Waiting to deliver

The pregnant women in the maternity ward sleep on the beds, under the beds, on the floor between the beds and down the hallway. Some of the expectant mothers even sleep outside on the dirt.

At any given time the maternity ward at Muko Health Center IV is beyond capacity.

There are 6 beds in the maternity ward and about 20 pregnant women. It is difficult to keep count of the number as there is no official census. Some have delivered and are waiting to recover enough strength for their long walks home. Most are pregnant and waiting to deliver.

Pregnant women journey to the hospital on foot in anticipation of delivering as they lack transportation and know they could never reach the hospital once they are in labor.

The women and their families at the health center have to cater their own food, firewood and bedding supply during the duration of their stay, which can be a few days to a few weeks. One high risk patient, Pamela, recently stayed there for 4 months before she delivered.

The main reasons for maternal deaths in these rural areas are the lack of skilled birth attendants, remoteness, lack of transportation, delay in referral for emergency obstetric care, and delay or poor implementation of interventions at the facility level.

The majority of maternal deaths occur at homes in rural areas, among poorer communities and during the peripartum period — the last 3 months of the pregnancy to the first week after the end of the pregnancy. A peak in maternal mortality occurs during the intrapartum period around childbirth and the first day post-partum. Over 90% of these deaths are preventable with access to skilled obstetric care.

Maternity waiting homes

Maternity waiting homes offer a place to reside within easy reach of emergency obstetric care. The service aims to enhance access to care by bridging the geographical gap between women and services.

These waiting homes provide a residence for high-risk pregnant women or those who are living far away to await labor during the final weeks of their pregnancy. The mothers have the opportunity to receive antenatal care and health education about pregnancy, delivery and neonatal care.

The key to success is offering a quality facility that is not overcrowded and one that can address the problems of access to water, food, firewood and the cost of reaching the health center. Addressing cultural issues, such as lack of awareness about the existence of the waiting homes, lack of privacy, inability to use traditional birthing practices, being away from the family and lack of respect from health staff are also vital to the success of these waiting homes.

Muko Health Center IV in Uganda is in dire need of a maternity waiting home.

Worldwide Healing Hands enabled this center to offer cesarean sections and helped educate women and their families about the importance of delivering with skilled health care providers. We observed a two-fold increase in the number of mothers delivering at Muko Health Center IV and subsequent improvement of maternal health care services due to our teaching.

Photo Credit Nathan DeHart