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The first cry is the most precious sound in a maternity unit—to both mum and midwife; it is the announcement of the miracle of life. But in Zambia, like in many countries across Africa, childbirth can be the most dangerous moment in a mother and her baby’s lives.
The Shortage of Midwives
Patricia manages the maternity unit at New Masala Health Centre in Ndola City in Northern Zambia.
The centre serves over 54,000 people, so nurses and midwives like Patricia are always stretched as there are not enough skilled health workers to attend to mothers.
“There's a time that you are all alone at the maternity unit, and you have ten mothers about to deliver. So immediately, the baby comes out, you put the baby on the mother's abdomen, you go to the next one, you put the baby on the mother's abdomen. You go to the next one until they all have their babies on the abdomen." Patricia describes a typical night for a midwife in a setting where resources are stretched to the limit.
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The Magic of Midwives
Childbirth is the most dangerous moment for a woman and her baby in these settings. Common emergencies include when a baby does not receive enough oxygen, pre-clampsia, and haemorrhage, when a woman experiences heavy bleeding after birth.
These complications are frightening and stressful for mothers, their families, and their midwives. In these situations, what Patricia calls the “magic of midwives” kicks in to ensure that mothers and their babies get effective diagnosis, treatment, and get to go home to their families.
But the reality is that every year here in Zambia, nearly 26,000 children die before they can celebrate their fifth birthday. There are about 15 stillbirths for every 1,000 total births and 213 mothers die during and following pregnancy and childbirth per 100,000 live births.
Most of these deaths are preventable.
When health workers are trained to deliver quality maternal care, pregnant women are empowered to seek it, and facilities are strengthened to provide it, we can help eliminate preventable maternal deaths.
Hope and Blessing
Hope Banda, a mother of three boys and a young widow, knows what problems the lack of access to maternal health services can cause.
Each of Hope’s pregnancies has been difficult, but her first pregnancy was particularly problematic. She says that she didn’t receive any health education or attend any prenatal classes; she wasn’t aware of how she should be taking care of herself during pregnancy.
One morning when she was eight months pregnant, she woke up to find she was bleeding heavily and was rushed to hospital. “To save both the baby and me,” she says, “I had to undergo an emergency surgery.”
During her post-natal sessions after the life-threatening incident at the local clinic, she was connected to local community health worker, Josephine. Josephine educated Hope on reproductive health knowledge, and supported Hope when she lost her husband during pregnancy.
When the time for delivery came, she was nervous. But despite a challenging year, there was joy in the labour ward as she welcomed another boy, called Blessing.
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We need to act now to help prevent emergencies for mothers and their babies. When midwives like Patricia are trained in up-to-date skills and to deal with emergencies, they can save more mums and babies like Hope and Blessing. When women like Hope are empowered with access to information and care before, during, and after childbirth, they give themselves and their babies the best start to motherhood and life.
This is a critical foundation which becomes even more important when public health emergencies and crises hit. Right now, Zambia is going through one of the worst cholera outbreaks in recent times. This puts health systems under severe strain as staff and medicines are diverted to the cholera response. This includes regular services like ambulances, laboratories and other diagnostic services.
We need to act now
To save more mums and babies in these challenging times, we need to train more health workers and support more health facilities so that they can better serve their communities’ needs.
Donate today to help us provide more women with access to life-saving healthcare and support.
All images above © Amref Health Africa/David Brazier