In the birthing centers we visited, there was a lack of emergency medicines to keep mothers alive. This was accompanied by inadequate equipment to carry out safe deliveries, and poor sanitation in the delivery room that raises the risk of infection. In addition, many birthing centers do not have a full staff, and we often see that one employee is in charge of an entire medical facility.
Mothers often make a long journey to the District Hospital during labor because their community-based health facilities are inadequate. Many do not even have maternity waiting rooms or proper maternity beds. Their journeys are often filled with risks, and at times they are forced to deliver on the roadside in the middle of their journey. These factors increase the risk of postpartum hemorrhage-related deaths.
Strong cultural beliefs
One of the biggest risks of death for soon to be mothers in Dolpa is also due to cultural factors. The local communities still follow harmful traditional practices that date back centuries. For example, if a pregnant woman experiences problems, she would rather go to a faith healer in her community than to a hospital.
Similarly, when newborns have health problems, the families will consult with faith healers and not seek healthcare with medical professionals. This is also the cause of a high number of newborn deaths.
In their community underage marriage and early pregnancy is commonplace, which raises the risks for both pregnant women and their babies. Even when a newborn survives after the mother’s death, the risks are high - the baby won't be able to receive warmth from the mother, breast milk, and other neonatal care. Among newborns, this causes malnutrition, as well as emotional and psychological problems as they grow.
Additionally there are many cases of mothers in the community who are against institutional birth delivery due to negative cultural values that persist. There is a belief that pregnant women shouldn't cross rivers as that would put the baby at risk. This prevents many of them from getting to a proper health facility. If a mother gives birth in a birthing facility, she is prohibited from entering a home for 13 days and is forced to live outside in a goat shelter. This increases the danger of infection for both mother and child as well as the possibility of newborns suffering from hypothermia.