Saving Lives at Birth; Maternal Health in Uganda

There is nothing better than being at Shanti Uganda’s birth centre on a Thursday. On any given Thursday you will likely find Shanti’s traditional birth attendant Flora leading a pre-natal yoga class, expectant mothers waddling through the reception area waiting for their antenatal appointments, new mums cradling their infants. Last Thursday, Flora gave a short session on breastfeeding to a group of six new mums, who sat on straw mats in the warm June sun. A few of the mums were breastfeeding, and I watched as the women laughed throughout Flora’s animated presentation. I also managed to engage in a periodic staring contest with a little girl who couldn’t have been more than 6 months old. She won. Once the workshop was finished, Flora turned to a large group of pregnant women and led an energetic yoga class. Thursdays at Shanti are always so full of life. 

On Thursdays, the midwives are also always kept busy. Unreliable electricity and the inability to refrigerate vaccines for long periods of time means that Shanti has to dedicate just one day a week to providing vaccinations -- Thursdays. Women come from as far away as Kampala to have their children vaccinated at Shanti. The staff here are also kept busy as Shanti has been steadily gaining more and more clients. Over the past 5 months, the number of deliveries at Shanti have increased, more women are given a second dose of intermittent preventive treatment of malaria, and more infants are vaccinated against childhood illnesses. The midwives tell me that this increased use of Shanti’s services is likely due to positive feedback by word of mouth. As the community continues to increase its trust in Shanti, it seems to me like the staff here have a lot to be proud of.

“Ekyama kyetulina mu buwangwa bwaffe kiri nti okuzaaia tekuiuma wabuia abakyaia bamaanyi”

This quote greets clients and visitors as they enter Shanti Uganda’s reception area and when I first arrived I curiously asked Sister Mary what it meant. She laughed and said, “we have a secret in our culture that says birth in not painful, but women are strong.” Birth is not painful. Women are strong.

While I have only been in Uganda for one month now, I have already heard plenty of stories that speak to women’s resilience and strength. I have been learning so much about pregnancy and childbirth in Uganda and about mother centred care. Shanti Uganda not only addresses the pressing problem of maternal mortality in Uganda, but they do so in a way that respects cultural beliefs and offers women quality of care that is not found in publicly funded hospitals. Mother-centred care stresses the importance of providing individualized care based on a woman’s needs and desires, ensures that women can deliver in a supportive and respectful environment and empowers women to participate in their own birth experiences. Learning about the principles of mother-centred care has caused me to reflect on how we think about and address pregnancy and childbirth in Canada, particularly the deep-seated idea that childbirth necessarily must be a painful experience. Being at Shanti reminds me that even though the way we think about birth is determined by our cultural understanding of it, all women possess the necessary strength to deliver a healthy child into this world. 

Another reminder of Shanti’s commitment to mother-centred care is a series of cut-out paper hearts fastened together with string that hangs underneath the quote about strong women. Each heart has a word written on it, representing an aspect of mother-centred care. Words like  “compassion,” “connection,” and “strength” are further reminders of Shanti’s goal to provide safe and mother-centred maternal healthcare to women in Uganda.  This same string of hearts hung at the Stanbic maternal health week that happened a few weeks ago. And while it served as a powerful reminder of women’s strength and Shanti’s support network of women helping women, I was pleasantly surprised by how many men were interested in learning more about family planning options. I met one young Ugandan man who spoke so passionately about a woman’s right to maternal health. He knew all the statistics about maternal mortality in Uganda and was resolute about the government’s responsibility to do more to ensure that rates of maternal mortality are reduced. This was a memorable conversation. It left me feeling hopeful about the future and it motivates me to continue contributing as best I can to Shanti’s mission and goals.