The Perilous Journey to Motherhood: The Impact of the Horn of Africa Crisis on Childbirth, Labor, and Delivery

Edited by Lillian McKenna

This article was originally published by the New York University chapter, in Edition 001.

The Somali peninsula, also known as the horn of Africa, is currently undergoing one of the most severe humanitarian crises it has ever endured. A combination of drought, political violence, and climate change has devastated the lives of over 8.5 million people in Ethiopia, Somalia, Djibouti, and Eritrea for the last three years [6]. One group of people who are impacted the most are also overlooked: women and girls who are at increased risk during pregnancy, childbirth, and post-partum.

Access to critical maternal care services has been extremely limited due to the ongoing crisis. Both a lack of access to food and water along with an increase of attacks by regional groups on civilians has caused healthcare workers to flee the area and be displaced from their homes [2]. The physical buildings of hospitals and other healthcare facilities have also been targeted in conflict. The combination of a lack of staff and facilities results in a steep decline of women who are able to fully reap the benefits of pre and postnatal care as well as skilled medical providers during the actual event of childbirth.

By investing in women, we invest in the future of the entire Somali peninsula.

The absence of these services reflects in staggering numbers. Somalia, for example, has the seventh highest maternal mortality rate in the world at 621 deaths per 100,000 live births [1].

Another obstacle for these women is the physical one. The rugged terrain of the horn of Africa, long distances and brutal weather conditions makes access to hospitals increasingly difficult. This is crucial when it comes to something as time sensitive and delicate as childbirth and pregnancy, and women often resort to home births. A home birth without medical supervision can lend itself to risks such as hemorrhage, infection, and several other complications that put the life of both the mother and the child at stake [5].

In addition to the difficulty in the birthing process alone, the crisis has also impacted women’s health in other instances. The drought also decreases accessibility to food and water overall. Without these necessities, new breastfeeding mothers or simply looking after their children are highly susceptible to malnutrition and general physical weakness. The lack of food and water also means a lower immune capacity, making them more prone to illnesses and a decreasing chance to survive those illnesses [3].

Besides the overall physical health of mothers and their babies, it is not possible to ignore the profoundly negative impact that the crisis has on mental health. Women are often the victims of sexual and domestic violence, the rates of which nearly doubled between 2019 and 2021, the time of the onset of the most recent drought [4]. Living in such stressful environments makes mental health conditions like depression, anxiety, and PTSD more common. These mental illnesses have the capacity to be crippling enough to stop women from being able to care for themselves and their families.

In order to adequately resolve tensions in the Somali peninsula, solutions must include acute relief plans as well as long term and sustainable interventions. Acute relief plans must prioritize increasing access to natal care and women’s healthcare as they are one of the most vulnerable people groups. This level of relief plans can manifest in more medical personnel being sent to the region as well as new areas to provide healthcare.

Long term relief interventions must tackle larger issues like sustainable solutions to droughts and changes to alleviate climate change. Other interventions can include educating women, and empowering them to take charge of their physical and mental health.

The crisis in the horn of Africa has had an overwhelmingly large effect on the health of women, particularly those who are pregnant. In order to overcome this emergency, special attention must be given to address large issues such as climate change and gender inequality, but also more niche issues such as returning hospital services and staff to the peninsula.

An investment in the health, education, and empowerment of women is a worthwhile investment. By investing in women, we invest in the future of the entire Somali peninsula.

Works Cited

1. Central Intelligence Agency. (2020). Maternal Mortality Ratio. Central Intelligence Agency. https://www.cia.gov/the-world-factbook/field/maternal-mortality-ratio/country-comparison/
2. Farge, E. (2023, March 14). Exodus of healthcare workers from poor countries worsening, who says. Reuters. https://www.reuters.com/business/healthcare-pharmaceuticals/exodus-healthcare-workers-poor-countries-worsening-who-says-2023-03-14/
3. Karimi , M. (2022). Horn of Africa drought means hunger and malnutrition for people at a clinic in Kenya: World Food Programme. UN World Food Programme. https://www.wfp.org/stories/horn-africa-drought-means-hunger-and-malnutrition-people-clinic-kenya
4. New IRC data: Horn of Africa drought leading to increasing violence against women and girls. The IRC. (n.d.). https://www.rescue.org/press-release/new-irc-data-horn-africa-drought-leading-increasing-violence-against-women-and-girls
5. Teferi, H. M., San Sebastian, M., & Baroudi, M. (2022). Factors associated with home delivery preference among pregnant women in Ethiopia: a cross-sectional study. Global health action, 15(1), 2080934. https://doi.org/10.1080/16549716.2022.2080934
6. United Nations. (2022). Horn of africa: Extreme drought deepens hunger in a region facing conflict | africa renewal. United Nations. https://www.un.org/africarenewal/magazine/november-2022/horn-africa-extreme-drought-deepens-hunger-region-facing-conflict#:~:text=To%20avert%20a%20humanitarian%20catastrophe,the%20number%20of%20malnutrition%20cases.