OpEd, Politics

Free and respectful maternity care for all laboring mothers

By Esther Aurelio Agira Lohutuhureng

Childbirth is one of the most beautiful experiences for the mother and her family, especially if she is a first-time mother, the joy and happiness of having her first child is a memorable life event that sticks with her for the rest of her life. However, mothers go through a lot of pain during labour. The pain is caused by contractions of the muscles of the uterus and pressure on the cervix. Nevertheless, the pain is bearable. In some developed countries, the pain is manageable through some medicine to lessen it, while in my country, the pain is bearable without any medicine to lessen it. However, the childbirth process is often handled by doctors, nurses, and midwives.

Midwives are the main professionals who help mothers during childbirth with little intervention from doctors and also intervene if complications arise. The functions of a midwife are very wide, including supporting the mother during labour, helping a labouring mother, and encouraging and counselling mothers throughout the delivery process. On the other hand, some of our midwives, especially those who work in different hospitals in Juba, are short-tempered instead of showing compassion and respect to the labouring mothers; they abuse them physically and verbally.

The labour process is always associated with pain. That is why most mothers scream, writhing in pain, shut out loud, and others pray when experiencing labour. In a moment like that, all they need is support and compassion from their people and midwives. In such moments, midwives should talk to labouring mothers slowly and assure them that everything is going to be alright. By doing so, the delivery process will be easier and less scary. On the contrary, a few midwives slap labouring mothers, which is a violation of women’s rights.

A number of mothers are beaten or slapped by midwives during giving birth, in addition to poor quality of care. Sometimes a midwife will be seated outside the maternity ward, leaving a labouring mother in the maternity ward unattended.

Another poor behaviour practiced by midwives is verbal abuse. For instance, some midwives will yell at the patient for not pushing hard enough during birth. But when the baby has a large head, it is very difficult for the labouring mother to push the baby. Instead of yelling at labouring mothers, midwives should encourage and support the patient throughout the labouring process.

Some midwives mock the labouring mother, saying that she is making things up and also comparing her with other women who don’t make sounds during the delivery process. Not knowing that labour pain varies from one woman to another. Therefore, midwives must treat pregnant mothers with respect and kindness in order to encourage pregnant mothers to deliver at the hospital. Nevertheless, hospital birth should be the first option for every pregnant mother.

Numerous studies demonstrate that women’s perceptions of how they will be treated at health facilities can strongly influence their choices about where to deliver and deter them from accessing services in a timely manner. However, some of the expecting mothers deliberately give birth to their babies at home, not because they prefer it. But due to fear of mistreatment by midwives or because they don’t have money to pay hospital bills and midwives,

Midwives always demand soap and sweets from labouring women, apart from the usual hospital bills. Nevertheless, whether one delivers in a public hospital or a private hospital, those midwives share one thing in common: they demand soap and sweets. And if someone fails to afford them, they will insult and embarrass the mother and patient companion.

The hospital’s bills for labouring mothers are different from one government hospital to another, starting from 10,000 SSP to 20,000 SSP for a normal birth. However, keep in mind that these prices don’t include operations. Remember, this is only for public hospitals with maternity centers.

The demands of the midwives are different from one midwife to another, like some demands: Four washing soaps, one washing powder soap, three birthing soaps, and three candy bags.

Other midwives demand: Three washing soaps, medium-sized washing powder soaps, any type of birthing soap, and three candy bags

Sometimes, if the labouring mother doesn’t have soap and candy bags, she can give them money, but they do prefer soap and candy bags to money. When asked why one should buy soap and candy bags, one of the midwives explained that one candy bag is for the midwife who attended to the labouring mother, the second one is to be distributed to the people in the hospital, and the third one is for the midwives to distribute among themselves. As for the soaps, they argued that they were for their personal hygiene due to the nature of their job. However, her explanation was not appalling, but it should not be obligatory to purchase soaps and candy bags for midwives; rather, if someone is happy with their work, she or he is free to motivate them.

Another factor contributing to home birth is the lack of transportation. A certain woman gave birth to a healthy baby at home. When asked why she didn’t go to the hospital, she said that it wasn’t her intention to give birth to her firstborn child at home. She stated that she couldn’t find a means of transport. Besides that, she experienced labour at night, and it wasn’t easy for her to get a car to take her to the hospital at that time. That woman and her baby were lucky enough not to experience complications, such as infant death, among others. However, we have countless women like that woman in South Sudan.

The government should allocate more funds to provide hot-line ambulances. This hotline should be strictly for vulnerable expecting mothers so that they can access free transportation services to and from an appropriate health facility. For example, if an expecting mother is under antenatal care at Munuki Primary Health Care Centre (Kuwait), she has to be given two files; one should remain with her and another should remain in MPHCC (Kuwait). Both files must include her details, starting with her home address and telephone number, and vice versa for the health center. And once the expecting mother starts experiencing labour, she will just call the hotline number, and the care will be at her doorstep. This will result in a reduction in child and maternal mortality.

Midwives should stop asking for money, candy bags, and soap from patients. Instead, they should give information, encouragement, and emotional support to all pregnant women throughout pregnancy, during and after childbirth.

Hospital birth should always be the first and safest option for pregnant women in order for them to access high-quality care. Some complications could have been prevented if the pregnant woman had delivered in the hospital. Free birth (home birth) should be banned in all parts of South Sudan in order to prevent infant and maternal deaths.

The author can be reached via Tel: 0921492857; Email: Esther090119@gmail.com

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