Sita’s Story: Childbirth in rural Nepal
Restoring dignity and giving hope for a better future.
Words by Melissa Morris (PR & Communication Manager, Thankyou). Photography by Jessie Brinkman Evans.
In Nepal the maternal and child mortality rate is amongst the world’s worst. 64 per cent of pregnant women deliver their babies at home without the care and support of a trained birth attendant. Because of this, every four hours a Nepali woman dies due to preventable complications in pregnancy and childbirth and every two hours a Nepali newborn dies. — World Health Organisation 2015
Coming face to face with our ‘why’ is something I’m lucky to be able to do in my role. A crucial part of our impact model is to visit the projects before we commit to funding them to make sure they align with our development goals. On these trips, we also take with us a team dedicated to listening to and capturing stories of the people we exist to serve. I’m privileged to be a part of that team.
I recently travelled to Nepal to visit the maternal and child health projects run by the team at One Heart World-Wide.
We spent two days in Kathmandu learning about One Heart World-Wide’s goal for every mother in Nepal to give birth in a birthing centre with a skilled birth attendant, their innovative Network of Safety Model and the strides they’re making in lowering the maternal and child mortality rate in rural areas. Armed with a heap of new knowledge, we departed for the field to see the infrastructure and meet the people who have benefited from the programs.
After a short flight on a small propeller plane, we arrived in Pokhara, collected our bags and made our way to our transportation — two 4WDs. They weren’t the large, wide, solid–looking 4WDs I had expected, and seeing the steep mountains we were about to climb, I was more than a little nervous.
As we drove, Surya, the Program Director at One Heart World-Wide told us about a woman named Sita who we were going to meet in Jaljala, one of the first villages we’d visit.
It took nine (slightly tense!) hours of driving with a break overnight to reach Jaljala. The last four-hour leg of the trip was filled with nervous laughter and sideways glances as we drove along a slim dirt road, peppered with rocks, potholes and the aftermath of landslides. The car clung to one side of the mountain as we drove, as the other side was a sheer drop down. I was suddenly grateful for our slimmer-than-average 4WDs — I’m not sure we would have fit through some parts otherwise.
When we arrived in Jaljala the whole community was out to greet us with flowers, dancing and music. They walked us up the mountain and into the birthing centre that took pride of place in the village.
We met with the Skilled Birth Attendants (a.k.a. real-life heroes) and toured the birthing centre. It houses all the elements needed for a safe delivery — sterilised utensils, a bed, a stethoscope, an IV drip. Then there are the stark reminders that you’re on top of a rural and remote mountain — a backup generator, solar power head torches and educational posters on the benefits of women giving birth with a skilled birth attendant rather than at home.
Looking at the daunting terrain, I struggled to fathom the reality that before the birthing centre was built in Jaljala, the women we were about to meet would walk over six hours on these roads while in labour to have a safe and assisted delivery.
If that option wasn’t possible, they’d give birth at home or in a cow shed usually lying on a piece of plastic on the floor, with their mother-in-law on hand (which is cultural tradition) and unsterilised utensils to assist with the birth.
After we saw the birthing centre and met with the skilled birth attendants and health workers, the team at One Heart took us up the mountain to Sita’s house. She had just finished preparing dinner when we arrived.
She lives in a small, tidy and unassuming house with her husband, daughters and parents-in-law.
Inside her house is dark — no electricity means that daylight is their only source of light. We moved to the back to sit with her. There are blankets and tiny baby clothes hanging to dry in the sun and on the ground is a large knife and chicken feathers — remnants of the food she prepared for dinner.
She tells us that she’s lived here for four years since she’s been married; her family is in another village that’s a four-hour walk away.
Sita has had two pregnancies and deliveries — one at home and one at the birthing centre built by One Heart World-Wide.
“For my first pregnancy, I never had a check up. There were no medical facilities in the village so [if we wanted to see a nurse] we would have to go far and it’s dangerous for both mum and baby.”
“My first labour was 15 hours and my aunties were there with me during the delivery. I remember I was very uncomfortable.”
“I had twin girls, born five minutes apart, but because I never had a check up, I only knew I was having twins when I was delivering,” said Sita.
Like many women, Sita had trouble breastfeeding and was unable to produce milk for three days.
“On the fourth night, all of a sudden, one of my babies started to scream and cry, and I didn’t know what was happening. There were no doctors or nurses to help.”
The closest hospital was a six hour walk away, but because Sita and her husband were yet to perform a Nepalese naming ritual for their newborns, traditionally, the babies weren’t able to leave the house.
She speaks then pauses and tears start to well in her eyes. She looks at me and tears well in mine. The gravity of what she is about to say is written on her face before she says it.
“On the fifth day, we gather our family and perform the ritual. But it was too late and by evening I lost one of my babies.”
“One made it and one didn’t,” said Sita.
From where we sat we could hear her little girl laughing in the background with her family. I was sad then angry that there was one happy laugh instead of two.
Sita went on to tell me about her second pregnancy.
In time for Sita’s second delivery, the birthing centre was built in Jaljala. She went for her antenatal and postnatal check-ups and delivered her happy and healthy daughter there with the help of the trained Skilled Birth Attendants.
“For my second pregnancy everything was much easier. I was comfortable and after the delivery there were no problems,”said Sita.
Sita believes that if she had access to a birthing centre for her first delivery, one of her twins would be alive today and she would have three daughters in her home. After seeing the incredible facilities, program and dedicated team, I believe her.
Her hopeful and resilient characteristics shine through as she goes on to tell me she has become a change agent in her community and teaches other women that there’s a better way to give birth safely and with dignity. She tells them, “Your health will be good, and your child’s health will be good.”
We stayed overnight in Jaljala and before we left, I visited Sita again to say goodbye. I wanted to tell her so many things — that she’s my inspiration, that she’s the strongest woman I know — and I could see on her face that there were a million things she wanted to say too, but there was no translator around, so we hugged, looked at each other, cried and smiled, and I knew that we’d both said everything we wanted to.
As we drove down the mountain (which was equally as intense as driving up!) I realised that it’s so much more than giving families access to facilities and education — though those are vital. It’s restoring dignity, giving hope for a better future, building friendships and bonds and quite literally saving lives.
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