In February 2024, Kayla Jackson, a student in the Master of Science in Global Health program at Duke Kunshan University’s Class of 2024, embarked on a field research trip to Phnom Penh, Cambodia. There, she collaborated with the University of Health Sciences in Cambodia to conduct her thesis research. Her study focuses on maternal and child health, delving into the complex psychological processes behind pregnant women’s decisions between natural childbirth and cesarean sections, and uncovering the deeper motivations behind these choices.
“Cambodia is a country with a rich culture and resilience. Conducting field research here has given me a profound understanding of the intricate issues surrounding maternal and child health in this nation. This experience was not just an exploration but a journey of discovery that has had a lasting impact on me.”
— Kayla Jackson
Childbirth isn’t just a medical issue, it’s also a cultural one
The choice of this research topic stemmed from her concern over the rising global cesarean section rates. Kayla explained that childbirth is a subject closely tied to social and cultural contexts. Factors and practices that were originally non-medical have been incorporated into modern medical research and services, significantly influencing women’s childbirth choices across different socio-cultural backgrounds. At the beginning of the 21st century, Cambodia faced extremely high maternal and neonatal mortality rates compared globally and regionally. In an era of limited medical resources, most Cambodian women gave birth at home, assisted by midwives and local women.
Today, with improved medical infrastructure, contemporary childbirth practices have shifted toward medical facilities such as hospitals and health centers. While advancements in medical technology, such as Cesarean sections, have saved countless lives in medically necessary emergencies, they have also sparked debates over their use in non-medically necessary situations.
Kayla’s research focuses on two core questions: First, can cesarean sections for non-medical reasons lead to positive outcomes, such as effectively reducing maternal mortality rates? Second, who should have the right to decide the mode of birth? These discussions touch on the deeper conflict between evidence-based practice and patient autonomy, prompting profound reflections on medical ethics and humanistic care.
Fortunately, over the past decade, Cambodia has made significant strides in maternal and child health. Like many other countries, its population and health survey reports indicate a steady rise in cesarean section rates, reflecting both advancements in medical technology and the country’s growing emphasis on maternal and child health. Kayla conducted in-depth interviews with local pregnant women, listening to their thoughts and feelings as they chose between natural childbirth and cesarean sections, and meticulously exploring their decision-making processes and key influencing factors. The results yielded a profound discussion, revealing that while many women strongly believed in their right to choose, they also placed significant trust in their families, friends, physicians, and medical teams to provide them with the necessary information to make informed decisions based on their unique life circumstances.
Patient-centered medicine
Currently, Kayla is a first-year medical student at the University of Oklahoma Health Science Center. The first two years of her medical education will primarily involve classroom-based learning alongside her peers, focusing on the complexities of health and well-being. While much of her time will be spent in the classroom, she will have opportunities to volunteer in the community and shadow various medical specialties. Her last two years will transition to a clinical setting, where she will rotate through various specialties and departments, gaining hands-on experience and seeing the lessons learned during her first two years applied in a hospital environment.
Looking back at her fieldwork project in Cambodia from a year ago, it has profoundly shaped her perspective on healthcare, reinforcing the importance of patient-centered care and cultural sensitivity in medical decision-making. The firsthand insights she gained through conducting interviews now shape her understanding of medical ethics and the broader challenges of health disparities. Through these conversations, she came to appreciate how a person’s health is not just a medical condition but an encompassing factor that influences every aspect of one’s life. As she immerses herself in her pre-clinical studies, she finds it empowering to deepen her understanding of the human body and health, knowing that this knowledge will one day allow her to provide more empathetic and improved care for her future patients.
Kayla reflected with gratitude: “Every day I spent in Cambodia was unforgettable. I am deeply thankful to those who shared their stories with me. Their heartfelt narratives and experiences enriched my understanding of global health and allowed me to appreciate the warmth and resilience of the Cambodian people. This country will always hold a special place in my heart. In the future, I will continue to explore and contribute to the fields of global health and medicine, strivin
