Where pregnancy is a deadly gamble

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Where pregnancy is a deadly gamble
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Sierra Leone is one of the riskiest places to have a baby. One teen fears repeating her mother’s story of dying in childbirth.

Cost was one of the top obstacles deterring pregnant women from medical professionals. So in 2010, the countrymajor progress. The share of women giving birth at a health facility in Sierra Leone jumped from 25 percent in 2008 to 54 percent in 2013 to 83 percent in 2019, national statistics show.

Extending the funds over the long term became unsustainable, said a British development official, speaking on the condition of anonymity to discuss sensitive matters.“It’s a life saver,” Demby said of Free Health Care. “The government is trying our very best to maintain it, but it’s getting a lot more difficult. The funding side of this is precarious. The value, and the need for it, is inordinate.

“Every time we cannot give a pregnant woman what she needs, it’s a tragedy,” said Isata Dumbuya, director of reproductive, maternal, neonatal and child health at Partners in Health in Sierra Leone.Dumbuya, who was born in Kono, worked previously as a nurse midwife in London, where she witnessed one pregnant woman die over two decades.

She earned her room by cooking dinner for the couple and their children, squatting above a small grill. Cash was scarce, and some days she ate only two bananas. Her uncle, frustrated by it all, muttered so Susan could hear: “Girls today sit around and do nothing but get pregnant.”Her aunt had been frosty, too, until she had a dream about Satta. Satta asked her to take care of her daughter and the baby.

Even in the maternity ward, the sight of women cradling babies roused the old melancholy. She’d wanted that kind of love for herself as a kid. She wanted it for her baby.Her pelvis was too small for safe labor, the doctor said. Before Susan’s first contraction, he wanted to perform a Caesarean section. Without the surgery, he explained, she could die.

Ami had a reputation for helping the sick. They’d stayed in touch. Susan knocked on Ami’s door after her period stopped. She was probably busy with her four kids, Susan thought. Ami was pregnant with her fifth, so she couldn’t donate blood, either. Susan pictured them raising their newborns together. Observing Ami. Imitating Ami. Susan longed to hear her voice, her familiar questions in their native language of Krio: How di belleh? How di body?Susan slid on her rubber Nike sandals. She changed into a blue medical gown.

Rebecca had done her best to prepare, May said. She’d gotten blood from their mother. But they hadn’t made it to the hospital in time.The other messenger cutting through the courtyard that day was Ami, who had shown up with baby clothes while Susan was in surgery. She talked her way into the recovery room and bee-lined to Susan’s aunt, who was perched on a stray cinder block as a friend bent behind her, brushing her hair.

The number of women who gave birth at the hospital had risen every year since 2018, a victory of aggressive outreach, staffers said. And the number of maternal deaths had fallen from 31 to 29 to 25 by 2021.

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