Pregnancies In Zambia More Difficult Than Most

My nearest neighbor Anna had a baby recently. Like the majority of preg­nancies, this baby wanted to come in the middle of the night, so she was rushed to the local clinic — via the back of a bicycle —sometime around midnight.

  

The clinic tries to meet the demands of those in the sur­rounding areas but often fails due to a lack of resources. This time was no different: there was a shortage of blood. Luckily, the district hospital is nearby (just 10 miles) and she was sent there to deliver her baby, again on the back of a bicycle.



Anna with her new baby... this is just 10 hours after delivery and she's back in the village.

But not all women are lucky enough to live near a govern­ment hospital.

  Sometimes, the clinic must do, and the labor room in a clinic is spartan at best.

  The only way to describe it is as being bare.  A clinic’s capacity is usually limited to giving anti­biotics and occasional injec­tions. There’s a blood pressure cuff available but no machines to help a woman if she goes into shock or has other, more seri­ous, complications.

  Even electricity is a luxury, which most go without. And the most important resource — ac­tual medical personnel — is of­ten unavailable.



Combating this issue is the job of the traditional birth atten­dant. TBAs have been around in Zambia for ages, but recently the Ministry of Health outlawed their use because they wanted women to give birth in clinics where hygiene and safety were thought to be better.



TBAs like this one, Finnesse Magenda, do a lot in the local communities to ensure safe births.

Yet, the issue of the lack of proper medical personnel didn’t disappear so many TBAs are now going through formal train­ing where they’re becoming trained birth attendants and thus allowed to deliver babies at the clinic.



The training involves mother and child nutrition, recognizing danger signs in pregnancy and labor, emergency response to those situations, and preventing mother to child transmission of HIV.

  When a woman goes into la­bor, a TBA is called in to help and there she’ll stay through the en­tire process. 

Although many of the clinics have the bare mini­mum in terms of equipment, they’re still better than a home birth where absolutely nothing is available.



However, many births still occur in a village setting due to distance from a government clinic, pride and even mistrust of the clinics. 

In these areas, the TBAs go about their job of bringing babies into this world in the same manner as they have for years. 

Weighing babies beneath a mango tree.  It's not the most ideal place, but it does work in the villages.  Funny side note - that scale in the middle of the photo is also the same one we used to weigh fish during our fish harvests.



For the actual birth, it’s a cultural taboo for men to be in the room.  Only female members of the father’s side are allowed in.  

Because of this, the mother will go through the entire childbirth without making a noise or the use of pain medication. Let me repeat that – without a single sound. Complete silence. This is because the mother doesn’t want to appear weak in front of the father’s family. 

And this doesn’t just happen for the first child, it happens for all the mother’s births, which average about six babies in a woman’s lifetime. 

 Some mothers are as young as 14 when they give birth to their first child. The national average hovers around 18. Anna is 17. 



After the birth, the clinic or hospital will make the mother wait for six hours to make sure both her and the newborn baby are healthy and safe. Once they’ve been checked out, they return to their village and back to their lives — often on foot. 

Due to the high child mortality rate in rural Zambia, the mother usually won’t give her baby a name for a few days until it is clear that the newborn is likely to live.  I’ve seen women back in their fields just days after giving birth.  It’s incredible. 



Six days after the birth, the TBA will make a follow- up visit to be sure of the general health of mother and child.  She’ll do a second follow-up six weeks later.  TBAs in my area have delivered so many babies (at least one of the eleven local TBAs will deliver a baby per day), that at some point they lose count.  But they always know the mothers and which babies they delivered, which creates a sense of pride for the TBA. 

Rhoda, a local TBA, filling out paperwork at a local Under five clinic.  Under five clinics are held once a week and all women with children below the age of five are supposed to bring their children in to be weighed and measured as a way of tracking the baby's health.

I’m continually astounded at the resiliency and toughness of women in Zambia and the entire ordeal of childbirth is no different.  In fact, it only helps solidify my amazement: no sound is made, a woman with no formal training provides much of the technical knowledge to bring a child into this world and at the end of the day there is a mother, a child and a TBA that have all connected through the miracle of life. 

It’s crazy and wonderful. 



My namesake - Baby Jordan

Oh, and before I forget — the name of Anna’s baby? Jordan.

* Special thanks to Charlie Brink for some of these photos.