Better maternity care saves lives of Tibetans

For years, the preference for home deliveries in Tibet pushed up the region's infant mortality rate.

When 27-year-old Tibetan Weaser, who had never heard about surgery or anesthesia, had complications, the doctor's plan to "cut open her belly to get the baby" sounded like a death sentence.

Her 70-year-old mother chanted sutra for her daughter's safety and was vehemently opposed to the "unnatural" procedure. But the nurses eventually convinced Weaser's husband to agree to surgery.

One year on, and with her baby in her arms, Weaser reflected on being the first woman to undergo a cesarean birth in Tibet's Maizhokunggar County.

Weaser's case is just one example of a safer birthing environment in Tibet. The region's maternal mortality rate in the first half of 2014 dropped to 154.5 per 100,000 from 399 a decade ago, and its infant rate fell to 20 per 1,000 from 26 in the same period.

Behind the trend is improved obstetrics capacity and a growing acceptance of hospital births. Tibet's health authority says 82 percent of women chose hospital births in the first half of 2014.

Home delivery has long been the preferred method in rural Tibet, home to 80 percent of the population. Many residents live in remote areas and it is difficult for them to get to the region's large hospitals.

A belief that home births are more "natural" was also widespread, said Tseten Lhamo, a doctor at the hospital where Weaser underwent her c-section.

Government investment has funded the construction of medical centers in remote areas, bringing health care closer for many. A 2014 white paper on Tibet's development noted that every village in Tibet now has a clinic, and all rural residents have access to public health care.

Local health authorities have also launched a campaign to train more obstetricians and to make maternity care more affordable.

"Tibetan women are now reimbursed all of their hospital fees. They also receive subsidies between 100 yuan (US$16) and 500 yuan, in addition to necessities like baby clothes," Tseten Lhamo said.

However, mortality figures of both mothers and babies are still higher than the national average, a situation blamed on a lack of capable doctors at rural hospitals and clinics.

Bai Shufang, a doctor from the eastern city of Nanjing who works in Maizhokunggar under a government-led Aid Tibet program, observed poor obstetrical capacity in local hospitals. Babies with serious health problems had to be transferred to large cities, in some cases even out of Tibet.

Weaser considers herself lucky. Like many other Tibetan counties, Maizhokunggar's hospital could not offer c-section deliveries until last year. Before that, women had to go to Lhasa, a two-hour drive along mountain roads, said Aid Tibet doctor Su Dongmei. "Many babies didn't survive the journey."