July 08, 2008 

Sir,

It is said “A society that fails to protect its women and children have no right to exist.” Well, then we have no right to exist because we have failed to protect our women and consequently the children by cutting the maternity leave to half the previous entitlement.

   To me as a health worker it came as a surprise. I fail to understand how the cut is justified. In fact I have heard unconfirmed words among responsible health officials that the health sector may try and push to increase the duration of maternity leave to four months in line with the global concept of ‘Exclusive Breastfeeding’ for minimum of four months.

During my capacity as a medical officer in the dzongkhags I might have then wrongly conveyed that the leave may be increased in the future while talking to other health staff during trainings and workshops, to parents and students during school health talks and to the public on health education talks. If there are any who remember then I ask for forgiveness.

If you read any medical textbooks or guidelines on breastfeeding you will come across words like exclusive breastfeeding for four to six months, breastfeeding on demand (feed whenever the baby wants/cries), practice rooming-in (mother and baby to be together 24 hours), give the baby no food or drinks other than breast milk unless medically indicated, why breast milk is better than any other feeds, etc. And concerning delivery there are requirements of rest, good nutrition, physical and psychological support.

One and a half month of leave (45 days) is just enough for what we medically call the puerperal period (six weeks). This is a very critical period after delivery. Many things can happen to the mother and the child. The mother can have complications like secondary post partum hemorrhage and many psychological problems. Infants are very prone to infections during this period. Going to work immediately after this period will be quite unfair both for the mother and the baby. It will be really difficult especially for the ones who delivered by surgery.

We have one of the highest maternal mortality rates (death of mother due to pregnancy related complications extending up to 42 days after delivery per 1,000) and infant mortality rates (death of babies in the first year of life per 1,000) even in the SAARC region. The government and the health ministry in particular are trying very hard to bring up our record to a comparable level. We are only better than countries like Afghanistan, a war torn country. Should we be contended comparing to Afghanistan but not strive to be one of the best at least in our region. If so, this is not the way we make decisions for our mothers and infants.

A mother who doesn’t get good rest during delivery is likely to see more complications during the next childbirth and also it will affect her health in general. A baby who is not breastfed properly is more likely to suffer from infections and complications.

I believe there has not been any representation on this matter from a medical expert. If a gynecologist or a pediatrician was called to throw some light on this matter I strongly feel that the committee would have unanimously agreed to keep the leave as it is or may even have considered making it four months after listening to facts and figures of delivery and child care.

So something was wrong and an expert opinion was not sought or is it that the expert was not expert enough to convince the committee or perchance the members never bothered to listen to him? And it would be wrong in any matter to decide blindly and enforce rules that will directly affect half the society members in some time of their life as mothers and the other half indirectly as fathers. Decisions would not have been made because all committee members have completed their family for it will affect their children one day and they have genuine social responsibilities as executives in the system

After all, what great differences do we achieve in terms of work output by slashing the leave? We as Buddhists and a flexible society, every colleague in the work place is sympathetic to those who have recently delivered and most of the time everyone accepts them to come late, go for feeding in between and to leave early for her child at least for the first three to four months. So at last nothing much is achieved and a short maternity leave will be seen as a blow to the morality of the employees. The work output remaining the same in the end, why can’t the authorities take the credit of allowing three to four months maternity leave? However, it should be accepted that in the world there are government rules, corporate rules and private company rules quite different in different places. Maternity leave ranges from very short to as high as one year. There are even places that do not give any maternity leave but a few days of leave as temporary disability leave. Those who do not give any leave or those that give years are extremes. Why can’t we follow the middle path followers as always? To cite a few examples - in Sri Lanka leave entitlements are initial four months including Saturday, Sunday and government holidays with full pay and if required next four months including holidays with half pay and still if required an equivalent duration without pay. In Germany, if I am not mistaken, because there has been a drop in the birth rates and the population was seeing a downfall the government encouraged deliveries by giving fully paid leave for one year.

I very much hope that this writing invite experts and the general public to contribute their opinion and discuss further. I hope the Ministry of Labor, Ministry of health, and the National Commission for Women and Children will do something.

Dr. Tshokey
PG Institute of Medicine
University of Colombo, Sri Lanka