You have lived!

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Expectant mothers at a village maternity waiting home.

This is a special request blog, on birth and motherhood in Congo, in comparison to the US of A and the rest of the world.

I should preface this by saying that I am not a mother, and have never experienced childbirth so this is purely observation! Slap me if I get things wrong, verbally only please.

For women who are pregnant in rural Congo, life does not change much. It is not a celebratory occasion in the way that it is in the developed world. This may be different for wealthier families, or women in more urban parts of the country, but in the villages, pregnancy is just another day. Most women interchange between being pregnant and breastfeeding. The average Congolese woman, has an average of over 5 children in her lifetime.

And so, for pregnant Congolese women, life continues on as normal, there is no break in the field or household work. In most villages, women are not able to, and do not seek prenatal care. Its very often not available, and if it is, it is usually too expensive to go to a doctor, especially for something preventative like a prenatal checkup.

When the big day comes, it is usually by surprise, since for most village women, it is almost impossible to accurately gauge a due date, particularly if they haven’t had any prenatal appointments and have no knowledge on their menstrual cycles. If she has however, and she knows when her baby will be born, and she can afford it, she will usually find her way to the nearest clinic beforehand. This can be on foot, lifted ahead on a table or wooden chair by the men in her family, via motorcycle, or if she is quite well-off, a rented taxi. The woman who is fortunate enough to do this, will then wait, typically at a waiting home, which in most cases is a shack with mattresses, with other expectant mothers, waiting to give birth.

For the woman, unable to go to a clinic like this however, which is the majority of rural Congolese women, it is the local traditional attendant who comes to help her birth her child. Traditional attendants, will walk at night with little torches to the house where the mama is, she moves quickly, determinedly and quietly.

Once there, she can get to work, if she does not have tools, which is often the case, they will use whatever is available. The mama is laid on the ground, sometimes on a piece of kanga, there’s no time to wash it or make sure it is clean.

There is no epidural for the mama giving birth, typically no soothing husband’s voice or hand, there is only that moment in time, and the urgency that it brings.

Once the baby is born, the cord is cut with a kitchen knife, that is sometimes, sometimes not, boiled. He or she is wrapped, but then taken away, because they think the mother is too tired to hold the child. (In our training, we explain that the first thing should really be skin to skin contact between the mother and child, excited to see if they have been doing it yet.).

The next day is usually when the mother sees her child, and the harrowing process is complete.

For other women though, this can be completely different. As many as 15% of women experience complications during childbirth, and without access to proper antenatal care, this percentage risk is greatly increased.

There is no emergency room to take a woman to when she needs a C-section or some sort of emergency procedure and there is usually no doctor on call to come help.

For the woman who is experiencing a complication, she must endure the travel, whether on foot, or carried overhead by family members or friends to the nearest facility. The travel can be anywhere from an hour to a day or more long, depending on their location.

Countless women and babies die on the way, or once they arrive, having lost too much blood or been in distress for an extended period of time.

This is the plight of the majority of rural women in the DRC and other countries around the world.

Pregnancy is a scary thing for anyone anywhere, but it is even more so, in countries like the DRC, where the basic things you need to reduce that risk, are not present, or are unreachable.

It is no wonder that the congratulations in many Congolese villages, for women after giving , is “You have lived!”.

The great thing about this situation, is that is changeable. Significant successes in reducing maternal mortality can be achieved in the Democratic Republic of Congo, through simply ensuring that women have access to primary health-care. What does this look like? Well, starting with ensuring that there is an equipped health-center within reasonable reach, what is the point of a center far away from the people who need it? Ensuring that women are able to access it, without economic devastation, or stigma, or excessive toil. And ensuring that they have the knowledge to understand their bodies and their health, and all that they need to do to protect themselves and their families.

Check out http://channelinitiative.com/ to learn more about all that we’re doing to change this reality.

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