Home > Maternal Health > Giving Birth a Nightmare in Zambia's rural Petauke
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“Whenever I fall pregnant. I fear for myself thinking I might die any time when giving birth because I do not know what the future holds for me since we do not have a midwife.”

by Doreen Nawa

Sourced from 'Lusaka Daily News'

florencedevouard
Photo Source: Wikimedia Commons. 2007 Rural Zambian village. Photographer: Florence Devourard. Creative Commons Attribution-Share Alike 3.0 License.

Bringing forth life in form of a baby is a source of joy for many women and brings about fulfillment in a marriage. It is a moment when families unite to celebrate the arrival of a new family member. But this is not the case for most women in Mulimbu Village in senior Chief Kalindawalo’s area in Petauke district in Eastern Province where giving birth has not only become a burden but a nightmare.

Women dread falling pregnant due to high costs and risks associated with giving birth in this area. Despite only having one clinical officer and no midwife, the nearest and only rural health centre called Luamphande has introduced child delivery charges which are beyond the reach of most rural women due to high poverty levels in these areas. This has left no option for most pregnant women who instead deliver their babies at home with the help of untrained traditional birth attendants.

Giving birth at home, as cheap and convenient as it may seem, comes with its own risks and complications. According to Royce Nyaradzi Banda, a retired midwife at the University Teaching Hospital (UTH), apart from the risk of complications and even death that women face when giving birth on their own, home births often result in non-repair of perinea sensitive tissues, delayed clamping of the umbilical cord which can result in infections, and the non-use of routine examinations during labour. Mrs Banda pointed out the need for strengthening community midwifery care to rural women. “I think the best way to handle this is to strengthen community midwifery in order to bring professional midwifery care to rural women thereby facilitating access in the face of inadequate infrastructure and inadequate resources,” she says.

According to Mrs Banda, most rural women in Zambia are still fond of traditional antidotes and that when pregnant, the practice of using traditional herbs against Western style medicine is common amongst pregnant women and that this has increased the risk in child birth. “Rural women here in Zambia still strongly adhere to traditional practices and beliefs during labour and this is a trend that has proven to be difficult to fight,” she said.

Mrs Banda says some of the concoctions that women take to expedite child birth could be the cause of some of the complications and that giving birth at home with the help of untrained birth attendants may pose even a greater risk because the birth attendants may fail to recognise or even alleviate these complications as they lack medical expertise. However, most women in Mulimbu Village still contend that it is not their wish to give birth at home but prevailing circumstances at the only health centre force them to. Most women complain of ill treatment by the medical personnel and the high child birth charges as some of the hindrances to accessing maternal health services. She says the clinical officer is never there to monitor the process and that they are left to be attended to by cleaners.

According to Agness Tembo, a mother of four, most rural women cannot afford transport when labour starts and other necessities like decent clothes for the unborn child due to high poverty levels in the area. She says the child-bearing charges are therefore farfetched. “We are charged K50,000 when you take a child that has been born at home to Luamphande Clinic to get an under-five card. We also pay K15,000 to the traditional birth attendants commonly known as Anya mwinu, failure to pay the said amount will land you in problems. It’s either you do not get the under-five card for the baby or the traditional birth attendant takes the matter to the induna and later to the headman,” she says.

She further says besides paying child-bearing charges every pregnant woman must secure baby clothes before giving birth. Mrs Tembo says it is a prerequisite for any pregnant woman be it in rural or urban to have a towel, a complete baby suit which includes a hat, socks, a vest or dress, nappies and baby blanket. But just finding all these requirements is a nightmare for many families in Mulimbu Village.

“Money is very difficult to come by here in the village and just to be charged K65,000 here in the village it’s unacceptable and cruel. We need government to intervene in this matter.

“Whenever I fall pregnant. I fear for myself thinking I might die any time when giving birth because I do not know what the future holds for me since we do not have a midwife at Luamphande Clinic and we also do not have trained traditional birth attendants,” Mrs Tembo said. According to Mrs Tembo, every pregnant woman hires a traditional birth attendant at their own expense to accompany them to the clinic or home once the labour pains begin.

Luamphande Clinic has no midwife and is manned by one person, the clinical officer only identified as Mr Banda and has only two cleaners who also work as nurses but are not trained.

“We have a big problem here, the only medical personnel, Mr Banda who is in charge of the clinic is always out of the station and whenever you ask his children you will be told that he has gone to the Boma (Petauke). He is never there for us and that is the reason why most women end up delivering in their homes,” another resident of Mulimbu Village Dainess Zulu said.

Asked why the charges were introduced, Mrs Zulu said it is a penalty fee to those that give birth at home. She said the charge is meant to discourage women from giving birth at home. “We were told that it is a penalty fee but it is not helping anyone because it is too high and mothers have continued to give birth at home and not take their babies for under-five,” Mrs Zulu said. Then giving birth at home and not taking a baby for under-five clinic becomes the preference for most women because it is cheaper. Another reason is the fact that a large proportion of pregnant women deliberately opt to give birth at home because they find hospitals to be very uncomfortable because of the unavailability of medical personnel. There are often situations where some women fail to deliver safely due to complications like the case of Temwani Njovu of the same area.

Mrs Njovu says she is lucky that she is alive today. Most of her friends, she says, gave birth at their homes without any complications. The 34-year-old resident of Mulimbu Village about 24 kilometres from Petauke says her experience is different from others.Mrs Njovu says she owes her life to a good ‘Samaritan’ who gave her a lift from the junction to her village to Petauke District Hospital because her baby lay across and could not be delivered using the normal birth canal.

“My baby was breech and could not be delivered using the normal birth canal. I went to the clinic and found a cleaner but Mr Banda (Clinical officer) was not there. After a few minutes, the baby came out first using the hand and my husband was told to rush me to Petauke using a bicycle.

“Just when we were about to join the Great East Road, my husband stopped a vehicle. Thank God the driver accepted to give us a lift up to Petauke District Hospital. Unfortunately my baby died of suffocation, I was on the verge of death,” Mrs Njovu said. Apart from the general lack of adequate medical staff at Luamphande Clinic, rural women in this area continue to be faced with challenges such as long distances to the nearest health centres and high cost of public transport.

GBC-mapparium2

Visitors at the Mapparium in the Mary Baker Eddy Library in Boston, Massachusetts. This was the site to launch Dr. Jean Watson's Million Nurse Project—during the 2010 International Year of the Nurse—to radiate heart-centered Love, Caring and Compassion through individual and collective global meditations. Photo Courtesy of the Mary Baker Eddy Library.