Out of Luck? How BEmONC helped Ashura survive


In a mini-blog series ICM is highlighting the role of midwives in family planning. The series continues with a guest blog from the partner organisation Jhpiego, written by Maryjane Lacoste, Country Director, Jhpiego-Tanzania

Wampembe, Tanzania—In this remote corner of western Tanzania, where the nearest hospital is four hours away on a rutted, rock-strewn dirt road, pregnant women are relying on midwives Adelina Kizzila and Flora Mwananjela (on the right, photocredit Jhpiego) to help them give birth safely and deliver healthy newborns. I visited the Wampembe Health Center, where these midwives work, and quickly discovered the precariousness of giving birth here.

Midwife Flora Mwananjela
Not a single phone company provides service to this health center, and the lorry that travels twice a week from the village to town takes much longer than the four-hour trip by jeep that I took. If a woman in labor has complications before 3:30 p.m., the health center can radio for an ambulance. But it will take four hours for the ambulance to arrive, and another four hours for it to return to the district hospital on that same rutted road. In short, any woman with a complication during labor is basically out of luck.

A properly trained midwife is the only hedge against death for an expectant mother. Ashura Baraka (at the bottom, photocredit Jhpiego), a 25-year-old mother who gave birth to her fourth child at the Wampembe Health Center during the middle of the night, knows this well.
After delivering her daughter at the center, the new mother received a shot of oxytocin. Soon after, however, midwife Kizzila discovered that Baraka had a retained placenta and began to bleed. Kizzila shouted for help. Mwananjela, the facility midwife in-charge, came to Kizzila’s aid, guiding her step-by-step to manually remove the placenta and give the mother an additional oxytocin injection, thus stopping the postpartum hemorrhage.

Thankfully, both of the midwives on call that night had been trained in basic emergency obstetric and newborn care (BEmONC) under the Mothers and Infants, Safe, Healthy and Alive (MAISHA) Program, funded by the United States Agency for International Development and implemented by Jhpiego and partners. As a result, Ashura went home healthy with her new baby girl, Upendo, in her arms.

Mother Ashura with BabyMy visit to Wampembe underscored for me the vital role midwives play in keeping women alive and healthy. By increasing the number of midwives in remote, vulnerable areas and ensuring they have the training they need, we can help to save the lives of countless mothers and newborns.