The story of Aisha Tiro Bahero, aged 30 and a mother of six is not only one of resilience and determination, but also of how access to maternal and child health services is critical in saving women’s lives and empowering them to live productive and healthy lives.

Aisha lives in Kiwayuu, a small island located in the eastern part of the Lamu Archipelago in Coastal Kenya. The only health facility on the island was established two years ago by the Lamu County Government, and serves its 600 inhabitants. Prior to its inception, patients, including expectant mothers would travel to Lamu Island, a 7-hour trip by dhow or an hour trip by a motorboat.

“I got married when I was barely 18 years, and delivered my first child at home,” says Aisha. Her subsequent three deliveries happened at home.

“As a marginalized community, we were ignorant about the importance of antenatal care, largely because for the longest time we didn’t have a health facility in Kiwayuu,” adds Aisha.

Consequently, the community relied heavily on the services of traditional birth attendants, who had limited knowledge and skills. “In the event of pregnancy related complications, or even maternal deaths, we would conclude that it was God’s will,” she says.

Life-threatening

Three years ago, everything changed for Aisha when she was expecting her fifth child. “I was set to deliver at home as usual,” she says. “The traditional birth attendant who had helped me deliver in the past was at hand to assist,” says Aisha.

All was set and Aisha was looking forward to a normal delivery just like in the past.  

“As I went into labour, I began to bleed profusely. I couldn’t stop or control the bleeding. No one could,” she says rather thoughtfully. “I knew something was wrong. It was scary, and frankly speaking I thought I was going to die,” she adds.

The only nurse at Kiwayuu Dispensary at the time was called, but she too couldn’t figure out what was wrong with Aisha. Her verdict was quick: it was a life-threatening, pregnancy-related complication that needed urgent medical care, if Aisha was to survive.

The nightmare

For Aisha her nightmare was only but beginning. The nearest hospital besides the Kiwayuu Dispensary was on Lamu Island, an hour trip on the rough Indian Ocean waters by a hired motorboat. Thirty minutes on the rough ocean, with difficulty Aisha delivered her fifth child.

“Its an experience which I will never wish any woman to go through,” she says. “Not only did I get close to loosing my life and my child’s, but the trauma of delivering on a motorboat on rough waters was unbearable,” she adds.

When she arrived at King Fahad County Refferal Hospital in Lamu Island, Aisha was diagnosed with postpartum haemorrhage and the baby was diagnosed with low birth weight as a result of intrauterine growth retardation, also known as "intrauterine growth restriction" which refers to poor growth of a fetus while in the mother's womb during pregnancy. The causes of intrauterine growth retardation can be many, but most often involve poor maternal nutrition, anaemia or lack of adequate oxygen supply to the fetus. Anaemia in pregnancy is a risk factor for heavy bleeding during delivery. Aisha admits not having access to appropriate antenatal care during her pregnancy, a decision that almost costed her life. 

Leading cause of maternal deaths

Complications in pregnancy and childbirth continue to be a leading cause of death for women in developing countries. Aisha’s story is simply a representation of what many women go through in many parts of Kenya, where access to maternal health services, in particular antenatal care and skilled birth attendants, is lowest.

According to the 2014 Kenya Demographic and Health Survey, it’s estimated that 5,000 to 6,000 women die while giving birth each year in Kenya, while 22 out of 1,000 babies die at birth.

Ironically, simple acts such as providing health education to pregnant mothers in the importance of antenatal care services is enough to save lives of millions of mothers and children.

Ending preventable maternal deaths

UNFPA, United Nations Population Fund, works with the national and county governments and partners to train health workers, improve the availability of essential medicines and reproductive health services, strengthen health systems, and promote international maternal health standards.

For instance, at the Kiwayuu Dispensary, UNFPA has improved its capacity by supporting the procurement of assorted maternal and newborn health and family planning equipment, as well as improving availability of essential medicines and reproductive health services. Community health workers have also been trained in provision of emergency obstetric and newborn care (EmONC).

Advocacy efforts have been stepped up amongst religious leaders to support efforts towards ending preventable maternal mortality and morbidity, and the elimination of harmful traditional practices such as Female Genital Mutilation and child marriage. 

For Aisha, who is now empowered to make informed choices, including the use of family planning methods, her ordeal changed her life.

“With support from UNFPA, I have been trained as a community health volunteer, and I now work in my community to raise awareness about maternal mortality, its prevention and access to maternal and child health services,” says Aisha. 

The community is now empowered, with most seeking reproductive, maternal, newborn, child and adolescent health services at the newly upgraded Kiwayuu Dispensary.

Having a child for mothers should not be tantamount to a death sentence. Childbirth should be a happy moment for families and communities, not misery. In this age and time, no woman should die while giving birth. It’s for this reason that UNFPA and partners are determined to deliver a world where woman’s health is protected, every pregnancy is wanted and every childbirth is safe.

Written by Douglas Waudo, Communications Analyst, UNFPA Kenya.