Social Justice During Pregnancy and Birth.
In segmented parts of our world today, for most women seeking proper maternal care, the care remains a nightmare putting into ridicule to shame the millions of dollars invested in the name of eradication of infant and maternal mortalities.
The whole process of pregnancy and birth always concluded as pity, dangerous and a punishment. In the developing world, a number of governments are in the lead introducing free prenatal and deliveries packages in public hospitals. However, this care sometimes ignoring the basics, simpler and the compassion easily required. In the end, the policies and programmes funded by billions of tax payers’ money, non-governmental organizations, donors and intergovernmental agencies bring into mockery, the noble intended outcomes out of care.
I have been involved convinced to see the essence of simplicity, safety, compassion and focused care that has led to better outcomes, a shining winning example in the developing world. FreMo didn’t invite millions of dollars to bring on the table the better outcomes it shares; it would be the basics in simple techniques with safe practices that matter. Cleanliness, respect and autonomy in the birth room, safety practice in care, recognizing deviation from the normal and the preparedness to intervene medically or transfer. The provision and the invitation of caregiver skills and to be ever present during pregnancy and at birth, while putting faith in the woman’s body, its biology and its design to birth.
FreMo didn’t invite millions of dollars to bring on the table the better outcomes it shares; it would be the basics in simple techniques with safe practices that matter. Cleanliness, respect and autonomy in the birth room, safety practice in care, recognizing deviation from the normal and the preparedness to intervene medically or transfer. The provision and the invitation of caregiver skills and to be ever present during pregnancy and at birth, while putting faith in the woman’s body, its biology and its design to birth.
At local maternal centres, women attending free prenatal care treated harshly and many times chased away from the illogical reasons, for example in for late enrolment, late during appointments and forced to follow instructions and never questioning or else be ejected. Every time the demographic health survey statistics are released, they either ignore or otherwise brush them out. During labour, these women would find it hard to access maternal care during for lacking the maternal booklet with the testing and follow-ups. The biological clock dictates nights for the majority of mama to go into labour, but with no transport mean available, they get stuck at home. These women beautiful and strong made vulnerable by dysfunctional systems and bureaucracies are prone to uncertain their lives and the unborn. These women end up birthing at home alone, sometimes with the aid of traditional birth attendants who do a great deal but lack information, updates and preparedness in dealing with emergencies and interventions including pre-eclampsia, postpartum hemorrhage, tears and medication of HIV and Aids for mother and infant. But I must agree totally their gentleness, the compassion and the dignity they practice.
On Monday morning 22nd February we were on outreach, Mercy, Anne, Carren and I we were on a mission to one postpartum mother. She delivered normally at home three weeks and three days ago. Dorine didn’t have any prenatal enrolment. The day she sought permission to get enrolled, she arrived at the local public health centre where on inquiring how old the pregnancy was, she was chased away, reason; she passed the first trimester, the recommended time to start antenatal clinics. Left with no choice, she walked home hating her pregnancy and what was ahead. She works in informal employment where it’s hard to get off date and worse still if she gets one on weekends all public centres are closed.
The same waited for her during birth; No admission without antenatal follow-up records. Three weeks earlier she was in labour at her tiny shanty room. She was struggling by herself, no support, no skills and nothing to foresee her through the womanhood experience of every reproducing woman, to get support; emotional and physical, encouragement and a shoulder to lean on during the labouring period. She struggled by herself through the latent phase of labour till the second stage when she went couldn’t sit pretending, her labour demanded a voice and she went screaming and shouting. Dorine lay on a dirty in a room that was not swept this day and doubled as living and sleeping room. Good Samaritan women next door ran to the nearby chemist/clinic begging for support, and over they came and helped the whole process, a little fee was attached.
Last week our new outreach staff, Anne was on the reach and care mission from the clinic, as she knocked door to door she was opened the door by Dorine. She was in shock of the state of the living when Dorine openly and candidly shared her birthing sorry story, three weeks ago. She didn’t have food, surviving on mercies from her sisters who rent next door. At her place this morning, on arrival she was holding her baby. She hasn’t gotten out to bask nor went to the shop but was nursing little Kemuma. Mercy started her postnatal care and went from one point to another, showing a few tips on caring for newborn and her, followed later. We found out that baby was given porridge, which scared all of us. When asked, she said when has gone out shortly, the baby started crying from hunger and the little one started sharing porridge.
With us were a few groceries and some food which we purchased before leaving the clinic.
Mercy had also been given some contraceptives by the head midwife. We also remembered
that she needed some pads beyond postpartum, courtesy of Friends for Kenya Donated last
year. On departure, as I ran back to the clinic, I hovered looking at all the shanties along the
road even deeper in the settlement, asking myself of how many Dorine’s are waiting for
salvation from God or mother nature appointed angel. As for the team, today it’s an
accomplishment for being there for Kemuma and showing company, compassion and concern.
Wherever I go I carry along optimism, glimmer of hope and faith in humanity, it doesn’t matter the prevailing circumstances. However, I must admit what troubles me most would be the inequality that makes social justice to pregnancy and birth under our watch. It worsens still when a pregnant woman becomes vulnerable due to the scarcity of resources to reach possible attainable pregnancy and birth.
No debate, persuasion or otherwise, all birthing mamas demand safety, skills, dignity and autonomy. My short-lived experience provides a platform to dissuade the norm that complexities and unnecessary mortalities can be eradicated when we start with the basics and pamper the care with compassion. They assert a woman that her care is secured imparting full confidence while enabling biology and body to simplify the best during labour and birth. Underneath they pave the way for informed choice, consent and fairness. On these foundations, her rights are respected and social justice will prevail.