No joy for pregnant women during economic crisis

Date: January 1, 1970
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Bulawayo, 25 January 2008. Ordinarily, falling pregnant should be a joyous experience for every woman. And with just 8 years to go before the 2015 target year for achieving the Millennium Development Goals, one would expect to hear accounts of how motherhood is increasingly becoming a memorable, safer experience for women as countries strive to fulfill the fifth development goal of “improving maternal health.À

Sadly, this is not the case for the majority of Zimbabwean women. Instead, with each passing day, motherhood has become a nightmare best avoided.
The dilemma starts at conception.  For most Zimbabwean women, the choice whether or not to fall pregnant is not there.  For a start, accessing contraceptives is not easy.  Even the low cost contraceptives that are hard to find, are too expensive for most women. 
Female condoms are not readily available in supermarkets and when available, again they are expensive. On the other hand, male condoms are cheaper and more widely accessible, but as most women will point out, these are used only at the discretion of the male partner. Therefore, women are falling pregnant against their wish.
Terminating the unplanned pregnancy is out of the question.  Abortion is illegal in Zimbabwe except in cases of rape or where there is medical proof that carrying the pregnancy to term poses a threat to the life of the mother.
All too often the responsibility of antenatal care and bringing up the child rests entirely with the woman. The plight of 5-month pregnant Bulawayo woman who recently appeared in court facing charges of illegally terminating a pregnancy illustrates the magnitude of the dilemma. 
Patience Matsetlo told the court she induced abortion because her wages were not enough to pay hospital bills.  She added that she terminated the pregnancy because she was “stressed up” because her monthly salary was not nearly enough to meet hospital bills and look after the unborn child. The 26-year old Matsetlo said she was already struggling to look after a 2-year-old child.  Her partner had disappeared to South Africa soon after she conceived.
Even for those who want and plan to start a family, accessing antenatal care is a big challenge. Local authorities offer the cheapest maternity services in urban areas.  However, even these are proving too expensive for most women. As a result, expectant mothers are foregoing antenatal care and praying they do not have any complications when they go into labour.
Some women are turning to traditional midwives to attend to them during birth despite being aware of the inherent dangers of doing so. Some of these women eventually end up in hospital. Midwives often botch up complicated deliveries leaving the mothers-to-be with no option but to seek medical care to save both the baby and their lives.
At some point, hospitals were detaining mothers until they settled their bills.  The “detentions” stopped after women’s groups protested. Hospitals have since devised a subtle but more sinister way of pressing for payment; withholding birth record cards.
This mode of debt collection has far-reaching effects on the welfare of the child.
Without hospital birth records, a child cannot be issued with a birth certificate and without a birth certificate, a child cannot be enrolled in school, cannot apply for a national identity, the list is endless.
A friend recently recounted how six months after giving birth she still has not got a birth certificate for her daughter. She owes Mpilo Central Hospital one million five hundred thousand dollars, enough for just one loaf of bread.  My friend admits it’s a small amount and is fully aware of the implications, but she points out, "there is always something that I need to buy urgently for the baby, so I keep putting it off."
For the few that can afford antenatal care, the quality of care is poor, as nurses and doctors are few and overworked with limited resources. Towards the end of 2007, Gweru City Council was forced to close one of its maternity clinics citing lack of resources to pay staff.  The clinic reopened after a well-wisher living abroad offered to pay the nurses’ salaries for two years.
Giving birth is a nightmare. Even while the woman is having labour pains, getting to hospital is a problem because ambulances are often off the road due to fuel shortages.  Inside of concentrating on getting to hospital, women in labour also have to think of where to get clean water for them to be assisted.  Widespread water shortages mean that health institutions often do not have running water and therefore, insist that patients including women in labour bring their own buckets of water.
Another challenge that Zimbabwean expectant mothers are facing is purely economic – how to clothe and feed their newborn babies? Queues are a common sight in Zimbabwe these days.  We queue for cash, water, milk, bread and meat, almost everything.  Like most items, diapers are in short supply and few shops still stock nappies.
It’s still a surprise though, to see expectant mothers, hands on their backs or protruding tummies queuing outside a shop for nappies. In Bulawayo, one shop which intermittently stocks nappies insists on selling to “visibly pregnant mothers only." So individuals wanting to help cash-strapped expecting relatives and friends buy nappies cannot do so. Desperate mothers are tearing up old T-shirts and accepting old nappies from relatives and friends to raise their children.
Clearly, Zimbabwe’s health delivery system is failing to take care of pregnant mothers. Women are dying due to pregnancy-related complications because they lack access to antenatal, delivery and post-natal care.  Southern Africa AIDS Information Dissemination Service (SAfAIDS) official, Alice Mutema notes that women continue to die because "maternal health is not being given the attention it deserves."
For women in Zimbabwe, there is not much joy left in becoming pregnant. Though Zimbabweans struggle to cope with the shortages with a brave face, when you have a new life inside you, or are struggling through a difficult labour, or trying to care for a precious newborn, it is all the more difficult.
Miriam Madziwa is a freelance journalist based in Zimbabwe. This article is part of the Gender Links Opinion and Commentary Service that provides fresh views on everyday news.


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