Special Delivery: Midwife Pledges to Help Save Mothers' and Infants' Lives After Losing Her Own Babies

BARDOT, San Pedro, Cote d’Ivoire — Odette Koffi-Brou knows firsthand the dangers of delivering a baby without a skilled birth attendant present. She lost her four babies – three boys and a girl – because her family insisted she give birth at home.

"I was a victim of ignorance when I was younger. I decided to become a midwife to save other children,” says Koffi-Brou, whose decision to train as a midwife has saved countless lives. “It’s like I’ve saved a thousand children for myself to replace the ones I lost.”

Koffi-Brou founded and today serves as president of the Association des Sages-femmes pour la Gestion de la Maternite’ Municipale De’le’gue’e du Bardot, an association of midwives dedicated to providing maternal health care to the impoverished residents of Bardot, one of the largest shantytowns in West Africa.

Working at the community level

Bardot is home to 80 per cent of San Pedro’s 160,000 residents. Approximately 60 per cent of Bardot’s mothers will deliver their babies at home. The maternal mortality rate for the are is 135 deaths for every 100,000 births, according to government figures.

Koffi-Brou saw the urgent need for the women of Bardot to have access to professional medical care where they could deliver in safety with trained midwives in clean settings. She petitioned city hall to set up a maternity clinic in the heart of the slum.

“I went to the mayor and the Minister of Health to ask for support for our association to open a maternity ward for the community of Bardot. The community and the midwives would run the maternity ward together,” she explains. “It’s very important to work with the community always – they will tell you what they want and need.”

Today the centre serves as a multi-service health station, providing prenatal and maternal consultations, delivering babies, preventing the spread of mother-to-child transmission of HIV and working with prostitutes to prevent the spread of sexually transmitted diseases. Trained volunteers go on home visits to teach women and their families about the importance of pre- and post-natal care for mothers and their babies.

Saving mothers and infants

“Maternal mortality and infant mortality are intertwined,” says Dr. Daniel Sebene, who is based in San Pedro for UNFPA, the United Nations Population Fund. “Women need to give birth in a safe environment so that both mother and child are in good health after delivery. UNFPA is committed to lowering maternal mortality, training personnel and educating the community.”

During a recent trip, a boisterous crowd from the local community welcomed visitors to the maternity clinic, dancing and singing with back-up from a band playing makeshift instruments, strumming a saw, blowing a whistle, beating a snakeskin drum and blowing into an empty wine bottle. Dancers whirl around faster and faster to the pulsating music, hunched over with forehead pressed to forehead as is the custom in the region.

Inside the maternity ward, Magnaka Diakite’, 33, watches over her one week-old baby boy. Wrapped in a blue and black pagne of traditional African fabric, Magnaka shyly smiles, showing off her son who is covered in a sheen of white baby powder against the humid heat. The baby, her seventh child, is tightly swaddled in a pink towel and zipped into a mosquito net. Magnaka came to the clinic after she suffered complications in the last trimester of her pregnancy.

“I couldn’t walk. I couldn’t breathe. When they told me I had to come here, I was scared. I knew I needed an operation,” she says. “In the operating room, they told me this would save my life and my baby’s life. I was no longer afraid.”

“The midwives here know how to take care of people,” agrees 26-year-old Agnes N’Guessan who rests in a nearby bed after giving birth just hours ago to her own baby girl.

Koffi-Brau believes the centre has been so successful and welcomed by the community, because it is committed to involving women and their families directly in formulating decisions regarding their healthcare.

Involving women and families

“Women can make decisions. The work we are doing is enormous. We are making decisions with our sisters in the community,” she says. “We give them the opportunity to decide what is good and what they don’t want for themselves.”

In neighbouring Zimbabwe, concrete was being poured to finish a new maternity clinic for the community, which will be served by eight midwives. The municipality had begun work on the Zimbabwe centre in 1998, but hadn’t been finished for lack of funds. UNFPA is supporting the completion of the centre, modeled on the successful Bardot maternity ward, to serve slum residents who otherwise wouldn’t have access to maternal and reproductive healthcare. The refurbished centre and equipment will cost about $80,000 to complete.

One room has been designated as a consulting room. Another will serve as a place to discuss family planning. An observation ward is under construction to monitor the progress of mothers after they have given birth for abnormal bleeding, fever or other signs of infection.

“Every woman has the right to have a trained birth attendant like a midwife,” Dr. Sebene says. “That is why we want to replicate this innovative programme in Zimbabwe zone, where they can give birth in safety.” 

— Angela Walker