Barely two hours after Lillian Mwikali delivered healthy twin daughters through Caesarean section at Kambu Sub-county Hospital in Makueni County, medics noticed something unusual with the patient.
Nurses quickly wheeled her back into the operating theatre. Here, it was a frantic race against time to save the patient’s life as she had started bleeding heavily while slipping into unconsciousness. Despite their efforts, luck was not on their side; the new mother’s life ebbed away right in front of their eyes.
Later, doctors confirmed that she succumbed to complications related to postpartum haemorrhage (PPH), which is excessive bleeding after childbirth, a leading contributor to maternal deaths, according to the World Health Organisation (WHO).
For her husband, Antony Ndolo, the memories of that day in December last year are painfully fresh. The young couple was expecting twins, and Ndolo was anxious, hoping to hold their double bundle of joy.
“The following day, during morning hours, I called her, and she told me that she had safely delivered twins. Around noon, I called her again, but her phone went unanswered,” he says, fighting back tears. The interlude of silence got the husband worried, only for him to later receive the devastating news of his wife’s death.
“I was shattered. We had prayed for twins, and here they were, yet my wife was nowhere to be found to celebrate the moment,” Ndolo says.
A casual labourer, he says, bringing up the infants without their mother is a real struggle. He relies on his mother, who lends a hand in bathing and feeding them at their Kiembeni village home.
This pain of losing a mother’s life soon after giving birth is also shared by Olivia Mbaika, from Utithi village in Machinery, Makueni County. Her younger sister, Caren Bahati, died at Makindu Sub-county Hospital, hours after delivering her first child through a Caesarean section.
Bahati, 20, developed complications after the delivery of her son. Although hers was not bleeding, she lost her life in what a postmortem report later revealed as perforated lungs filled with fluid.
Now at five months, Bahati’s child only knows her aunt, Mbaika, as his mother, given that she took the role of breastfeeding him alongside her daughter, who was then two months old.
“I breastfeed him, and he has got used to it. I could not watch my sister’s child suffer,” Mbaika told The Standard. Her sister’s death, coupled with the fact that their parents are deceased, has led to mental health challenges for Mbaika.
“Sometimes I don’t produce enough milk for both children because I am depressed, but what can I do?” she says.
The first time, the mother says she operated a small kiosk in Nairobi but had to close shop and stay at home to take care of the two babies. Their immediate needs, such as diapers and infant formula, are a challenge, she says.
“I am unemployed. It is not easy,” she reveals.
Figures from Makueni’s health department show that 12 mothers lost their lives in the county's public facilities to postpartum haemorrhage in 2022, but that number dropped to zero in 2023 and 2024. However, in 2025, three mothers lost their lives.
To avert maternal deaths, particularly deaths caused by postpartum haemorrhage, Makueni County has partnered with development partners and deployed a range of interventions aimed at saving mothers’ lives.
Key among these interventions is the introduction of a saviour drug called heat-stable Carbetocin, locally known as kausha, an injectable medicine with high efficiency in stopping severe bleeding after childbirth.
Once the drug is administered to a mother immediately after childbirth, it helps the uterus contract firmly, thus preventing postpartum bleeding that might lead to shock and the death of the mother.
Compared to Oxytocin, a globally recognised drug that has long been used to prevent PPH, heat-stable Carbetocin has a longer-lasting action effect (up to five hours) and requires only a single administration, unlike oxytocin, which requires continuous administration.
Governor Mutula Kilonzo Jnr says that his administration was alarmed by the rising number of mothers dying in hospitals after giving birth, prompting the county government to roll out a comprehensive package of quality-assured interventions to prevent and treat postpartum haemorrhage.
“With partners, we introduced lifesaving innovations, including heat-stable Carbetocin, tranexamic acid and calibrated drapes that enable early detection and rapid response. We replaced guesswork with precision,” says the Governor.
Kilonzo Jnr says that to get it right, every maternal death and near-death experience was reviewed with precision, then the county rolled out resources to scale up the life-saving interventions from 36 facilities to all 242 public health centres.
The county also procured 11,000 calibrated drapes to accurately measure blood loss during delivery, replacing unreliable visual estimations.
“The results are visible: Fewer referrals, fewer blood transfusions and faster clinical response,” he says. He notes that his administration has reduced the cost of heat-stable Carbetocin from Sh2,700 per dose to just Sh95, making it affordable even to mothers in rural health facilities.
The Governor called for stronger domestic investment to save mothers and newborns in the wake of depressed donor funding.
The World Health Organisation says that most maternal deaths are preventable and are linked to severe bleeding, high blood pressure in pregnancy, unsafe abortions, obstructed labour and delays in accessing emergency care.
A 2024 USAID report on Preventing Child and Maternal Deaths indicates that Kenya’s maternal mortality rate stands at 594 deaths per 100,000 live births, far from the Sustainable Development Goals (SDG) target of 70 deaths per 100,000 live births by 2030.
