The importance of care during pregnancy and childbirth

Gender equalityHealth

Notes to broadcasters

Pregnancy and childbirth are crucial times in the life of a woman and her child. Appropriate medical care during pregnancy and a safe delivery are essential to ensure the health and well-being of both mother and baby. Good care helps to identify and treat potential complications, provides nutritional advice and prepares the mother for childbirth. What’s more, quality care helps reduce the risk of maternal and infant mortality and promotes the optimal development of the newborn. It is therefore essential that all women have access to appropriate health care throughout pregnancy and childbirth.

This text is based on interviews conducted by Boh Kone and Djénèbou Sangare on Radio Kénédougou in their program Ladili Blon. The original program was broadcast in Bambara in February 2024 as part of the “HÉRÈ – Bien-être des femmes au Mali” project, which aims to improve the well-being of women and girls in terms of sexual and reproductive health, and to strengthen the prevention of and response to gender-based violence in the Sikasso, Ségou, Mopti and Bamako district regions of Mali.

To reproduce this script on your radio station, you can use voice actors to play the roles of the interviewees and adapt it to your local situation. If you choose this approach, be sure to inform your listeners at the beginning of the program that the voices are those of actors or actresses and not the original interviewees.

You can also use this text as a basis for developing programs to improve knowledge of childbirth practices in your area. Interview health professionals, midwives,and experts in prenatal and postnatal care.

During your interviews, you can ask the following questions:

  • What are the best practices for ensuring a safe, well-supervised childbirth?
  • What are the long-term goals for improving care during pregnancy and childbirth?
  • Can you share any examples of successes or positive outcomes in maternity care?
  • What efforts are being made to ensure that these practices continue to evolve and benefit expectant mothers?

Estimated length of radio script with music, intro and extro: 15 minutes

Script

BOH KONE :
Welcome to our radio program. I’m Boh Kone, and I’m here with Djénèbou Sangaré. This week, we spoke to a woman who delivered her baby at home without proper care.

The interview took place in the Lafiabougou district, bordered to the east by Sanoubougou 2 and Mancourani 2, to the north by Hamdallaye, and to the south by Lafiabougou Koko. Let’s follow the story together. It is worth noting that, due to the sensitivity of the subject, the speaker has chosen to remain anonymous.

SFX : Background sound

WOMAN :
I had a very healthy pregnancy. When I went into labor, I decided to deliver right at home. The problem arose during my home birth, which took place without proper assistance or care. I had a hemorrhage that didn’t stop even after the delivery. I was in pain and explained the situation to my husband, who informed his friends. They advised us to go to the hospital immediately.

Before going to the hospital, I first used traditional medicines, thinking it was some other problem. Eventually, I realized that my symptoms were the results of an unassisted home birth.

The doctors’ prescription helped me a lot to improve the situation, so today I’m fine and so is the baby. I’d like to tell other women in my situation that there are health centers in our communities that can help them in similar situations.

I received help from several people, including my husband and my mother. I wasn’t ostracized in my family or community because even though I didn’t immediately understand what was at stake, those around me were understanding.

Husbands play an important role during pregnancy and childbirth. They must accompany the woman to consultations, take care of her and stay by her side, whether she is giving birth or not.

You shouldn’t give birth at home, and you shouldn’t rely on traditional medicine alone. It is important to visit a health center to assess your condition and receive an appropriate prescription.

FADE OUT

BOH KONE :
As a reminder, this interview was conducted in Lafiabougou, but as mentioned at the beginning, the interviewee wished to remain anonymous. She gave birth at home without receiving the necessary care, which triggered her problems. Once in the hospital, she received a prescription that resolved the situation. She emphasized the importance of the role and support of spouses during childbirth. We thank her for her testimony, which will certainly have an impact on others. We invite our listeners to get ready as we’ll reconvene right after this break to enjoy some local music.

MUSIC

BOH KONE :
Good evening Madam, please introduce yourself.

MRS. OUATTARA :
Good evening to you and to the listeners of Radio Kéné. I’m Mrs. Sidibé Adiara Ouattara, midwife at the Sikasso referral health center.

BOH KONE :
Welcome. What is obstetric care?

MRS. OUATTARA :
The ultimate goal of obstetric care is to ensure that the fetus and its appendages are expelled from the uterus at term, i.e. to bring the child into the world. It consists of assisting the pregnant woman to ensure a safe delivery for both mother and child.

When monitoring labor and delivery, special attention is paid to high-risk pregnancies (pathological or complicated).

The partogram should be used as a monitoring and decision-making tool throughout labor.

All births must be performed in a health facility by qualified personnel.

DJENEBOU SANGARE :
What are the care activities during childbirth?

MRS. OUATTARA :
Childbirth care activities include prevention of mother-to-child transmission, monitoring the progress of labor using the partogram, birth of the infant, active management of the third stage of labor, detection and management of childbirth complications, and referring cases beyond the provider’s expertise.

For most women and families, childbirth is a time of excitement and anticipation, but also of uncertainty and anxiety.

Childbirth represents a major transition in a woman’s life. The memories and experiences of labor and birth stay with a woman for the rest of her life. The support of her loved ones and the care she receives during this time are essential. Overall, the purpose of the care provided to women during labor and birth is to create a positive experience for women and their families, while preserving the health of the woman and her baby, preventing complications and responding to emergencies.

BOH KONE :
What are the advantages of giving births in a health center?

MRS. OUATTARA :
The benefits are many. They include lower maternal and neonatal mortality rates, and better awareness of labor and danger signs. It also helps reduce childbirth-related complications, such as premature rupture of membranes, severe headaches, and abdominal pain. What’s more, it ensures that both the mother and the newborn are healthy and that the newborn is receiving the essential care as well as proper growth by performing tests within minutes of delivery.

DJENEBOU SANGARE :
What are the disadvantages of home births?

MRS. OUATTARA :
The disadvantages of home births, outside health facilities, are numerous and serious. It increases maternal and neonatal mortality, favors the birth of sick babies, and leads to birth complications such as hemorrhage, eclampsia (which is a sharp increase in the pregnant woman’s blood pressure), as well as mental disorders. What’s more, it can often lead to Cesarean sections, which can lead to stigmatization.

BOH KONE :
There’s a disturbing situation in our communities : many midwives help pregnant women deliver at home. What are the possible consequences of this practice?

MRS. OUATTARA :
Yes, unfortunately, there are some who indulge in this harmful practice, which has consequences not only for the woman but also for the newborn. With the evolution of medicine, this practice is not even allowed, because a single midwife should not assist a delivery. In health centers, the minimum number of qualified health personnel required is two or three. In case of complications, efforts are usually coordinated. However, if there is only one midwife at home, she may not be able to handle the situation alone. This could endanger the life of both mother and child, which would be unfortunate.

BOH KONE :
What are the solutions to eradicate home births?

MRS. OUATTARA :
It is essential to promote communication for behavioral change within families, communities and health structures, because any change is progressive. Here are the actions to be implemented…Inform and raise awareness through talks organized by health centers. Ensure the availability and training of qualified personnel, which is essential. Offer support to partners during pregnancy, childbirth and postpartum period. Facilitate access to community health centers in collaboration with municipal councils.

Local authorities, in particular town halls, must fulfil their responsibility for referral and evacuation by making these services free or reducing evacuation costs where necessary.

DJENEBOU SANGARE :
What role should husbands play in supporting their wives during childbirth?

MRS. OUATTARA :
In the past, husbands and wives thought that childbirth didn’t concern them directly. Fortunately, today they are beginning to understand that it’s a shared responsibility.

During childbirth, the woman must be completely calm. It’s crucial that she feels reassured by her husband’s presence and that she knows he cares for her; this aspect is very important.

BOH KONE :
What role can in-laws play in facilitating the birth in a health facility?

MME. OUATTARA :
The in-laws must support and accompany their daughter-in-law throughout her pregnancy and right up to the birth. It’s important not to add to the stress by arguing or fighting unnecessarily after the birth. They should concentrate on supporting and caring for both the mother and the baby.

BOH KONE :
The choice of attendant is very important. What qualities do you think the person accompanying a pregnant woman should have?

MRS. OUATTARA :
I would like to say to all those who are listening to me right now that the attendant must be someone in whom the pregnant woman has complete confidence.

BOH KONE
:
An elderly person, as is often the case, or a young person?

MRS. OUATTARA :
It doesn’t matter how old he or she is, as long as he or she is a trustworthy person, there’s no problem.

BOH KONE :
We had a question from our audience about the difference between a normal delivery and a Cesarean section. Could you explain it to us?

MRS. OUATTARA :
I think that’s a very good question. There are two types of delivery: vaginal delivery, which is the normal way, and Cesarean section. A vaginal delivery occurs naturally through the vaginal canal, while a Cesarean section is a surgical procedure to extract the baby through an incision in the abdomen and uterus. A Cesarean section is often necessary if there are complications that make a vaginal delivery risky, such as problems with the baby’s positioning or signs of fetal distress. Failure to undergo prenatal consultations will not necessarily result in a Cesarean section. While certain situations may require a Cesarean section, the goal is always to ensure the safety of both mother and baby.

DJENEBOU SANGARE :
Thank you very much, Sidibe Adiara Ouattara, for participating in our program today. We have all learned a lot about maternity care, the importance of proper preparation and understanding the options available to expectant mothers. Your expertise has helped us to better understand how to ensure a safe and peaceful birth. We hope that our listeners now feel better informed and supported. Thank you again for your time and valuable advice.

Acknowledgements

Contributed by : Boh Kone and Djénèbou Sangare of Radio Kénédougou

 Sources of Information :

Interviews: Sidibe Adiara Ouattara, midwife, February 2024

Anonymous interviewee in Lafiabougou, February 2024

This resource has been produced thanks to the “HÉRÈ – Bien-être des femmes au Mali” initiative, which aims to improve the well-being of women and girls in terms of sexual and reproductive health, and to strengthen the prevention of and response to gender-based violence in the regions of Sikasso, Ségou, Mopti and the district of Bamako in Mali. The project is being implemented by the HÉRÈ – MSI Mali Consortium, in partnership with Radios Rurales Internationales (RRI) and Women in Law and Development in Africa (WiLDAF), with funding from Global Affairs Canada.