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Childbirth particularly perilous in Guinea-Bissau

By Krista Larson

Associated Press

Published: Saturday, July 14 2012 8:36 a.m. MDT

The midwife is summoned and attempts CPR, in front of an open room full of other new mothers. A cleaning woman furiously guards the door, as other family members rush to see Djau.

The efforts to save her show no signs of working. Her distraught female relatives begin pouring out into the courtyard. It takes the strength of several women to keep her mother from collapsing to the ground.

Their cries of grief echo through the ward indoors, where her husband wipes tears from his face as the midwife checks for a pulse one last time. Her eyes remain open to the ceiling, her lips parted weakly. The midwife covers her body and face with the same orange, brown and blue wax print fabric she had been wearing around her waist.

Djau's family lifts her lifeless body into the back of a bush taxi. Relatives on motorcycles follow the makeshift hearse in a slow procession back to her home.

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Not long after Djau's death, Aissato Sanha shuffles over to the maternity ward with her mother by her side. She's given her age as 18, but the midwife believes she's as young as 15.

It is a triumph for health workers that Aissato is here at all.

The hospital has a House of Mothers, a building just a few minutes' walk away from a delivery room, where women count down the anxious days to birth under close medical supervision.

Outreach teams from a program operated by Caritas and Catholic Relief Services now regularly head into remote villages to identify high-risk pregnant mothers and relocate some closer to medical services. The teams also train traditional birthing matrons, helping them to determine when it's time to get women to the hospital.

Such efforts have made inroads in sub-Saharan Africa: The United Nations reported recently that the number of women dying from pregnancy and childbirth has nearly halved over the last two decades.

But even now, and even at the hospital, it is touch-and-go. Generators only hum to life when a surgery is being performed. There is no power for refrigeration to store blood donations, and no electricity to run incubators for babies who have come too soon.

A typed list pinned to the bulletin board in the hallway shows the grim statistics at Gabu hospital alone: Four mothers died here in January, seven in February and three in March. There were no totals kept for April, when a military junta seized power, or for the chaotic month of May that followed.

As the sun falls, the head midwife at the hospital works with only a flashlight tucked under her chin and sometimes the glow of a candle on a nearby countertop to guide her.

The night wears on, and Aissato tosses restlessly in the one-room ward lit only by candles. At one point, she catches a glimpse of another woman's baby coming out legs first, as the staff scream at her to push or the baby will die.

Tears stream down Aissato's bewildered face as her water breaks on the floor near the nurse's station. It puddles around the stools where they are logging each stillborn, each close call.

But by 10:30 a.m. the next day, her baby is no closer to birth. The hospital's director is called, opinions are shared. Aissato must have a Cesarean section, an expensive but lifesaving procedure for both her and her child.

"You must buy these drugs now or the baby will die," the surgeon tells her mother firmly as she sets off briskly to the neighborhood pharmacy.

Once the supplies arrive in a coral plastic shopping bag, Aissato, her mother, the doctor and the nurses walk over to the operation room.

After the surgery, as Aissato's mother tends to her in a hallway, staff workers approach her father to see the baby. When shown the little boy who had struggled for so many hours to enter the world, the grandfather recoils with horror on his face.

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