The Realities of Birthing in East Africa

My family is living in a small town in rural Uganda this year, and the population here has a disproportionately large amount of young children and pregnant women.  Being the birth enthusiast that I am, the sight of big bellies everywhere stirs up joy and excitement in me, as I see it as a sign of blessing and life.  Sadly, the celebration of life is overshadowed by the unnecessary suffering and loss that has resulted from the injustice of poverty.  Though there are many, many births here, necessary medical supplies and health workers are scarce at best.  Just the few weeks that I have been here so far have opened my eyes to a level of need that has exceeded what I thought possible.  Yet, in the midst of the families suffering loss and overburdened midwives, I see that God is working.

I regularly stop by a small pharmacy run by a woman named Lucy.  We’ve been developing a relationship with her over the past six years and I always enjoy her candor as we talk about health care and midwifery.   Lucy was educated as a nurse and has delivered many babies.  People come to her little shop during the day and deliver in a room in the back of her home at night.  As we were chatting, she pulled out some notebooks where she had kept record of all her births.  She showed me how one year she attended 382 births, one of which was triplets!  She has no assistant, and attends these births by herself, without backup.  She finally had to retire because the number of women coming to her in labor was keeping her from sleeping at night.  However, I could tell that she still felt the burden of need for the local women.  She told me how she always tried to refer out the high risk cases to the government hospital.  Often, however, the women would be unable to go to the hospital and thus have no option but return to her in labor.  She couldn’t turn them away; rather, she chose to assist them and cry out to God.  With the help of God and Lucy, many women in the area gave birth to healthy babies – even twins and babies delivered breech – with what little supplies that were available.

However, the birth is often the easy part.  My first day visiting the small local clinic that services all the surrounding villages, I was invited to attend a birth with Mary, the resident midwife.  She had been there through the night with a mother who had just delivered and was already dressed, sitting on the small cot with her tiny baby girl.  Mary was tired as she attended to the next laboring woman, who looked too thin to be pregnant.  Though her baby came quickly and without complication, she was sullen.  I was the only one in the room who became emotional at the miracle of new life.  The overworked midwife was too tired and the mother too overwhelmed by the reality that her husband had left her alone to fend for this child.  The mother was there alone.  No one came to bring her food after the birth and she was so hungry.  Amanda Aaseby and I rushed to collect the few foods that you can buy prepared from local street vendors, and brought them to her.  However, as I brought them to her and tried through muddled Luganda to encourage her, I could feel that what I had to offer wasn’t enough.

It’s heartbreaking to be so close to such real needs.  They cease being intangible, academic concepts, and instead become palpable, at times engulfing, realities.  I long for the day that these needs will be met, but until then we will continue to hold the hands of the single mothers and exhausted midwives.  We will let the reality of the needs of women in Uganda, as well as the rest of the developing world, to push us to work, study, and grow so that we can usher in a new reality where mothers are supported and cared for -- before and after birth -- and we rejoice with God for each new life.

By Celesta Bargatze