By Alanna Shaikh. We used to think that childbirth needed to be sterile, that the best place for a woman to give birth was as clean as an operating room. It turns out, though, that’s not true. A woman’s sense of safety and comfort has a lot to do with a successful birth, and it turns out that being in labor surrounded by people dressed like alien surgeons doesn’t create a sense of comfort and safety.

The best place for a woman to give birth is a clean place. Not sterile – no surgical masks or hairnets – but clean. Free of dirt and bacteria. It minimizes the risk of infection for mother and baby, but it’s also comfortable enough to help a woman deliver calmly.

Unfortunately, many women don’t have a clean place to give birth. For example, they may be giving birth at home, where they have to use old or dirty bedding that they don’t mind being stained by the mess of childbirth and they don’t have a scalpel. Or they may be giving birth at a facility that is too overburdened to stay clean and can’t afford single-use equipment.

There are far too many reasons that women can’t easily access clean places to give birth. That puts women and their babies at risk for infection, especially of the genital tract and umbilical cord. More than a million babies a year die from neonatal infections.

Enter the birth kit.

A birth kit is a set of items intended to make any place into a clean place to give birth. Common things to include would be a clean drape made of cloth or sturdy plastic, a scalpel and clamps to cut the umbilical cord, and sterilizing wipes for hands and surfaces. The kit can be used for home deliveries, or brought to the clinic or hospital to be used there.

Birth kits are the kind of simple, low-cost intervention that can save a lot of lives. There’s not a lot of evidence for the kits right now; the best data review I could locate found only weak improvements in newborn health. The logic of birth kits is sound, though, and the potential for harm is very small. I think as kits are used more frequently, the evidence in their favor will increase.

In fact, I believe in birth kits strongly enough that I’m on the advisory team for AYZH, a social venture that features birth kits as one of their products. AYZH is working to set up a distribution model that lets rural women sell the kits for a small profit. This ensures widespread access to the kits for women who want to buy them, and it provides income to the women who sell them.

Alanna Shaikh is a global health professional currently based in Dushanbe, Tajikistan.

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