Partnering with Local TTMs

Traditionally Trained Midwife, or TTM, is a woman who works in the community delivering babies. Her training has come through years of “watch and learn” experience traditionally passed down from her mother or grandmother. Though her education may be limited she is well-versed in the basics of Labor and Delivery.

Until recently in Liberia, most all deliveries in rural areas were done at the hands of TTMs. Caring for pregnant women throughout the prenatal and postnatal period has been their role in the community, and served as their means of supporting their families. However, with high Neonatal and Maternal Death Rates, the government is putting a stop to home deliveries throughout the country. Unlike the US where, under the care of a skilled Nurse Midwife, home deliveries can be quite safe, here in the bush they often have poor outcomes. With the lack of 911 and an ambulance company around the corner, it may take several hours of carrying mother and baby in a hammock through rough terrain to get the woman to a health facility for life-saving care when a delivery gets complicated. Any lapse in time from the onset of a problem to the intervention puts the mother and baby at great risk.

At Po River we are working to increase the number of clinic deliveries, while also supporting the work of our community’s TTMs. Though the TTM role is changing, their ability to support their families doesn’t have to. This month we’ve started a new policy, we are paying an incentive to all our TTMs for each delivery they refer. Normally the clinic charges 700LD (about $7USD) for delivery. Now we are giving 500LD of that cost to the referring TTM. We’re pretty sure our new policy is catching on… we’ve already done 4 deliveries this week!!