#EthiopiaNewborns: Challenges that remain

Ethiopia Newborn

Photo credit: Elizabeth Atalay.

ONE Moms Nicole Melancon and Elizabeth Atalay are traveling with the International Reporting Project on a New Media Fellowship to report on newborn health. This co-authored post is a continuation of our series of stories from the ground. Read more about the project here, Elizabeth’s post about their visit with Dr. Bekele, and Nicole’s post from Mosebo village. Follow their journey on Twitter with hashtag #EthiopiaNewborns.

“If she hadn’t started bleeding she would have had to struggle giving birth at home like me.” Those were the impactful words we heard from the mother of a young pregnant woman we met while visiting the “Lie and Wait House” for expecting mothers about to give birth.

We were in the mountainous Yetiban district of rural Ethiopia reporting on newborn health with the International Reporting Project. For both of us this was the culminating moment of all that we had learned up to this point.

For the past two weeks, we had been examining Ethiopia’s maternal and newborn health landscape. We received a comprehensive overview of the progress and challenges that lay ahead in reducing maternal and newborn deaths by visiting health posts, health centers, hospitals, and practitioners. At each new location we were able to meet expecting mothers, new mothers, or health care providers to gain insight into the shape of maternal and newborn health in Ethiopia.

We were both surprised by the poverty and lack of infrastructure we encountered upon arrival in Addis Ababa. As the headquarters of the African Union and the United Nations Central Office for the African continent, we had both been expecting a more developed city. It is certainly a city under construction, railroads, roads, buildings, and homes are under way, giving it a gritty, chaotic feel.

Regardless of the state of the infrastructure, the Ethiopian government clearly has made a priority commitment of maternal, newborn, and child health. Real progress has been made as evidenced in the dramatic reduction of maternal and child mortality rates in the country.

What became clear to us the more we learned however, was that the cultural shift towards women and girls will be as important to the plan’s success as the government provided health component. As long as families marry daughters off at the age of 13 mothers and babies will continue to die in childbirth.
lieandwaithouse

Photo caption: Each doorway of the Lie and Wait House is a separate room for an expecting mother. Photo credit: Elizabeth Atalay.

Technically it is illegal to marry before the age of 18 in Ethiopia, but we realized that most of the women we met did not exactly know how old they were. Though her first answer was 25, we soon came to learn that the pregnant mother we met at the Lie & Wait House was really just 15 years old.

We looked at her rounded cheeks, her still innocent eyes, and the way she deferred to her mother for answers, and thought, yes, that’s sounds about right.

She had started bleeding two weeks before, and that was the only reason she came to be waiting to give birth at a health care facility. She confirmed to us that otherwise she would have given birth at home, as most women in her area still do. As her own mother did with her eighth child just three months ago, whom she held and breastfed as we talked.

We were struck by the realization that this mother and daughter had escaped Ethiopia’s plans for improving maternal and newborn care. No health extension worker had ever visited the mother’s village, a two hour mountainous walk away from the new hospital where her 15 year old daughter would deliver. No health extension worker had ever educated either woman on the importance of family planning, pre and postnatal care, and giving birth in a facility with a trained midwife.

This woman and her pregnant daughter represented the missing piece: The 80% of Ethiopian woman who still risk their and their babies lives giving birth at home, many with no trained birth assistant. The magnitude of this reality, and how long it will take Ethiopia to reach every woman and girl left us acutely aware that there is still so much work to be done.

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