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After 14 years as a midwife, I’m impatient about ending maternal deaths

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Angela Nguku sits and listens to a women who nearly didn't survive child birth.
Angela Nguku speaks with a woman who narrowly survived giving birth.
Photo courtesy of White Ribbon Alliance
"We lost her to postpartum bleeding. We had no blood."

"She died of obstructed labor. The ambulance had no fuel to take her to the health facility."

"She died before reaching the hospital. For two days the roads were impassable due to the rains."

"We called the doctor, but she succumbed to antepartum bleeding before he arrived since he was in theater with another patient."

"Here is the graveyard of my wife and the triplets she was giving birth to. She died in the dispensary of obstructed labor."

T hese are the heartbreaking statements I have heard nearly every day in the 17 countries where I have worked as a midwife and advocate over the past 14 years. They continue to ring deep in my ears. I cannot unhear them.

In 2000, almost 200 countries agreed to the United Nations Millennium Development Goals (MDGs), including a promise to focus on maternal health. Still, women died in child birth. In 2015, the MDGs were replaced by the Sustainable Development Goals (SDGs), which pledged the world to good health and well-being and gender equality. Women are still dying in child birth.

A woman in Kenya holds both her baby and a sign that reads "What women want is enough medication"
Photo courtesy of White Ribbon Alliance
What is most sad to me is that as they are dying, the world is busy counting and reporting their deaths, yet very limited action is being taken to prevent them. This is despite the solutions being simple and well-known.

I am impatient because the statements above should not be the stories of the 21st century. In both the MDG and SDG eras, I have heard countless commitments from global and national leaders. It’s the same old rhetoric, with what often feels like deliberate inaction by the people making them. The questions that strike me are:

Who are these commitments being made for?

Are they done sincerely and for the women or are they for visibility reasons?

Are those making them competing to impress and earn praise? Are they doing it for the news headlines?

If these billion-dollar commitments from countries the world over are for the women, why are they still dying today?

When will we stop praising the commitments while quietly ignoring the lack of follow through?


22 women will die in child birth in Kenya today. This number is likely to be three times higher in Sierra Leone—and most likely eight times higher in South Sudan! I am impatient because those in power are not acting fast enough to end this carnage.
The era of simply making pledges and counting numbers must be left behind.
We must also remember that when women die in child birth, they are not the only ones who suffer. Often, their newborns die, too. Their surviving children are left desolate, their families are broken, and their societies lose out on everything they would have contributed.

Women have a right to live. I want to see deliberate, practical, and realistic plans to save their lives, and I want to see them implemented fully. I want to see women’s desires, choices, and realities taken into consideration in the creation of those plans. The era of simply making pledges and counting numbers must be left behind. Women must have a seat at the planning, implementation, and accountability table. They know best what they need.

It is the high time that we realized that women are born with power; it is society that takes this power away from them, putting them into vulnerable situations by denying them their rights in almost all spheres of their lives. It is our moral responsibility to save women and newborns from dying during pregnancy and childbirth. We cannot keep holding their lives for ransom; each life lost is just one too many!

Posted: May 14, 2019
Edition: Impatience


The ideas and views reflected in this article are those of the author and do not necessarily reflect those of Evoke or Melinda Gates.