Activitists in the Ugandan capital, Kampla, protesting about maternal and child death rates in birth.

Activitists in the Ugandan capital, Kampla, protesting about maternal and child death rates in birth.

Tabitha Mukiibi was already in labour in her village in Luweero, central Uganda, when she and her husband jumped on a bodaboda (motorbike taxi) to get to the nearest public hospital.

Upon their arrival at the crowded hospital, the couple was largely ignored by doctors and midwives. It looked like the 28-year-old would have to deliver the couple’s first child on the floor with only her husband’s help.

The commodities are not in hospitals and these women cannot buy them because they don’t have the money 

But when things started to go wrong, Tabitha’s husband, Livingstone, pulled her into a private room. It was only then that midwives came to help with the birth of their daughter, Prossy Patience.

Shanti Uganda's birth centre.

Shanti Uganda's birth centre.

Livingstone works in Iraq, and in the past five years, since his daughter’s birth, he’s only been home for four months. He explains that his daughter is named her late grandmother, but that her middle name, Patience, is because she "gives us mainly challenges when I’m away".

A world apart

Having a healthy wife and child is a somewhat rare sight in Uganda. A staggering 16 women die every day from childbirth-related complications, such as partum hemorrhage, severe bleeding after birth, which is easily preventable. Ugandan officials aim to improve their rate to 131 deaths per 100,000 live births by 2015.

Local women practicing antenatal yoga at Shanti Uganda.

Local women practicing antenatal yoga at Shanti Uganda.

In contrast, in Australia, there are about eight maternal deaths per 100,000 births, according to Childbirth Australia, a not-for-profit childbirth information and advocacy association.

"All women in Australia have access to a schedule of antenatal care, and access to screening and diagnostic tests as required - whether they plan to birth at home, at a birth centre or in hospital and whether they choose a midwife or doctor as their primary carer," says Debbie Slater, vice chairwoman of Childbirth Australia.

"Postnatal care is also available, although the nature and extent can depend upon the health service or healthcare practitioner providing that care."

Meanwhile, in Uganda, crippling poverty, potholed roads and few resources make it impossible for many pregnant women to reach urban medical facilities. Wheelbarrows commonly become ambulances.

Traditional birth attendants (TBAs) complete apprenticeships in order to help labouring women. They aren’t trained midwives, but they assist in the majority of Ugandan births, usually in rural villages.

Those who do make it to hospital may meet brash midwives. But with not even 2000 qualified health professionals, all staff members are overworked and underpaid. Each mum-to-be is supposed to be given a Mama Kit, containing cotton wool, gloves, razor blades and other items, but supplies regularly run out. 

"They leave you there to die," says Nakibuuka Noor Musisi, a program officer at Uganda’s Center For Health, Human Rights and Development (CEHURD).

"The commodities are not in hospitals and these women cannot buy them because they don’t have the money."

New hope

Last month, Tabitha and Livingstone welcomed their second daughter, Lisa. Their baby was born at a birth house run by Shanti Uganda, a charity which aims to reduce maternal and infant mortality in Uganda. She, like the other expectant mothers who use the birth house’s services, paid a small fee for supplies to have her child in a safe, positive, and more hygienic environment.

A quote from US writer Laura Stavoe Harm is painted on the reception wall in the local language: "There is a secret in our culture and it is not that birth is painful, but that women are strong."

The centre offers antenatal yoga and massage to expecting women – a controversial move, considering that some Ugandans believe yoga is linked to witchcraft, and that massage is an extravagant luxury.

But blending these practices with traditional childbirth methods can make labour more comfortable for African women. Tabitha took part in the yoga classes leading up to the birth, and her midwife, Stella Namugan, massaged her feet and calf muscles while she was having contractions.

"When she was in true labour it took us five-and-a-half hours to get her [delivered]," Namugan said.

"If we hadn’t used massage it would take her 12 hours to get out of true labour and it’s really painful."

Tabitha, who took her newborn home via motorbike, said her second delivery was "very okay" compared to her "hard" first one.

Later this year, Uganda’s Supreme Court is expected to deliver its judgment in a landmark case being brought against the country’s government by CEHURD and the husbands of two women who died during childbirth. They want the government to devote more resources to maternal health so more mothers, like Tabitha, can live to see their children grow up. The activists are hoping to make a change in their desperate battle to save women’s lives.

To learn more about Shanti Uganda, or to make a donation or buy handicrafts made at the house, visit Shanti Uganda's website.