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Life or death at 40 weeks: Why are women still dying during childbirth in Uganda?

Two women that I know died this week on the birthing table. One was a friend’s sister and the other a stranger whose story I listened to the radio. Both women were young, healthy and had no prior complications. They were expectant of a future filled with happiness that their babies would bring. They survived the nausea and psyche alterations of the first trimester, the pains and discomfort of the second and the swollen feet of the last trimester[1]. The restlessness of having a full-grown person inside their body, only to never meet that person.
My friends’ sister had been scheduled for a vaginal delivery of twin girls at 40 weeks. That evening, she had waddled into the hospital with her husband in tow, in the full throng of labour pains. They had been received by a kind and helpful nurse. Her doctor with whom she had experienced the pregnancy had arrived shortly and, after a brief examination, told her she was right on schedule.
A few hours and several trips up and down the stairs of the big and popular hospital in town, the pain started to feel less like something she could handle and more like something that would definitely kill her. The doctor examined her again and when he raised his head above the curtain this time, the chirpy, boisterous demeanour was gone, replaced by a furrow on his brow.
There was a sense of urgency in his voice when he said they needed to get to the theatre, her blood pressure had risen significantly and the babies were distressed. She died within an hour; her daughters lived. 
On the radio, I listened to the story of a woman who had arrived at the hospital on foot. She had sat around the health centre for hours without being attended to, until she passed out. She never woke up and her child was never born. 
It is a shame that something as natural as childbirth should cause death. It’s been said that labour pains, while unbearable, could never result in death, only negligence does. Haemorrhage, prolonged labour, complications from unsafe abortion and hypertension are some of the major causes of maternal deaths, and they are preventable. [2]  Why then is there still room for negligence in labour wards? How are we benefiting from globalization, knowledge and technology transfer when 15 women are still dying every day during childbirth? How do we justify the hundreds of medical doctors who are leaving the country in droves[4] and taking their expertise with them when health centres, in rural areas especially, are understaffed?
Beyond the figures and statics are our friends, sisters, girls we went to school with, neighbours, wives and women we do not want to hear died as they gave birth. That they might not leave the hospital with their baby is a waking reality for Ugandan women.
How well a country treats its women is a key contributor to its holistic development.[5] Uganda is failing if it cannot guarantee that women will not simply because they are pregnant. As the privileged and upper-middle class opt to have their babies in developed countries with more reliable health care, the majority of women in Uganda remain at the mercy of the broken health care system with underserved health centres, frequent drug stock-outs, overworked health workers, poor infrastructure and fraudulent staff. While it is possible that in some rare cases everything is done right but death occurs, more women have died from negligence and treatable complications.
The health and wellbeing of women should be a priority. It is unacceptable that women continue to die while giving life. It is not too much to ask that adequate resources be allocated to ensure this does not happen. The health sector should be allocated more than 7.4% of the national budget that it currently receives.[6] It is not fair that women keep up with their antenatal visits, take their supplements, exercise and maintain a healthy diet, only to die on a birthing table or hospital veranda. While we all take personal responsibility for our lives and health, the state within which we live, pay taxes and swear allegiance to should accord women longevity through improvements in reproductive health.
In the ideal scenario, maternal health is prioritized and hospitals employ more advanced technologies to cater to pregnancy and birthing complications. Health workers are motivated, trained in soft skills, fairly remunerated and not overworked. Pregnant women are treated with dignity and attended to with urgency. Power does not go off in the middle of a caesarean operation, women do not die as they give birth. Both mums and babies leave the hospital and no one has to mourn their friend or wife in a time of celebration.


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