TOP
Friday,October 23,2020 23:11 PM

Has the midwife been deserted?

By Vision Reporter

Added 4th May 2010 03:00 AM

Many health centres have long queues of pregnant mothers seeking antenatal help. These mothers wait for a chance to enter a room in a corner, big enough to accommodate a bed, table and a midwife for diagnosis.

Many health centres have long queues of pregnant mothers seeking antenatal help. These mothers wait for a chance to enter a room in a corner, big enough to accommodate a bed, table and a midwife for diagnosis.

By Joyce Nyakato

Many health centres have long queues of pregnant mothers seeking antenatal help. These mothers wait for a chance to enter a room in a corner, big enough to accommodate a bed, table and a midwife for diagnosis.

Health centres are the targets of the average Ugandan woman who cannot afford the luxury of private clinics and hospitals. Though there are no delivery services at Kiswa Health Centre, the work still remains cumbersome for the two midwives.

“We receive about 50 pregnant women for antenatal services daily,” says Mary Naikazi, one of the midwives at the centre. Many midwives are overworked as a result of understaffing at some health centres.

Despite the Government’s efforts to make health services free and accessible, some women cannot afford basic requirements like gloves and the polyethylene paper needed during delivery.

“Sometimes a woman goes into labour without requirements and one fails to assist her because of that,” Naikazi says.

The role of a midwife is not limited to assisting normal deliveries, but also providing antenatal and post-natal services.

This diversity in the roles requires a lot of flexibility and sharp thinking because a small mistake can cost a life. “A woman in labour is in serious pain and demands the full attention of a midwife. It is very normal for her to feel that way but so are the five or so other pregnant mothers in labour,” says Jane, another midwife.

A midwife who finds herself alone on duty faces the dilemma of helping three or more women who go into labour simultaneously. Armed with the mandate to conduct a safe delivery, she helps delivering mothers and monitors those wailing in pain — a situation far from the World Health Organisation’s recommendation of two midwives for one woman in labour. In order to cope, Naikazi helps women according to how close they are to delivery.

“This does not always go according to plan, sometimes the ones you think are about to deliver don’t and others come in ready to deliver,” she says. There are special cases like HIV-positive mothers and those with high blood pressure who need close monitoring.

A midwife’s divided attention may look like lack of care, but that is primarily a result of the heavy workload that rests on the midwife’s shoulders. When she worked at Naguru Health Centre, Naikazi would sometimes be the only midwife on duty. There are nights she would deliver about 20 babies.

“Being a midwife is one of the hardest experiences in life, you always have to make the right decision even under extreme pressure because you don’t want to be held responsible for the death of any child,” she says.

Sometimes, the delivery beds are not enough and the midwife has to manoeuvre and make sure that the women give birth safely. They have to tolerate the screaming mothers who kick them while some go to the extremes of plucking out their hair.

Beth Mukirane, a midwife at Kampala dispensary, says midwives shout at mothers because they do not want to compromise the lives of both the mother and the baby.

“What most people perceive as being rude translates to doing our work to save the mother and her baby,” she affirms. With all these setbacks, coupled with low pay, many midwives do not adhere to the nitty-gritty of the profession and therefore opt for greener pastures.

With high fertility rates, Uganda places a strain on the few available midwifery services. Increased awareness has caused more women in the rural areas to access antenatal services and the burden rests on the few midwives whose mandate is to see them off to safe motherhood despite the load of work.

“Most maternal deaths are avoidable, as the health care solutions to prevent or manage the complications are well known,” spells a World Health online publication on maternal mortality. Women giving birth need care from skilled health professionals.

Sakina Kiggundu, president of the association of Uganda Private Midwives, says midwives should only assist in normal deliveries and refer multiple pregnancies to a hospital that has a doctor.

Kiggundu advocates for training of midwives to build their capacity to mange complex births in emergency cases when the referral process takes long and urgent intervention is required.

Has the midwife been deserted?

Related articles

More From The Author

More From The Author