It's a Girl!: Maternal Health Care in CAR

Fifteen-year-old Marie* was eight and a half months pregnant when she went into early labor after drinking traditional medicine. The closest health facility was 17 kilometers away from the village where she lived in the Central African Republic (CAR). Usually the only options are to walk, or wait, and hitch a ride on a passing car. Marie was able to go by motorbike, but this was a risky choice that could have further triggered contractions.

By the time Marie arrived at the maternity ward in the district of Boda (180km southwest of the capital, Bangui) she was experiencing strong contractions, but her cervix was taking too long to dilate. There were signs of fetal distress. This was putting her unborn child at risk of oxygen deprivation and Marie at risk of damage to her uterus.

Given the risk to Marie and her unborn child, the midwife on call, Dorcas, admitted Marie into the hospital, where she underwent an emergency Cesarean section.

The operation went well and Marie is now the mother of a healthy, 2.8-kilogram baby girl.

"If she hadn't arrived at the hospital when she did, her and her baby would've likely both lost their lives." - Patricia Marcel, ALIMA nurse

Unfortunately, not all pregnancies have the same happy ending. The Central African Republic has one of the highest maternal mortality rates in the world - 890 deaths per 100,000 live births. There are less than two licensed midwives per 10,000 people.

Due to the far distances that some women live from the nearest health center, many try to give birth at home. If a complication arises, it is often too late to get help. For those that go to a clinic to give birth, few structures are well-equipped to handle complications, such as hemorrhaging, and lack the ability to perform surgical procedures, such as C-sections. The high rate of teenage pregnancy puts young girls at an increased risk of complications.

"The story of Marie could be the story of any Central African woman. Sometimes these young mothers are saved at the last second, but more likely, if the birth isn't going well...even a small problem can quickly become a tragedy if they have no access to proper care. So more centers for C-sections are vital for pregnant women's survival." - Patricia Marcel, ALIMA nurse

To help more women give birth safely and successfully, ALIMA medical teams are supporting 3 local healthcare facilities in Boda and the district hospital. They offer free prenatal consultations and help with deliveries. Midwifes also offer family planning and even make house visits to check in on new moms. Lactating moms also receive free health care.

Since the program began in 2014, more than 3,100 women have given birth at these centers and more than 200 C-sections have been performed. Nearly 13,000 women have benefited from prenatal consultations. In 2016, an average of 115 pregnant women were hospitalized each month.

"I gave birth to my first five children at home. The last one was stillborn. This time I came here because I'm aware now that you should come to the hospital when you are pregnant. There are many advantages here. ALIMA gives you prenatal consultations and helps you give birth." - Rouga Yadou Amadou, maternity patient at the Boda clinic

The maternity project in Boda is able to help women like Marie, thanks to funding from the EU's humanitarian aid department (ECHO).

*FOOTNOTES: Name has been changed to protect the patient's identity; All photos by Nanna Kreutzmann / ALIMA