It was in the dead of the night. The whole community had gone to sleep on a quiet and peaceful night. She was resting in a wide but smoke filled room and the weight of her body was too burdensome as her belly was as ripened as a pear. She couldn’t sleep nor sit because the pangs of labour had just started. She moved up and down the room and finally sat in a contemplative mood. The thought of delivering safely run through her mind after several pregnancies which resulted in miscarriages. Afroza is a 32 year old banana seller with six children. When she noticed she was pregnant again after her sixth child turned nine months she refused to attend antenatal care services for fear of being ridiculed by health workers and friends in her community. She hid the pregnancy from the community until she was due for delivery. As she lay on the floor, her contractions kept increasing by the minute and when she couldn’t bear it she whispered to her mother in-law who was also sleeping in the same room about her sharp pains. ‘Sleep my daughter, you‘ll be fine’, said her mother-in law. Young girls of today don’t know how to endure birth pains, she chided. Afroza returned to her mat and tried to sleep. Before long she started to bleed. The only village delivery attendant or what most refer to as the Traditional Birth Attendant (TBA) was called to assist but realized she could not be of much help since she had no medical equipment to stop the bleeding. Afroza was losing so much blood now. The TBA quickly advised that she should be sent to the health facility in the community. The only mode of transport in the community was a motor bicycle. The owner was immediately awoken from his sleep by Afroza’s husband who pleaded with him to send her wife to the health care facility, whilst the rest of her family made arrangements to go by bicycles to the health post. Half way through the journey on the motor, they had a flat tyre. There was no vulcanizing shop or garage nearby to assist them at that hour of the night. Left with no option, the remainder of the journey was embarked on foot until a member of the family caught up with them. Afroza had to be carried on a bicycle to the health post. At this stage, she was barely hanging in there as her body was weak and she was experiencing delirium. They arrived finally at the health facility after three hours by which time the labour had grown from worse to severe. Unfortunately, the health facility was empty. The only nurse in the facility was on outreach services to other communities the day before and could not return to her post before midnight. Afroza’s husband sat down with great sense of anxiety not knowing what will happen to his wife. He watched as his helpless wife struggled to deliver their unborn baby who would turn out to be number seven in the family. He began to wonder how the first was a still birth, with the subsequent deliveries also saddled with pregnancy complications. The community health nurse was immediately contacted and upon seeing Afroza, she referred her to the district hospital where she could be assisted by a professional trained midwife. On their way to the hospital, Afroza died a tragic and painful death because she had lost a lot of blood.
In that community, women were losing their precious lifes during delivery. This turn of events made the village earth priest to consult their gods, the prayer camps organized fervent and unrelentless prayers all in a bid to unravel the circumstance leading to the death of pregnant women and their babies in the community.
This is the story across several parts of Bangladesh, Africa, Southern India, and Latin America where women lose their lives each day during pregnancy or childbirth. Must women continue to die in a political economy of maternal health?