Notes to broadcasters
Pregnancy-related problems that women face are many, and, in most cases, unpredictable. Some of them lead to death or permanent injury. Social, political or economic factors should not be allowed to deny a woman her fundamental right for a healthy pregnancy and childbirth. Reducing maternal deaths is therefore a matter of rights and an urgent priority. That is why every family needs to be encouraged to make savings in advance preparation for emergencies. Fortunately, modern medicine has the capacity to handle most of the problems in health facilities.
Both mother and baby stand to benefit from treatment at a health facility. Some treatments at the prenatal stage have the benefit of preventing children from being born with complications and defects. In the home delivery in this drama, the placenta retention could have resulted in death.
This is part two of a two-part drama. In part one, the setting and some of the main characters are introduced. It is recommended that these two scripts be played back-to-back, or on two successive days. You might want to market the drama with a short advertisement or “teaser,” which offers a short description of the drama or a short audio clip, in order to entice the listeners.
Script
CHARACTERS:
Azuma (Tontie’s wife, also a daughter-in-law to Halosu)
Tontie (Azuma’s husband, Halosu’s grown-up son)
Halosu (Tontie’s mother, mother-in-law to Azuma)
Nurse (A community health nurse, who pays routine visits to the community)
SYNOPSIS:
Azuma, who got married to Tontie in the first part of this drama, is in labour at home, being attended to by Tontie’s mother, Halosu. Azuma did not go to a health facility as earlier developments led one to hope. She succeeds in delivering a baby boy but retains the placenta, thereby bleeding profusely. Halosu, the mother-in-law and Traditional Birth Attendant (TBA), accuses her of infidelity, believing that this is the reason the clan gods and ancestors are visiting punishment on her by causing the placenta to be retained. Halosu’s belief is a common one in her community. Fears of infidelity are usually confirmed by divination. When the placenta is retained, there is no other verdict but guilty.
During a routine visit, a community health nurse sees Azuma. Her intervention saves Azuma’s life. Subsequently, she advises Tontie and his mother on the importance of antenatal and postnatal care, insisting that even though they risked denying Azuma the essential prenatal care, she must receive postnatal care.
Signature tune up. Hold 10 seconds and fade out.
SFX:
The cry of a newborn baby.
AZUMA:
(Groaning in pain) Take me to hospital, my mother-in-law.
HALOSU:
This is no hospital matter. You only need to confess your unfaithfulness to my son, and the placenta will come out. You certainly know that our gods hate infidelity on the part of a woman.
AZUMA:
(Sounding angry, feeble, and sobbing) I have not been unfaithful to your son. Which man in this community have you ever seen me with? I’m not a rotten woman. Please, stop ruining my good name and take me to hospital before I bleed to death.
HALOSU:
Well, the diviner said it. The fact that you are retaining the placenta clearly confirms your unfaithfulness. I know your type very well.
AZUMA:
Oh my God! Maybe it is the Assemblyman?
SFX:
Barking of a dog. Enter community health nurse.
NURSE:
(Teasingly) Ha-lo-su. Conducted your own daughter-in-law’s delivery. Hey! A bouncy baby boy, too.
HALOSU:
(Sighing) Hmmm. Not without a problem. She has retained the placenta and is bleeding profusely.
NURSE:
But why? I advised you to make arrangements in advance for transportation to carry her to hospital at the slightest sign of labour.
NURSE:
Ahaa! Now I understand why you haven’t sent her to hospital. As a TBA, what do you do in a situation like this, when a woman gives birth retaining the placenta?
HALOSU:
She delivered the baby alright, but retaining the placenta is the result of her unfaithfulness to my son.
AZUMA:
(On hearing this, Azuma begins to sob) Lies! Who told you that? I wish you could enter my heart to see my innocence.
NURSE:
Don’t weep, my dear. God is great. Science is too. All will be well soon. We have to let the child suckle without further delay. Poor thing.
HALOSU:
(Protesting vehemently) No, no, no! We can’t suckle him on the first milk.
HALOSU:
It’s bitter milk. It failed the ant test (Editor’s note: see note at end of script for explanation of the ant test), and has to be expressed and thrown away to allow fresh, clean milk to form, which is then good for sucking. Apart from that, we have to bathe both mother and baby first.
NURSE:
Never mind. I know what I am doing. This first milk that the people here term bitter milk is the best for the baby. It is God’s own immunization against diseases. Just watch me!
HALOSU:
Well, I’m watching. Our people say if you hurt a witch, you may as well pray that night won’t come.
NURSE:
Yes, but also note the Chinese saying that the one who says that a thing cannot be done should not interrupt the one doing it. You see how vigorously the baby is sucking? Now, hold the placenta and pull it gently and let’s see what happens.
HALOSU:
Look, it’s coming! (Surprised and a little reluctant) Hmmm …
AZUMA:
(Sigh of relief) Thanks, nurse! Where diviners were ruining my life, reputation and marriage, you came to mend my soul and preserve my chastity.
NURSE:
Let all thanks go to God. How do you feel now, dear?
NURSE:
With so much loss of blood, it’s natural to feel dizzy. You should drink a lot of fluids. A meat-based broth would be good, because you also need iron. And we should take you to a health facility as quickly as possible. Don’t try to get up yet. Halosu, let’s find a suitable place to talk about other matters and give the new mother time to rest. I’ll arrange for transportation to the health facility.
Play health-related music to link to the next piece.
HALOSU:
Now, explain your miracle.
NURSE:
When the nipple is stimulated through the sucking, it produces a substance in the body, a hormone called oxytocin. This hormone causes the muscles of the woman’s uterus – the bag where the baby was growing – to tighten and contract.When the uterus tightens like this, it helps the placenta to separate from the uterus so that it can come out as it should. By the way, Tontie, why didn’t you send your wife to hospital as I advised?
TONTIE:
You see, the labour took us by surprise.
NURSE:
I won’t accept that. If she had been attending a health facility regularly, healthcare providers would have been able to figure out her due date, an estimate of the day her baby would be born. Most babies are born within two weeks before or after their due date. The labour wouldn’t have taken you by surprise.
TONTIE:
(Angrily) I have told you that my mother could handle all emergencies. I am the husband, and I made the choice not to set aside funds for delivery or allow Azuma to go to prenatal care.
NURSE:
Your mother thought that, being a TBA, she could handle the labour. But some of the complications of pregnancy and childbirth cannot be handled by Traditional Birth Attendants!
HALOSU:
(Pause) Well, all I can say is that I’m happy it’s over.
NURSE:
And now she needs postnatal care. Here’s what happens with prenatal visits. At a woman’s first prenatal care visit, healthcare providers counsel her on the importance of proper nutrition, diet, and exercise. They ask the woman about her health and her partner’s health; they identify any medical problems; they weigh her and check her blood pressure, and they check a urine sample for infection. The Traditional Birth Attendant cannot take these precautions.
TONTIE:
(Quietly, ashamed) We were not aware that these things would happen. There were no signs of trouble …
NURSE:
In later prenatal visits, the health providers measure the woman’s belly to see how the baby is growing; they check her hands, feet and face for swelling; they listen to the baby’s heartbeat; later on, they feel her abdomen to assess the baby’s position. They also ask the woman if she has any other personal concerns bothering her. You took a big risk denying her all these vital services.
HALOSU:
(Still a little hostile, but with some respect) Well, nurse, what do you think we should do now?
NURSE:
Postnatal care is equally important in ensuring good health for mother and child. In the first few days after delivery, when her breasts begin to produce milk, she can have engorged or swollen breasts if care is not taken. She’ll also need to know how to prevent cracked nipples. There is a lot to know about. Simply let her access the nearest health facility.
HALOSU:
Already she complains of dizziness.
NURSE:
Yes, I have arranged for transportation, which should arrive very soon. With the dizziness, we can’t always tell what might be happening. So this time round, be advised.
TONTIE:
(Speaking slowly) I may have made a mistake which put my wife and my newborn child at risk. I do not wish to repeat such a mistake. I promise you that, if we are blessed with another pregnancy, I will ask your advice, nurse.
HALOSU:
(Reluctantly, with respect) Yes, nurse; it seems that modern science does have something to offer. I also do not want to place my daughter-in-law at risk again.
NARRATOR:
(Pause) Maternal mortality is a global issue. It is estimated that at least 583,000 women die each year around the world from the complications of pregnancy and childbirth. Be advised!
Music Play choral music of women (particularly, about women’s welfare), and exit.
Acknowledgements
- Contributed by: Tennyson Wubonto, Ghana Community Radio Network.
- Reviewed by: Ellen Brazier, Anglophone Africa Program Director, Family Care International.
Information sources
Note:
The “ant test” that Halosu refers to is a test which happens after childbirth. When a baby is born, it is not allowed to suck the first milk (colostrum) until a test is carried out to determine whether it is good or bad for the newborn. A bit of the colostrum is expressed into a container and an ant is placed in the milk. If the ant is able to swim out, the colostrum is said to be wholesome for the baby. If the ant is unable to swim out, the colostrum is said to be bad, and is therefore expressed and thrown away. As colostrum is slimy, the ant is often unable to swim out, and so it is denied the newborn.
