September 22, 2017
Written by Monica Kerrigan, Jhpiego
This post originally appeared on The Lily. Reposted with permission.
For almost seven years in the 1980s, I lived on Mali’s Dogon Plateau. I was a Peace Corps volunteer focused on primary health care and spent most of my time with women. I learned about their joys, sorrows, dreams, struggles and, surprisingly, their great fear of childbirth.
As a young, single American woman, I thought of birth as natural, safe and joyous. Nothing had prepared me for the death of Yabara, a 27-year-old pregnant woman in my village. Like many rural Malian girls, she had married early, during her teens. She had six children at home and was pregnant with her seventh child when she died from obstructed labor. The complication is easily treated by cesarean delivery, but in this rural village, without access to surgery, it was — and still is — a death sentence.
The memory of Yabara dying while giving life pains me.
Even more unacceptable is the fact that today — more than three decades later — vulnerable women and poor mothers living in rural areas and urban slums throughout sub-Saharan Africa still can’t get lifesaving surgery. They don’t have access to cesarean delivery — a common surgery needed by up to 10 to 15 percent of laboring women, according to the World Health Organization.
The Lancet Commission in 2015 reported that “universal access to safe, affordable surgical and anesthesia care is essential for widespread and equitable improvements in global health, welfare, and development. More than 100,000 maternal deaths might be averted by timely intervention, and increased access to cesarean delivery reduces neonatal mortality by 30 to 70 percent.”
An appalling 99 percent of maternal deaths occur in low- and middle-income countries. It’s no coincidence that this grim statistic aligns with regions where unmet need for surgery is greatest: in eastern, western, and central sub-Saharan Africa, and South Asia.
In fact, a woman in sub-Saharan Africa is 175 times more likely to die during childbirth than a woman in a high-income country.
When a woman is in labor, complications can be exacerbated by the long distances she may have to travel to reach a health facility and the conditions she finds upon arrival. At our health clinic in Mali, we provided care for normal deliveries but like so many places on the continent, we lacked running water, electricity and basic medical supplies. There wasn’t a skilled provider within 50 kilometers able to provide cesarean delivery and other elements of emergency obstetric and newborn care.
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