By Oleen Ndori
â€˜Roses are red, violets are blue, sugar is sweet and so are youâ€™. This is one of the many clichÃ©s used in courtship. But when it comes to motherhood and child-bearing the sweet words of affection and love often shrivel away killing the marriage and leaving the woman emotionally lonely and frightened.
The woman then begins her journey to motherhood and protects her young one from the harsh outside world.
Amai, umama or mother can easily be the most used word in the human vocabulary. It signifies a role model, a leader, a teacher, manager, an organiser, representative, and a mentor. It reflects a person who gives all and expects nothing in return. She carries her young one through the 9 months of pregnancy, from birth to childhood and youth until that child becomes a human being capable of becoming his or her own person.
The journey to motherhood has notbeen an easy walk for women, especially those from developing countries like Zimbabwe.
Experts define maternal health as the fitness of a woman during pregnancy, childbirth, and the postpartum period. It encompasses the health-care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal mortality which is death while giving birth.
Preconception care includes education, health promotion and other interventions in women of reproductive age. This is done to reduce risk factors that might affect future pregnancies.
The goal of pre-natal care is to detect any potential complications of pregnancy early, to prevent them if possible and to direct the woman to appropriate specialist medical services as appropriate.
However, in several regions such as sub-Saharan Africa, the maternal mortality rate is continuously on the rise mainly due to no access to ante-natal care, medical facilities and attention and this is attributed to extreme poverty.
Women are dying everyday whilst giving birth and in Zimbabwe a maternal mortality ratio of 725 deaths per 100 000 live births is prevalent. There is therefore the need to continue doubling efforts towards lowering the maternal mortality rate.
Upon realising this need the Zimbabwean government with its fellow members of the United Nations signed the United Nations’ Millennium Development Goals in 2000.
Key among them was targeting a reducing the number of women dying during pregnancy and childbirth by three quarters by 2015 and the number of children dying under the age of five by the same year.
Goals 4 and 5 also call for the increase in skilled birth attendants, contraception and family planning and access to ante-natal care among others.
High maternity fees remain a significant barrier to accessing reproductive health for expectant mothers especially those in rural areas, a hindrance that continues to drive the maternal mortality rate.
Expectant mothers at rural health centres are charged as much as US$25 for delivery, a figure beyond the reach of many.
As a result a lot of women end up giving birth at home with little or no medical care. Postnatal care issues include recovery from childbirth, concerns about newborn care, nutrition, breastfeeding, and family planning remain vague to the new mothers.
Factors associated with maternal deaths also include the delay in deciding to seek medical attention, delay in reaching a health care facility and receiving appropriate care. The absence of skilled personnel during child birth, lack of services to provide emergency obstetric care, reproductive health commodities shortages and weak referral systems also contribute to maternal mortality.
One mother spoke of her ordeal at a public hospital: â€œI was now in labour when I had to go the nearest hospital in Guruve using a scort cart. When I got there I spent the whole day in labour. The health-care practitioners then referred me to a public hospital in Harare. I was taken to Harare in an ambulance. When I got to Harare the nurses said I had come with nurse aides and I was supposed to go back to the rural hospital and fetch certified nurses. My rescue was a junior doctor who opted for an operation since I had spent two days in labour. I was finally operated on, but my child had died.â€
Such is the maternal health system in Zimbabwe. The government has to work tirelessly to provide proper healthcare for expecting mothers as the children are the future of the country.
In recognition of these maternal and neonatal health challenges the government in conjunction with the civil society have embarked on awareness programmes aimed at educating the public on maternal health and child mortality in all district hospitals across the country.
The programme also aims to educate the general population on how to access emergency obstetric care for mothers.
Recently, Mutoko Maternity Waiting Homes were opened. The waiting homes accommodate high risk women and those living far from the hospital. The women are provided with essential obstetric and neo-natal care during the final weeks of their pregnancy.
This move facilitates the reduction in maternal mortality by expediting womenâ€™s access to emergency care should complications arise.
At the homes there are also frequent HIV and Aids tests which help in the prevention of mother-to-child transmission. This will help to lower the estimated 80% of infants being born with the disease and in turn spurs the number of children dying below the age of five; a phenomenon Zimbabwe wishes to lower by two thirds by the year 2015.
After all these initiatives by the government and civic society, the onus is now upon society to reflect upon its norms and values with regards to maternal and child mortality.
In the Zimbabwean culture they say â€˜amai mutorwa mukudzeâ€™ or â€˜musha mukadziâ€™ reflecting the important role that the mother plays for the family.
In this patriarchal society the role of the wife is to bear children and look after those children for her in-laws. What this society then fails to address is the journey to motherhood which is viewed by the medical fraternity as a 50-50 situation and remains a life threatening occurrence.
With practices such traditional home delivery through untrained midwives (mbuya nyamukuta), the use of herbs and manual works continue to threaten the life of the expectant mother and in most cases results in still births. At the end of the day the still birth is the fault of the child bearer.
For how long shall our women continue to die whilst giving birth because of a health system defined by a patriarchical society?
And how can the issue of traditional beliefs, culture, religion and societal attitude be addressed?
For the above questions to be answered and adopted there is need for a united approach from stakeholders and the nation at large to ensure that no woman dies whilst giving birth and no child shall die below the age of five.