Then I Opted for a Traditional Birth Attendant

This post is based on a real-life account shared with the author by a woman she spoke with during her research on the role of Traditional Birth Attendants in protecting the right to health for expectant mothers in Uganda.

Part 1: Her Story

“Like any other expectant mother, I started planning for the delivery of my child immediately after I learnt about the pregnancy. There is a public health facility about six miles from my house which is a Health Centre II. After my first trimester, I started visiting the health facility for antenatal services, and assumed that was were I would give birth when the time came.

One night, I started to feel some abdominal cramping that I believed was related to what the nurse and older women in the village had indicated were labour pains. Soon enough, I was noticing some signs that the baby was close. The waters broke, leaving me terrified and suddenly feeling unready! I was in a panic as my husband helped me to prepare and pack some necessities. We rode off to the health facility, arriving around 8:30pm. My body was weary and I couldn’t stand upright. My husband helped me sit on the pavement before he dashed towards the triage room to call the health worker.

“Knock knock.” The sound of my husband trying to find help. We knew the health workers should be around but despite almost 40 minutes of calling, knocking, screaming, and crying, no one showed up to our rescue. Realizing the knocking wasn’t enough, he started screaming at the top of his lungs. but to no avail. By this time I could not even talk. I could not even hear the sound of my husband running to check the back door of the health facility.

We knew the health workers should be around but despite almost 40 minutes of calling,
knocking, screaming, and crying, no one showed up to our rescue.

My inner voice whispered ever so persistently that this was the end of the line. This was the closest I would ever get to motherhood. My body was shutting down. I could feel no pain, could not hear or say anything. The first whispers from my lips seemed to fail to come out. I hoped my baby would live, even if it cost me my life. But here I was levitating, losing it, my body giving up. The fight my husband put up revitalized my fight . I gave my all, even just for one more moment to make this dream real.

It was almost 9:00pm when my husband finally gave up on the health center and decided that we would go to an old woman who we had heard assists women without the financial resources needed to give birth at a health center. The 1.8 km journey felt like 20 miles of unrelenting pain. I bit my lip and groaned to suck it all in. I don’t remember how and when we got there for sure, but by the time I regained my senses the old woman was carrying me into her house. Once inside her home, I got a breath of fresh air as I endured the pain of child birth. I heard “Push! Push! Push! Here it comes, relax…” These tender encouragements got me through it.

My eyelids slowly cracked open and I could see a silhouette of this amazing old woman behind the cracks of the wooden door to her bedroom. The smoldering dying flame from her tadooba, a local kerosene lamp, neatly outlined her wrinkles. In her strong arms lay my bundle of joy, crying away, perhaps in celebration. I was finally pain-free and my baby was safe. She wrapped the baby as she cried and bundled her into an old chair in her living room then returned to me, helping me clean up.

I marveled at how this woman had managed to save my child and myself.

I marveled at how this woman had managed to save my child and myself. She was surely heaven-sent. Something else grabbed my attention — she had not yet asked for money and she had asked my husband to stay around for the night. As my heart continued to pound away in wonder, this old woman came in with a notebook and asked a for a few details from me: age, number of children, and so on. She was acting professional like a health worker. Her whole house was neat, and she treated me and my husband with immense kindness.”

Part 2: Call to Action

In the face of inadequate health centre staffing, lack of morale, limited infrastructure, and other challenges faced by the health sector in Uganda, many expectant mothers are left in the hands of Traditional Birth Attendants (TBAs) in their quest to enjoy the right to health. Despite health reports worldwide indicating that TBAs have not made a significant contribution to reducing maternal and child mortality, it’s time to re-evaluate the role and contributions of TBAs.

It is also time to design programs that equip TBAs with the skills and resources they need to support formal healthcare. TBAs are an affordable alternative to expensive formal healthcare. In many cases, they are closer to the communities they serve and are more socially acceptable compared to health workers. TBAs are a tradition embedded in so many societies and they daily prove their by filling gaps in health and medical care, often supporting mothers who desperately need their help.


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