Fantastic Stories from the Field
In the past few weeks we have met so many women with incredible stories. Their experiences do a better job than we ever could of illustrating maternal health and barriers to care in Zanzibar, and we would like to share a few.
We have read about overcrowding of hospitals and spoken with numerous health workers about staff shortages. But the concept was reinforced when a mother who delivered at Zanzibar’s top public hospital gave us her opinion on hospital delivery. She explained that she did believe hospital delivery was safer than home births, but mentioned the doctors are not around much. She then proceeded to tell us that she actually delivered her baby before the doctor came to see her.
Transportation is another very obvious problem. Many women have to walk over an hour to get to the facility. One woman was walking to the hospital with her mother to deliver, but labor pains started and she was forced to deliver on the side of the road while her mother ran ahead to get a nurse. The nurse arrived after the baby but did help cut the cord. We’ve also spoken to numerous women who were forced to deliver at home because of transportation failures such as the late arrival or cost of a taxi.
A third issue that we have noticed and that has been mentioned by staff is that women wait too long before leaving for the hospital. They don’t decide to leave home until labor pains are severe, which is another reason many end up delivering at home or en route to the hospital. This was the case with one woman we interviewed who was about to leave her home when labor pains became too intense. Her mother sat her down and assisted her in delivering the baby at home. For her second child, the woman decided she could use the knowledge she had gained from her mother during the first delivery and delivered herself, without assistance, at home. She delivered safely, and made the same decision for her third child.
The woman explained that she prepares for delivery by buying a clean razor and some string, and laying out a mat. Once she delivers the baby, she ties the string tightly two times around the umbilical cord and uses the razor to cut it. She massages her belly until the placenta is delivered, and then cleans and wraps the baby and flushes the placenta down the toilet. Her husband waits outside the room, asking if everything is going well. She takes her new baby to the hospital after about one month.
Despite hearing stories of complications with home births, and actually witnessing obstructed labors and severe bleeding at home, the woman has no fear of complications during her own deliveries at home. She said it is in God’s hands.
