ang pagpalatch sa baby. Meron ding paniniwala na if pagod ang mother galling sa work or salabas, ‘daut’ or sira daw iyong unang milk nalalabas at baka ‘masubawan’ daw ang bata," Alex shared.

She, however, said breastmilk from both breasts have the same nutrients. The first milk that comes out is the foremilk (high in volume, low on fat) and the hindmilk (low in volume, high in fat) is what follows at the end of the feeding. One can let the baby finish the first breast then offer the other if the baby still wants more breast milk.

"When the mother is tired or not feeling well, breastfeeding can help her recover fast. As long as the mother's illness is not contagious. You can breastfeed even if you have fever," Hao said.

Dr. Villafuerte said a breastfeeding mom needs to eat a balanced nutritious diet. "If under nourished ang mother, she'll not produce good milk for the baby. Kailangan talaga healthy at nutritious din ang kinakain at iniinom ng mother. Exclusive breastfeeding up to six months and continue up to two years even with supplemental feeding."

Villafuerte said CHO and barangay health centers also have breastfeeding programs that include education during pre-natal check-ups and immunization of their babies. She noted though that breastfeeding culture in the city has somehow changed, "The more educated and who can afford to buy formula milk, opt to breastfeed. That's for the case in the urban areas ha. Most mothers would easily buy formula milk and some not even trying to breastfeed. Those in far-flung areas, mapugos sila mag breastfeed kay walay mapalitan ug gatas (Mothers in remote areas are forced to breastfeed as there was nowhere they can buy formula milk)."

There are sacrifices in breastfeeding for a mother, Villafuerte said, but the pains will just be for the first three days. The joys and benefits far outweigh the discomfort of sore nipples. "Mothers who just gave birth, whether by natural or CS, breastfeed your baby. You can and you will have breast milk if you just continue to let your baby latch and suck. Even if you have inverted nipples, ask help how it can be done because you can still breastfeed. It will be painful pero antos lang (just endure it). Kahit na sa incubator si baby, pwede siyang i-breastfeed mas best sa kanya ang breast milk," Villafuerte added.

She went on saying that beast feeding minimizes the risk of breast cancer in women and giving birth also helps prevent cervical cancer. "Recent study shows that women will not develop breast cancer or cervical cancer when they breastfeed and give birth. May ibang nagde-develop pero mas malaki ang chances na hindi mag-develop," Villafuerte said.

CHO held a breastfeeding summit in Maa recently where pregnant women were taught how to breastfeed and prepare supplemental food.

It is indeed interesting to note that CHO and other private organizations share the same objective of helping Dabawenyas appreciate taking good care of their bodies more and keep living a healthy lifestyle not only for themselves but also for their own families.

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