Giving Birth should not be a death sentence
Pauline was 9 months pregnant and perhaps even overdue.
Like many women living in rural parts of Africa, Pauline’s access to antenatal care was limited. Her nearest clinic was more than 20 kilometres away. Yet over the months, her husband would carry her on the back of his bicycle to the clinic. There she would be weighed and given iron tables to take until her next visit.
Believing she was about to deliver, Pauline decided to move closer to the clinic so that when her time came , she would easily find her way there. She lived with a relative, who still expected her to join in the farming activities – weeding millet, an activity that required her to bend over for hours.
One hot December afternoon, , Pauline felt the first labor pang. She ignored it thinking it might be a false alarm. The pain came again, and she told her hostess that the baby was on its way. They decided to rush her to the clinic.
First, they walked, with Pauline, holding the older woman’s arm. The pain became too much, and they opted for the only other available means of transport – the wheelbarrow. However, the path was rough and they feared the bumpy ride might kill the baby. They abandoned the wheelbarrow and tried again on foot. They made it as far as a primary school compound. Pauline’s screams brought a sudden huge crowd of children, who soon surrounded her.
Pauline sat astride on the ground, and the old lady found herself playing mid-wife. The baby’s head appeared and then got stuck. The mid-wife pushed her muddy fingers into Pauline to dislodge the body’s chin so that it could come out. Pauline fainted and the mid-wife literally yanked the baby out of her.
Then came a series of dilemmas. Dilemma number one: what was to be used to cut the umbilical cord? The children quickly offered their razor blades that they use to sharpen pencils, which were accepted despite the risk of infection.
Next was dilemma number 2: the placenta had not come out. As the new-born baby was put on the grass on her mother’s head scarf (no time to pack a few towels they use to carry babies in that part of the world), the older woman started to massage and squeeze Pauline’s abdomen.
Suddenly, spurts and clots of blood started to come out of Pauline. She was bleeding to death in front of everyone. A women by-stander suggested that instead of massaging out the placenta, they should just plug Pauline with some cloth to stop the bleeding while someone ran to town 4 kms away to look for transport to take her to hospital.
The final dilemma: money for transport. No one had the money to hire the lorry in town. The local school headmaster was respected in the community and he told the lorry driver he would a guarantee payment.
Pauline was rushed to hospital where she had an operation to remove her womb to save her life. The doctors explained that the nature of the birth ruptured her uterus and that was why she was bleeding so much.
Pauline and the baby survived, but other mothers are not so lucky. Africa has the highest records of maternal mortality, according to a draft report from the United Nations Economic Comission for Africa (UNECA). The report, called ICPD and MDGs: Working as One, says that 48 percent of the maternal deaths that occur globally happen on the continent.
“There is no doubt that pregnancy related deaths can be considerably minimized in Africa,” the report states.
With the deadline of achieving Millennium Development Goals (MDGs) in the next five years looming, the cause of lowering the maternal mortality rate in Africa has never been more urgent. In a ministerial conference, being held in Addis Ababa, Ethiopia, 19-23 October, government ministers, along with experts and civil society organisations will discuss this along with numerous other issues. The meeting is being organized by UNECA, along with the United Nations Population Fund (UNFPA) and the African Union Commission (AUC).
The report goes on to state how there are a few steps that could cut maternal mortality rates by a large margin. They include:
- Ensuring the presence of skilled birth attendants
- Improving access to Basic and Comprehensive emergency obstetric care
- Access to postnatal care (a large proportion of maternal deaths occur 48 hours after delivery because of lack of access to health services)
