I remember gazing at the hands of a traditional birth attendant in pastoralist Laikipia, Kenya, and wondering about the stories they might hold. How many newborns had these hands supported into the world? What challenges had been faced by the women they helped through childbirth, in their remote rural homes far from any health clinic? Beneath the rough and wrinkled surface, how much loss had they absorbed through these experiences?
Sub-Saharan Africa has the highest maternal mortality rate, bearing the burden of more than 50 per cent of the world’s maternal deaths. One in 39 women in this region faces the risk of dying in childbirth in their lifetime.
Yet less than half of all mothers in sub-Saharan Africa have the support of a trained midwife, nurse or doctor during childbirth. Even fewer mothers from the marginalised nomadic pastoralist communities of Kenya and Ethiopia have access to skilled birth attendants. While evidence has shown that access to skilled care during pregnancy, birth and post-delivery, is key to saving lives, many women don’t have an option.
For the past two years, I’ve had the privilege of working on The Road Less Travelled project and coordinating this blog. I have learnt so much during this time. As I reflect on my experiences, what stands out to me most is the strength and resilience of the pastoralist communities at the heart of the project – and especially that of the mothers. They want what all women want for their children: the chance to survive and thrive.
Having met and spoken with expectant mothers in the Afar region of Ethiopia and Samburu in Kenya, I gained a sense of the complexity of challenges they face. There are the financial and geographical barriers that prevent them from accessing healthcare; the cultural traditions or preferences for particular types of carers; and the lack of skilled health personnel in remote rural areas, if they do seek help.
Now, expecting my first child, these issues are all the more real to me as I navigate the road to motherhood in Australia. Unlike many of the women I’ve met in sub-Saharan Africa, I have been fortunate to have access to skilled health care throughout my pregnancy. I have been able to track my baby’s development and monitor my own health – through scans, check-ups with midwives, and mobile phone apps. I have been able to choose where to give birth, and I know there will be transport to get me there when the time comes. There are endless support networks and maternal health education classes for new mums. Not a single day goes by that I don’t feel grateful for these choices and opportunities.
At each step in the journey, I have thought back to the pastoralist women I met in Kenya and Ethiopia, and the individual experiences of motherhood they shared. Perhaps, for this reason, I feel far removed from many of the traditional aspects of becoming a mother here in Australia, that many new mothers get swept into. Baby showers. Deliberating over the best pram (or bassinet, or baby carrier). Nursery interior design.
None of that matters, really. It is wonderful to be able to celebrate the birth of a new child, don’t get me wrong. But I can’t help feeling frustrated by the often unnecessary expense that goes into these traditions, and how these resources could be better used. The reality is that many of us remain ignorant or detached from the experiences of mothers in developing communities. And this needs to change.
Whether we give birth in a hospital or on the dirt floor of a hut, our hopes as mothers are essentially the same. All we really want is for our child to enter the world safely, and to have the chance to survive and thrive. As mothers, we all deserve to have access to safe, respectful and quality healthcare, wherever we are. As I think back to the hands of the traditional birth attendant, I know we were ultimately fighting for the same thing.
While my role in The Road Less Travelled is now coming to an end, my belief in the importance of this project, and others like it, is ongoing. The Road Less Travelled uses a participatory, strength-based approach to work directly with communities through teams of locally-engaged personnel in Kenya and Ethiopia. Their collective focus is on building understanding and application of safe motherhood practices, strengthening links between traditional birthing practices and formal health facilities, and increasing the rates of skilled birth attendance.
Because no woman should die giving life to another human being. Simple as that.
If you’re reading this, I encourage you to get involved in the global maternal health challenge. Whether that means sharing this blog post, increasing your knowledge of the issues, joining the conversation on Twitter, or telling someone about the importance of investment in maternal and newborn health (check out this great infographic from Women Deliver).
Each of these small steps can help on the road to safer motherhood for all women.
Thanks for reading.