By Dr. Kate Celauro
My colleagues who work in Afghanistan have an up-close perspective on one of the most dangerous places in the world to give birth.
In a country where maternal mortality is at an estimated 1800 women per 100,000 live births, Micah and his wife, Amy, have seen it all. They work alongside Afghan doctors and nurses to save mothers every day.
During a recent conversation, Amy relayed her observations that many girls in Afghanistan marry very young and have little knowledge of pregnancy and delivery. And, she explained, since the girls live with their in-laws after marriage, they are often too afraid or intimidated to ask questions. Most of these girls have no idea what to expect from pregnancy or how to take care of themselves, especially when things go wrong.
Before the Baby Arrives
While Amy and Micah and their co-workers treat obstetric emergencies every day, Amy is quick to point out that some of the most important work they do is in the community before a woman ever gets pregnant or presents to the hospital in labor.
They support trained Afghan nurses to go into rural communities and give seminars to young women, teaching them to recognize danger signs in pregnancy.
The women who attend also learn to prepare basic things for their delivery and they get training on helping other women in labor or after the baby is born. The information is simple, the strategies straightforward, but the impact is life-changing for these girls, most of whom are illiterate.
I asked Amy to share with me some of the attendees’ revelations after these training sessions. Here is what the women said (roughly translated by the nurses):
Nadira commented, “My uncle’s wife was pregnant with her first baby. When the time for her came to deliver she didn’t tell anyone in the family that she had pain and then she gave birth in the latrine outside of the house! Her mother in law found her there and took her to the house but the baby got very sick. After this course, I understand now, that her baby got an infection during this time as it wasn’t a clean place to deliver a baby!”