Liberia: Pregnant Women Dying

Teenager Comfort Jo has walked for 12 grueling hours through choking dust, blistering heat and tropical rainstorms subsisting on just a little rice and vegetables.

As she reaches the end of her terrible journey, overwhelmed with exhaustion, she sinks into a chair – her whole body shuddering with relief.

Shockingly, 19-year-old Comfort is nine months pregnant. But for the sake of her baby, and indeed for her own health, she had no choice but to make the long trek through the bush, as it was the only way for her to reach some proper medical care.

Liberia, on the west coast of Africa, is one of the toughest places in the world to have a baby.

Only 32% of women give birth in a health facility and girls of 15 there currently face a one-in-12 chance of dying during pregnancy at some stage in their life.

Listening to Comfort’s story are three midwives from Channel 4’s One Born Every Minute, the hit show that reveals everyday life in a maternity unit.

Maud Hardy, Louise Holt and Gemma Raby, from Leeds General Infirmary, travelled to Liberia with Save the Children to see just what conditions are like for expectant mums there.

“Our job can be tough but the situation here is totally different,” says Maud, 34.

“We know we’re going to hear some upsetting stories and see some things that we wouldn’t back home.”

Until 2003, Liberia was ravaged by 14 years of civil war.

Today, just 10% of women and children have access to basic healthcare. Comfort is one of the lucky ones.

Smiling shyly, she explains through an interpreter that this is her first time with “big belly” – as pregnancy is called here.

She has already made the demanding journey through the bush an astonishing five times for antenatal care.

This time she will stay at the clinic’s maternal waiting home – one of four funded by Save the Children.

It is a vital service and today the charity is launching Build It For Babies, a campaign which it hopes will raise £500,000 to create six further health facilities in remote areas, including two more maternal waiting homes.

Comfort is very grateful to be here. She knows of one woman in her village who recently died while giving birth.

Maud, who has been a midwife for 12 years, says: “It’s shocking that in 2013 women have to accept such conditions.”

On the clinic’s veranda, 22 local TTMs (trained traditional midwives) are waiting to meet their British counterparts.

Many have been delivering babies for 20 years but have only received proper medical training in the past 10 years.

Before then, dangerous practices were rife – such as pushing women’s stomachs and rubbing dung on a newborn’s umbilical cord.

Now the TTMs are excited to show how much they have learned.

They demonstrate the eclampsia dance – which mimics the fits associated with the life-threatening condition and which is taught to help them spot the signs and save lives. It may be unusual but it is surprisingly effective.

“We’ll have to show that one to the girls back home,” jokes Louise, 45, who has been in the job for more than 22 years.

One TTM, Fatu Garjah, reveals the shocking details of her own labour.

“The traditional midwife put a rope round my neck, made the father of my baby wash his private parts and then made me drink the water,” she says.

“I was being tortured throughout the labour.”

Tragically, stories like Fatu’s are all too common.

The midwives meet women who miscarried after contracting malaria or lost babies after walking to their nearest clinic only to find it shut. While conditions are improving, they have a long way to go.

Bebe Roberts, 19, is eight months pregnant but still works six days a week on her village farm.

When her son Peewee was born nearly two years ago she had no choice but to walk five miles to her nearest clinic. “I was walking so slowly because of the pain,” she says.

“My husband ran ahead to fetch the midwife but then the baby came. I had to give birth alone and my baby just fell on to the rocks – I felt so terrified.”

With just a month till her second baby is born, she is praying a maternal waiting home will open near her in time.

This is all tough for the UK midwives to hear.

Maud says: “It may sound selfish but I’m glad none of my friends or family has to go through such an experience.”

The risk of sepsis, obstructed labours and post-partum haemorrhages make giving birth in the bush a potentially deadly prospect.

However, as the Liberian government has now made it illegal to give birth without a health professional – imposing heavy fines when maternal deaths occur – deliveries are now more often covered up than talked about.

On Saturday night the midwives are called to the local hospital in Kakata, where a mum is in labour.

Save the Children part-funded the building and pays for the hospital’s medicine.

Louise and Gemma throw on their blues just in time to help a new baby girl into the world. It is an experience neither midwife will forget in a hurry.

“Out here is nothing like back home,” says Gemma.

“Working in a hospital with the latest technology, you forget how vital basic midwife skills are.”

Louise adds: “I’ve never delivered a baby outside of Yorkshire, so it’s absolutely amazing.

“But it makes me wonder about the areas where hospital isn’t an option.”

Her question is answered the next day. Blessing Jones, the 19-year-old mum of the new baby girl, had suffered a secondary haemorrhage.

If she had not been in hospital she would without doubt have died.

It is just the start of a long day, during which the midwives have to help a woman with eclampsia.

Later Gemma, 34, a midwife for nine years, assists in a C-section – and the baby is named after her.

Even for the lucky few giving birth in hospital, conditions are hard.

Maud says: “We don’t want women back home to feel bad at having access to a higher level of care.

“But at the same time we in Britain don’t know how lucky we are. Help is a phone call or a taxi away. We’re minutes not days from first class care.

“If Save the Children makes its target, then the kind of care we think is a basic right will reach more women in Liberia.”

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