Meet Our Patients (49): Ma Myint San’s Story — Newborn baby

5 children’s mother, Ma Myint San delivered her baby at Mae Tao Clinic 3 days ago. She is healthy during and after the delivery. Nevertheless, her baby is premature, born at 8 months, has low birth weight (2kg; 4.4 lbs), and is jaundiced with neonatal sepsis…

Ma Myint San is 38 years old, a mother of a newborn baby. Originally, she is from Bago Region[1], Burma. She together with her husband moved to Thailand 16 years ago in search of work. She has five children including the newborn: Pa Pa Hlaing – 16 years old; Honey Htun – 14 years old; Hein Ko Aung -11 years old; Hein Htet Ko – passed away when four months old. Her first daughter was married when she was 14 years old. Her 2nd and 3rd child stay with their grandparents and study in Burma. Ma Myint San divorced recently because her husband got a new wife and often neglected his family.

She lives in Mae Sot area[2], Thailand together with her eldest daughter and son in-law. They stay in a house provided by their employer. All three of them were working together before she delivered her baby. Her daughter and son in law make THB 150 (USD 4.5) and THB 180 (USD 5.4) per day, respectively. However, the salary is intermittent as the job is not constantly available. It absolutely depends on the need expressed and decision made by their employer. They do not have any legal documents such as passport, residence permit or work permit but hold a document made by their employer under the agreement with the regional authority.[3]

Ma Myint San has attended antenatal care (ANC) and delivered her children at Mae Tao Clinic before. For her newborn, she also attended the ANC three times and gave birth 3 days ago. She is healthy during and after the delivery. Nevertheless, her baby is premature, born at 8 months, has low birth weight (2kg; 4.4 lbs), and is jaundiced with neonatal sepsis. Reproductive Health Inpatient Department (RHIPD) staff provided the baby with IV antibiotics, phototherapy, and are continuously monitoring the baby with three hours check-ups. Ma Myint San already registered her baby’s birth at MTC and will go to get a Thai birth certificate at Mae Sot district office together with the birth registration team. She is waiting for being discharged after her baby is recovered.

When we visited the RHIPD again for the follow-up, Ma Myint San was holding her baby, breastfeeding, looking down her baby with a full smile. RHIPD staff told us that the baby doesn’t need phototherapy anymore as her baby’s condition got much better.

“I’ve never been to any Thai clinic or hospital because I cannot speak Thai and I cannot afford the medical bills. That’s why I always come to Mae Tao Clinic whenever I have health issues. I really appreciate the services that the clinic provides to people in need of health care. MTC takes good care of moms and babies like us.”


 

 

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In recent years, the proportion of complex cases in need of higher level care has increased, while the number of women attending our reproductive health clinic for normal delivery has decreased, which is likely due to improvements in services along the border. Our reproductive health team provides care to women through multiple services:

Antenatal care: Women are encouraged to come for at least four antenatal visits over the course of their pregnancy. Pregnant women are assessed following our protocol, which is regularly reviewed. Over half of women who were admitted at MTC for delivery came the recommended 4 times for ANC.

Family planning: We offer emergency, short, and long-acting reversible contraception (LARC) family planning options. Most women prefer contraceptive injections and need to attend the clinic every 3 months. The reproductive health team is trying to advocate for more LARC contraception methods such as implants or intrauterine devices (IUDs). Over the past 3 years, approximately 10% of women visiting for family planning received LARC.

Delivery: We aim to ensure specific training for our midwives, improved clinical supervision and improved infection control in the delivery room. We regularly review the patients we refer and monitor our referral outcomes. Of 2,327 admissions, 179 women (7.7%) were referred to Mae Sot General Hospital for advanced emergency obstetric care.

Neonatal care: We continue to face challenges in the management of premature babies and low birth weight babies, due to our limited resources. However, through improved staff training and parent education on monitoring of new-borns, we can achieve better outcomes.


[1] Bago is a city and the capital of the Bago Regionin Myanmar. It is located 91 kilometres (57 miles) north-east of Yangon (Capital of Burma/Myanmar). [Wikipedia: https://en.wikipedia.org/wiki/Bago,_Myanmar]

[2] The district (Amphoe) Mae Sot, Tak province is subdivided into 10 subdistricts. Mae Tao Clinic is located in Mae Sot.

[3] The CI (Certificate of Identity) is for migrants who don’t have a Burmese ID card and household registration document at hand. A CI allows migrants to travel freely in order to obtain necessary documents and ultimately apply for a Burmese Passport. Nevertheless, many cannot afford to get the CI due to its cost.