A labour of love: The perilous journey to give birth

Childbirth is said to be one of the most challenging and painful, though rewarding, experiences a woman can endure. But imagine if the process of childbirth wasn’t the only difficult aspect of the delivery process: what if simply getting to the hospital was a challenge in itself?

This is the reality that millions of pregnant women across the developing world face. While in labour, many women have no choice but to walk long distances to reach a health facility, a strenuous and potentially dangerous endeavour; others don’t go at all.

Fearful or physically unable to tackle a long and gruelling route by foot, many pregnant women are discouraged or prevented from reaching the nearest health clinic. As such they are forced to give birth at home, without the presence of a skilled attendant or access to crucial resources – increasing the risk of complications and potentially resulting in death for the new mother and/or infant.

Reaching every woman and child
Dr. Hawa meets with community members in Mali.

Dr. Hawa (at left) meets with community members in Mali.

Thanks to support from generous donors and the Government of Canada we're improving Maternal, Newborn and Child Health (MNCH) in developing countries through the Women and Their Children's Health project (WATCH).

“The project really aims to reach out to the populations that are the most underserved, vulnerable, and hard-to-reach … it addresses the very root of problems,” shares Dr. Hawa who works with Plan in Mali, where approximately 82,000 children under 5 die each year, compared to 2,000 in Canada (WHO).

Plan staff like Dr. Hawa work hand in hand with communities, encouraging participation to promote sustainability.

“Thanks to this project the population are taking ownership … They understand that they should be the ones contributing to their own health,” she says. “We give them the tools and they do the work for themselves.”

She recalls the first day she visited the furthest community in her district and how the entire village was eager to get involved.

“When I introduced myself to the village chief and started to talk about health, the women and children asked if I would come back every day,” she says.

They told her that women from the village had to cross 5 rivers and many hills – sometimes while already in labour – in order to reach the nearest health centre.

“They asked me to share that they are really touched because Plan is one of the very few organizations that has come to their village,” she shares with emotion.

Whether bringing individuals to health centres or bringing healthcare to rural communities, “there are communities that need us,” she urges, “and we are definitely able to do something.”

Rickshaw to the rescue in Bangladesh
This special rickshaw transports women to a local clinic.

This special rickshaw transports women to a local clinic.

When it comes to accessing maternal health care, one of the primary obstacles women in remote areas face is the availability of affordable and reliable transportation.

A Plan-initiated Community Support Group in a remote area of Bangladesh decided to address this issue by pooling funds and investing in a communal rickshaw specifically for bringing women – especially those in labour – to the nearest clinic. The designated rickshaw driver also has a mobile phone so that he can be reached at all times in case of emergency.

“It is our pleasure that we are able to purchase a rickshaw with the collective effort of all Support Group members with a view to carrying pregnant women and mothers who live in hard-to-reach areas,” says one Support Group member.

A welcoming ward in Zimbabwe

For years, the small number of women who ventured to a small Zimbabwe clinic to give birth had to first collect water for their own delivery. The clinic lacked clean water and had little means to accommodate expectant mothers in the days leading up to childbirth. For these and other reasons, women were deterred from attending the clinic, opting for risky home births instead.

Agnella, 24.

Agnella, 24, has enjoyed the final days of her first pregnancy in the comfort of the Zimbabwe clinic’s maternal waiting home.

Today, the clinic is a very different place. It now has its own source of clean drinking water – essential for health and hygiene. The clinic has also added a brand new maternal waiting home with the capacity to house up to 16 expectant mothers at a time, giving them immediate access to skilled birth attendants.

Since the maternity waiting home’s completion in December 2013, more than 80 women have been admitted and all have delivered healthy babies.

“We have noticed a significant change,” said one village health worker who leads a group to encourage skilled health assistance. “People no longer deliver at home here.”

Community members are now committed to making lasting changes to support the health of mothers and children.

“We have buy-in from our local leaders to continue with these good practices,” says Moyo, a nurse at the clinic. “We look forward to maintaining this high level of performance even beyond the lifespan of the project.”

From left: Primary Care Nurse Primrose, and Registered Nurse Esnath

The structural updates to the Zimbabwe clinic were complemented by upgraded training and tools for healthcare practitioners (from left: Primary Care Nurse Primrose, and Registered Nurse Esnath).

Clearing a promising path

Pregnancy and childbirth are challenging enough. Together we can provide important resources to protect the health and interests of women and children around the world – supporting new mothers, giving babies the best possible start in life and helping save lives.

This project receives financial support from the Government of Canada through Foreign Affairs, Trade and Development (DFATD).