Sisterhood Unfulfilled: A Story of Unspeakable Loss

This blog post is the first of a three part series written by: Abby Tseggai

Almost everyone knows a woman who has brought a baby into the world- and how expecting families share a similar joy, full of optimism and big dreams as they anxiously wait to hold their little baby. It is easy to forget in all the excitement that the possibility of an unfathomable reality—the death of a child—can actually occur.

I want to share with you a very personal story of girl named Fana, from Eritrea. At the tender age of seven years old, she and her family experienced a tragedy that was only the beginning of decades of havoc to follow. Fana’s little sister, died unexpectedly at just five years old from an illness unknown. The emotional trauma Fana experienced stemmed in part from losing her baby sister – but mostly, it came from having to witness her mother grieve for most of her life.

Her mother’s pain and depression was so severe that she struggled to be mentally and emotionally present for her surviving children. She couldn’t move past the loss – her mind simply could not release the intense grief. She fought her hardest to manage it daily for Fana and her older brother who was 2 years older than her. Sometimes, Fana’s mom neglected their needs, falling short on being the stable adult every child needs. What Fana did not know at the time was that this was her mom’s second such loss; a year-old son who died from an unknown illness, before Fana was even born. She knew Fana was too young to understand the magnitude of having to bury her sister too, so she sheltered Fana from that tragedy, hoping to preserve her daughter’s innocence.

As the years began to pass, Fana’s sweet memories of her litter sister were becoming more and more faint. Fana would desperately pray every night to have a little sister again. It was not until 6 years later that she was able to see her mother smile genuinely, when she told Fana she was pregnant and they were expecting a baby.  Fana was now 13 years old and able to remember every detail of hopefulness and fear she felt waiting to hold the new baby. She just knew in her heart it would be a baby girl and not a boy.

The day had finally come; Fana was waiting outside a hut made of clay. She could hear her mother screaming during labor. This was the first time she heard anything like it but luckily her mother prepared her for what to expect. After 4 hours of waiting patiently trying to ignore what sounded like a nightmare, the screams turned into desperate prayers and now included more than three people screaming and crying. Her father rushed out of the hut, picked her up and ran fast while screaming “No…No…NO!”  She begged for him to tell her what was going on because she was so confused. It was indeed a little girl her mother brought to term, however she was not breathing. No one could believe it – the baby was a stillborn. Fana’s family would now be grieving the loss of another child.

Fana’s family experienced the deaths of three children- one stillbirth and two from unknown causes. Although the stillborn mortality rate has gotten better over the decades, women and communities still suffer from the psychological, social and economic impacts of stillbirth. Africa still accounts for 2.7 million stillbirths a year. And 5.9 million don’t live to meet their fifth birthday, due to diseases that are mostly preventable. The lack of qualified midwives and health workers and the shortage of hospitals throughout the continent are still heartbreaking. Many of the deaths occurring are unnecessary. All lives deserve the same chance!

Read more about stillbirths in The Lancet Series: Ending Preventable Stillbirths.

Cover Photo Credit: United Nations, Flickr Creative Commons

Note: Cover photo is not connected to the above story. 

 

 

 

 

 

A Conversation About Mom’s Superpowers with Mariam Claeson, Gates Foundation

In this Mother’s Day Special, The Mom Pod co-host Julia Wiklander asks some very important questions to an expert in the field of maternal, newborn and child health, Mariam Claeson, Director, Maternal Newborn and Child Health at Bill and Melinda Gates Foundation.

The focus of this conversation is all mother’s superpowers and the simple, cost effective interventions that save lives and ensure that mothers and babies survive and thrive.

“The interesting thing about maternal and newborn survival is that we actually have high impact interventions that are relatively low cost and could easily be made available for all mothers and newborns.”
Mariam Claeson

Mariam speaks about the evidence that scientists and clinicians have known for a long time and the need for that evidence to be communicated and disseminated to health professionals, mothers, families and communities around the world. She talks about these simple solutions that all mothers can do and the role that we all have to play to create an enabling environment where mothers can thrive and ensure that their superpowers come to life.

Our hope is that The Mom Pod is one such solution to share information and empower mothers everywhere to release their superpowers!

“We can present the data and show research findings, but what happens when a mother shares her own experience I think is very powerful.”
Mariam Claeson

Listen to the full episode below, or on Soundcloud and iTunes.

 

To celebrate Mother’s Day, we are working with illustrator Elina Tuomi, who has made some beautiful illustrations of mothers, babies and caregivers for The Mom Pod. Donate and claim one of the Mother’s Day Edition perks today and help us to continue these valuable and inspiring conversations that can save lives, strengthen the rights of women and children and make a lasting difference in somebody’s life. You can find our crowdfunding campaign at: https://igg.me/at/FundTheMomPod

Thank you so much for your support.

Happy Mother’s Day to all Mothers out there – you all hold superpowers that can change the world.

Building Bridges of Knowledge Between Mothers Worldwide

In January this year, Girls’ Globe launched a new initiative, The Mom Pod, a bi-weekly podcast series about all things related to motherhood. We want to pick the minds of the world’s parents, leading experts in maternal health and women’s rights, and build bridges between cultures, countries and continents.

My colleague Emma Saloranta and I became mothers two months apart in 2014 – and throughout pregnancy and in the early months of being mothers we frequently spoke via Skype about challenges and joys. We shared experiences, knowledge and information. We spoke about similarities and differences – being that Emma gave birth in the USA and I gave birth in Sweden. We discussed issues that we encountered and the disappointments that sometimes arose in our experiences during pregnancy or as new mothers.

What startled me were the strong norms in our societies that steer women’s opportunities and choices. Throughout pregnancy and especially as a new mother, there are so many other people who have opinions about your choices – and who express these openly. Yet, at the same time, there are so many tricky conversations that either end up in needless debates or are left unspoken. I felt that becoming a mother was something I had to learn myself, and that there was a lack of information, knowledge-sharing, and support in my community (and online!).

The Mom Pod is something that is so much more than expert interviews on maternal health and parenting advice – we want to create a forum for open and honest conversations on all things related to motherhood, and make space for learning from each other.

“I want to encourage your work of connecting young women globally and sharing different ways of care in the world. I think that if you hear about what is offered in some countries, you might start to think “I want that too” – and this can be extremely powerful.”

Mia Ahlberg, President, The Swedish Association of Midwives

So far we have produced four episodes, covering the global state of maternal health, the Zika virus outbreak, birth practices and experiences in Sweden and the Finnish baby box. You can listen to all of our episodes on iTunes or Soundcloud, also embedded below. We want our episodes to support and help You, so please share your comments and feedback with us and let us know what topics you would like us to cover. If you have a story to tell, or someone you think we should interview, let us know! We’re currently working on multiple episodes ranging from breastfeeding to fistula and cost of labor in the U.S. to maternal health among refugee women.

Our next episode will be out on April 8th – stay tuned!

Cover photo credit: Bridget Coila (Creative Commons)

Stillbirths – A neglected global epidemic reports The Lancet

Despite the fact that the majority of stillbirths are preventable, very little progress has been made to bring down the number of stillbirths. In the past 15 years maternal and child deaths have halved, while 2.6 million stillbirths continue to occur every year – a number much too high to be accepted.

This “silent” problem – stillbirths (in the third trimester of pregnancy) – has been studied in a new series by The Lancet. Not only does the Ending Preventable Stillbirth Research Series shed light on global reduction rates and risk factors of stillbirths, but it highlights the neglected psychological, social and economic impacts of stillbirth on women and communities. New evidence shows that at least 4.2 million women are living with the effects of stillbirth – suffering from depression, stigma, social isolation, as well as an increased risk of violence and abuse.

“We must give a voice to the mothers of 7,200 babies stillborn around the world every day. There is a common misperception that many of the deaths are inevitable, but our research shows most stillbirths are preventable.”

– Professor Joy Lawn, London School of Hygiene & Tropical Medicine

Women in the most disadvantaged communities are at a much higher risk of stillbirth. Yet, progress to decrease the stillbirth rate remains slow in high-income countries too, where the number of stillbirths is often higher than infant deaths. Globally, the annual rate of reduction for stillbirths is 2.0%, which is much slower than the progress that is being made for maternal (3.0%) and child deaths (4.5%). Nearly all stillbirths – 98% of them – occur in low- and middle-income countries.

Half of all stillbirths take place during labor and birth, usually when a pregnancy is in full term, and research shows that most of these 1.3 million deaths are preventable with improved quality of care. The first global analysis of risk factors associated with stillbirth is included in the new series – showing how deaths can be prevented. The research shows that the most effective methods to reduce stillbirths include: treating infections during pregnancy (Malaria and Syphilis in particular), tackling obesity and non-communicable diseases (diabetes and hypertension foremost), ensuring access to quality family planning services – especially for older women and girls, who face a higher risk of stillbirth, and reducing inequalities.

Evidence shows that prevention is possible.

The Netherlands is making the fastest progress, with an annual reduction rate of 6.8%. The United States is one of the countries making the least amount of progress, with a reduction of 0.4% per year. Rwanda is outperforming its neighbours with an annual rate of reduction of 2.9% – making it the fastest progressing country in Africa and showing that change is achievable everywhere in the world.

The Lancet’s Ending Preventable Stillbirths Series includes five papers developed by 216 experts from over 100 organizations. This series presents compelling evidence that most stillbirths are preventable, providing a platform for action by politicians, health care professionals, parents and pregnant women themselves.

Let’s make sure that ending preventable stillbirths does not only get on the agenda of maternal and newborn health, but that necessary action is taken and enough resources are allocated to this issue for there to be real, lasting impact and change.

Featured photo credit: Hien Macline / United Nations Photo (Creative Commons on Flickr).

Addressing Equity and Reaching the Most Vulnerable Mothers and Newborns

The closing plenary of the Global Maternal Newborn Health Conference began on an optimistic note. Cesar Victora, Emeritus Professor of Epidemiology at the Federal University of Pelotas took to the stage and told the audience that globally, the gap in coverage of health care is closing. The gap between how the rich experience health care and how the poor experience health care is decreasing.

Despite the progress, the gaps remain, without a shadow of a doubt, unacceptably large. They will continue to increase if vulnerable populations are unable to access the life-saving interventions that all women and newborns need and deserve.

Alicia Ely Yamin, Policy Director, Francois Xavier Bagnoud Center for Health and Human Rights, Harvard University posed an interesting question: why do we care? Why should we care particularly about equity in health when we tolerate such grievous inequality in so many other areas of our societies? Health, Alicia continued, gives us ultimate agency in our lives. It gives us agency as individuals and as members of communities and societies. Sexual and reproductive health matters enormously to all people, and particularly to women, because it is sexual agency that allows us to have control of our bodies and subsequently, control of our lives. Sexual agency allows every single one of us to define ourselves by our humanity and not by our sexuality – and sexual agency depends entirely on access to sexual and reproductive health services.

All too often, women and children in particular experience their poverty and marginalisation through their contact with health systems. In too many instances, maternal deaths occur as the culmination of lives filled with poverty and discrimination and void of choice.

So what does a human rights lens add to discussions on equity? Quite simply, it forces us to look at the faces, and into the eyes, of the people living such lives. It requires us to focus on accountability, and to understand accountability depends on regulation of power. We want and need people to participate meaningfully in both the definition of their own problems and the construction of their own solutions – this requires devolution of power – a vast and challenging task.

As we move forward from the Global Maternal Newborn Health Conference, we need to adopt a visionary approach. Alicia shared with us her ideas of how we can do this:

  • First – we must focus on identifying both pathways and opportunities for change within the Sustainable Development Goals, rather than solely on measuring targets.
  • Second – we must shift the weight of attention from global work to frontline work; from global conferences like this one to front line workers and individual lives.
  • And finally – we must acknowledge that the egregious inequities that currently exist in maternal and newborn health are not tragedies, they’re injustices.

At this pivotal moment in global history, it is imperative that we leave no one behind. No one today, no one tomorrow, and no one at anytime in the future. Today Girls’ Globe asked speakers and conference participants a key question:

How can we ensure no mothers or newborns are left behind?

 

Manuela, Mexico City

 

Marion, Liberia

 

Watch the recorded plenary

One Mother’s Response: What is integrated care for mothers and newborns?

Eleven months ago (today!) the most life-changing event took place in my life – I became a mother. The process of becoming a mother requires a support network that stretches beyond family and friends to a health care system that sees to all the needs of the expecting and new mother and baby.

The Global Maternal Newborn Health Conference is taking place in Mexico City this week, placing priority on the goals established to address the urgent needs of women and newborns around the world. Today’s theme is Benefitting Mothers and Newborns Through Integrated Care – and presenters will tackle this issue in various ways. So I decided to define what integrated care has meant to me as a new mother.

What does integrated care mean during pregnancy?

Acknowledging and addressing a woman’s needs, beyond the growth and health of her fetus, is necessary to make sure that her health and well-being is prioritized. Becoming a mother is most often an overwhelming experience, and women (and their partners) need not only care, but education, information and at times psychological support. Integrated care during pregnancy means meeting each woman in her situation, and forming her support thereafter.

In Sweden, throughout pregnancy, women create a relationship with their midwives, who see to their needs from day one. A midwife has the responsibility to understand the woman’s life situation – ranging from her relationships, any experience of violence or sexual assault, to her general health, eating habits and more. In Sweden, midwives are the cornerstone of integrated care for mothers and babies.

What is integrated care during childbirth?

Preparing for birth is an important part of pregnancy, and may sometimes take a bigger part of women’s preparations, than preparing for the new life that awaits with a baby. Having the option to choose how to give birth and who should be assisting her birth is an essential part of integrated care during childbirth. At the same time, one must be aware and open to the fact that childbirth does not always go as planned – as the case was for me. Integrated care means having a woman-centered approach, listening to and respecting her wishes and making sure that she has the options to make informed decisions in what may become a stressful situation. It also means making sure that necessary interventions and emergency obstetric care are readily available.

What is integrated care in the first weeks and months with a baby?

At this time, more than ever, integrated care is essential. Caring for a mother and her newborn requires both a woman-centered and baby-centered approach. During the first critical hours, days and weeks, a new mother needs support to strengthen her bond with her newborn, to support breastfeeding and her ability to care for her new baby in her home.

Evaluating possible postpartum depression and monitoring eventual childbirth injuries is a necessary part of integrating care for mothers. In Sweden I have had the possibility to follow up with the midwife who assisted my birth, to talk about my experience and evaluate decisions that were made. I have also had access to a support line to speak to midwives and lactation experts on any issues or questions that we have encountered.

Integrating care for mothers and newborns is an essential part of making sure that all women and babies access the support they need. No matter life circumstances, all women and their babies need access to essential maternal and newborn health care – and no one should be left behind.

Follow the hashtag #GlobalMNH and @GirlsGlobe on Twitter, Instagram and Periscope for live coverage from the Global Maternal Newborn Health Conference, and stay tuned on girlsglobe.org.