MIDWIVES MUST LISTEN TO WOMEN FOR QUALITY OF CARE

BY LUKE CHIWALA, White Ribbon Alliance for Safe Motherhood (WRASM), Citizen journalist/Midwife

One evening, a scene that is typical of inappropriate care by midwives played out in the most unbelievable of ways. I was walking to the postnatal ward with my colleague Nolia Chinkhwiri. She is a midwife and a very passionate one at that. Nolia is hardworking, caring and goal directed. She is hands-on and very observant.

That evening, I escorted her to the ward where she had to see babies in the Kangaroo Mother Care Unit. As we entered the door into the postnatal ward, we came across a woman lying on the floor. She was alone and crying deeply. Nolia stopped as I proceeded to the midwives’ station to find out what was going on and why are they not attending to the woman.

There were midwives sitting on chairs including students. I wondered why they had not attended to the woman despite that the fact that she was pregnant and had not delivered. This is one of many unfortunate scenarios  found at the maternity wards where some midwives tend to push away patients and deny responsibility.

Nolia sat the woman who was in tears, on the couch. She asked the woman to explain what had happened and why she was crying and lying on the floor. The woman (name withheld) narrated her story.

Apparently, the woman had gone to Mangochi District Hospital three days ago because she was experiencing vaginal bleeding pain on one side of her abdomen.

“I lost my first pregnancy because of the same problem. I was told that my uterus has an abnormality and that the other pregnancies should be delivered through caesarian sections. When I saw bleeding, I knew problems had started, that is why I went to Mangochi District Hospital for help,” narrated the woman.

The woman requested midwives at Mangochi that she wanted to deliver in Machinga so that she is close to relatives. The midwives honored her request and gave her a transfer letter to Machinga

On arrival at Machinga two days earlier, she had tried to explain her situation to the midwives about how she lost her first baby and what the doctor had told her. However, the midwives did not give her a chance to explain herself. She was examined and told that labour had not yet started. She had then stayed two days at the facility just waiting for the labour and had undergone several examinations.

“I am not in labor as they are saying, I have a tumor in my stomach and I know that. I cannot deliver vaginally or I will lose my baby again. All I want is for you to just listen to me. They have not given me a chance to explain my problem so that they don't know why I am here” she tearfully pleaded.

The woman had been neglected and verbally abused and not assisted at all. She had now stayed for two days without proper care.

I personally decided to take the woman back into the labor ward.  When the woman approached the midwife, she asked her; “Why have you come again? I thought I told you that your labour has not yet started and that you should wait?” the midwife asked.

She did not reply, she just looked afraid and worried. But why should women be afraid of midwives?  We continuously inflict psychological pain on women, we make them subjects of our care and we do not want them to say anything. We neglect their feelings and choices and yet we hope for better health outcomes.  At this point, I requested one of the midwives to first listen to the woman’s complaints. I convinced her that maybe the woman had a story behind her issues of labour. I did not tell them that she had told me everything. Luckily, the midwife responded, replied “let me call the clinician to see her”. I wondered why such a response could come at that time. I agreed with her that she should call the clinician, just to end the tension and have the woman listened to.

I left the woman in the labour ward with the midwives. However, she was afraid to because the Midwives acted as if she reported her the situation to me. I came back later with Nolia and secretly left her a phone number so that she calls if she needed any help.

During the night, the clinician assessed the woman and ordered caesarian section at once. The woman had some abnormalities with her uterus-the reason she was bleeding. Fortunately, her baby was saved and she left the hospital a happy mother.

Not giving women a chance to express themselves leads to neglect. Listening to women will help reduce incidences of disrespect and abuse in all maternity units as it strengthens the relationship between midwives and clients.