The White Ribbon Alliance has put together a series of stories of mothers whose lives have been saved through the intervention and work of organizations dedicated to improving maternal and child health. Jhpiego submitted several examples of our work. Here are two of them provided by staff from Nepal and Malawi:
Community Health Worker Helps Nepalese Mother Survive Post-Birth Bleeding
For Najini Khan, December 23, 2009 began like any other. She cleaned the house, fed the goat and cow, bathed her daughter and cooked the main meal. But when her family sat down to eat, the 25-year-old couldn’t—her labor pains had grown that intense. She asked her husband, Isharat, to call the neighbor who would help bring the newest member of the Khan family into the world.
“After eight hours of labor, my baby and [placenta] came out together,” says Najini, who began bleeding and quickly took the three white pills that she had been given previously by the local community health volunteer to control any bleeding.
Najini had prepared well for this birth—she received prenatal care at the local health post and learned what to expect from Chandrakali Kurmi, the community health volunteer. Among the potential problems—postpartum hemorrhage, the leading cause of maternal deaths in the world. The majority of women who bleed to death after birth live in the developing world.
The community health volunteer had explained to Najini that she could prevent such bleeding by taking three pills of the drug misoprostol (known in Nepalese as maatri surakchya chakki) after giving birth. This information was critical to Najini once she and her husband decided a hospital delivery was out of the question because they had no one to babysit their five-year-old. They planned for a home birth, including use of misoprostol, reviewed the drug’s side effects and prepared for a possible emergency that would require Najini to go to the hospital.
After giving birth to a lively baby girl, Najini took the three white pills as the community health volunteer had told her. But Najini’s bleeding wouldn’t stop. After soaking through five cloths, her husband called Chandrakali to help take his wife to the hospital.
Settled into the back of a buffalo cart, Najini traveled more than an hour to reach the town of Nepalgunj, which was just nine miles away. By the time they reached Bheri Zonal Hospital, Najini’s blood pressure and hemoglobin had dropped dangerously low.
There was no time to waste; Najini was taken immediately into the operating room where hospital staff removed a piece of retained placenta and the bleeding stopped.
The next day, as she cradled her baby girl, Najini recognized how lucky she was and how essential the prenatal care and advice of the community health volunteer had been.
“I was able to survive because of this maatri surakchya chakki,” said Najini, speaking about the misoprostol she had received. “I would have never known when to come to the hospital [for bleeding] if the information had not come with these pills. I might have died, leaving my two girls to struggle alone.”
In a Malawi Village, Prenatal Advice Proves a Lifesaver for Mother and Twins
In the village of Maunde in Malawi, culture and tradition value a woman who suffers through her labor at home and delivers a baby quickly. She is strong, worthy of emulation and an asset to her husband and family. But a woman who rushes to the hospital once labor begins is considered weak in this African society.
As the mother of six children, Agnes Chatha knew well the community sentiment on home birth and the views of her neighbors. But visits from Rose Kamphandira, a community health worker, offered the 32-year-old mother and her husband, Kennedy, a new way to approach pregnancy and some lifesaving advice.
Rose was part of a community health initiative to identify and counsel pregnant women and new mothers in four rural districts in Malawi. The ACCESS Program was funded by the United States Agency for International Development and managed by Jhpiego in collaboration with Save the Children in their work to prevent the needless deaths of mothers and newborns.
Rose visited the Chatha house when Agnes was six months pregnant with her seventh child. In subsequent visits over the next three months, Rose talked with Agnes and her husband about preparing for the birth of their new baby. They discussed danger signs during pregnancy, good nutrition, ways to prevent the transmission of HIV from mother to child, the importance of having a skilled birth attendant at delivery and giving birth in a facility, the safe feeding of an infant and family planning methods.
Agnes’s husband was especially interested in Rose’s visits and sat with his wife; he wanted to be sure his wife and new child benefited from this professional advice and received the best care.
During her pregnancy, Agnes followed Rose’s advice and had two prenatal visits at the nearby Ntosa Health Center. When Agnes felt the first pangs of labor, her husband didn’t wait for his wife’s labor to progress. Mindful of Rose’s advice, Kennedy rushed Agnes to the Ntosa Health Center, where she was examined by a midwife who had some surprising news for the couple: Agnes was carrying twins.
Within 30 minutes, Agnes delivered the first twin, a healthy boy. But the second twin proved more difficult and Agnes was brought to the operating suite of the district hospital. An examination found that the second twin was lying sideways with a hand presenting first; a cesarean delivery was her only choice.
Today, Agnes and her twins, Tionge and Chimwemwe, are thriving. She credits the prenatal advice and visits from community health worker Rose Kamphandira and her husband’s active participation in her pregnancy with the babies’ health—and her survival.
“If it was not for the visiting health surveillance personnel, I would be dead by now,’’ Agnes said.
Her husband concurred: “The home visiting program is useful and lifesaving. The advice given is really [important]. I am grateful that my wife and children were saved.”