It was mid-February, when a young woman, Selam, went into labour at home in her remote village. After many hours labouring with only her family present she began haemorrhaging, the sight of so much blood loss terrified her family. Her only hope was to be carried by stretcher to the nearest health centre.
Eight men were gathered in the middle of the night to carry Selam on mountain tracks to reach the health centre. They were exhausted when they arrived and sick with worry about her deteriorating condition. Sadly, it was too late and Selam died shortly after arriving. Her baby died with her.
This tragic story could have had a beautiful ending had the mother been able to attend antenatal appointments and laboured with a professional midwife.
For the 1.1 million people living in the Simien Mountains there is only one general hospital and small rural health centres which can take days to reach by foot or mule. And when women eventually arrive at the centres there are often shortages of staff and a lack of medicine and equipment.
One of our partners, the Simien Mountain Mobile Medical Service (SMMMS), reported that this year alone their region saw approximately 34,700 women delivering at home, without a midwife.
Shockingly, more than 270 mothers and 1,100 newborns died from a preventable or manageable complication. For the lucky ones who survive, more than 275 women will suffer a devastating obstetric fistula.
Whilst it is recommended that women see a midwife a minimum of four times in their pregnancy, in reality it is far lower. Household, family and financial pressures, along with the distances between villages and health facilities, mean women are lucky to even have one appointment, if any.
But thanks to our partners, there is hope.
Last year alone our partner in the Simien Mountains trained and deployed midwives to seven government health centres, providing 9,607 antenatal visits and safely delivering 2,511 babies.
In the Gubre region, another partner has increased uptake of antenatal assessments by taking midwives to women in their own homes for four comprehensive assessments. This means risks are identified, complications avoided, and lives are saved.
Woinshet joined the programme at 22 weeks pregnant with her first child. She received four visits at home and intended to also give birth at the local clinic. However, during the final home visit, the midwives identified worrying clinical symptoms of pre-eclampsia and recommended immediate transfer to the hospital with a nurse from the clinic.
Woinshet gave birth to her son, Beneyas, by caesarean section the following morning.
“Igziabeher yemesgen (thanks to God) for the clinic midwives. Through my pregnancy, they cared for me so well, and I never felt afraid or worried …… I am also so thankful for their judgement when I had a complication and had to go to the hospital. If I didn’t have midwives coming to my home who I knew, I probably would not have wanted to go to the hospital just because of a headache. I am so grateful, and thank God, that my baby and I are safe. I was also so happy to have Aster (the Clinic’s nurse) with me during my stay in the hospital, it was more than I could have ever expected. Thank you.” Woinshet
These two stories, one of the way it sadly is and another of the way it should be, a life lost and a life saved, gives us hope that by supporting a network of maternal health partners across Ethiopia – who are all working towards saving the lives of women and their babies – we can one day hope to achieve Dr Catharine Hamlin’s legacy of having a “midwife in every village”. Ethiopian women should be able to experience childbirth without fear.
