Pregnancy in Nairobi slums is matter of life and death for many

It was a chilly Tuesday, and just like the weather Eunice Atieno felt a chill run down her spine. She had just left Medihep Hospital in Mukuru slums for a checkup following a miscarriage. Bearing a loss, especially the loss of a child, is not easy.

The Friday before this particular hospital visit, Eunice had felt a sharp searing pain in her lower abdomen. She also noticed some liquid leaking out through her birth canal. She was about six months pregnant. She also started experiencing labour pains. Eunice was confused because she thought she was only about three or four months pregnant.

Labour persisted. Come Sunday, the pain had increased. So, she did what she would do in such situations: go to a traditional birth attendant. But the woman with the ancient birthing skills did not offer her much help. The next day, on a Monday, as she lay in her house, a sharp pain descended to her pelvis and she pushed.

“Water poured out and the baby came out with it. The baby was fully formed but dead,” she says.

She cleared the foetus up, hoping that the pain would subsequently subside and the placenta would follow.

The traditional birth attendant unsuccessfully tried to squeeze the placenta from Eunice’s womb. The experience only left her screaming in pain.

“I can’t afford to pay for services at a hospital. The traditional birth attendant only asked for Sh50 from me. We are not rich,” she says.

Not first option

Except for one, all of Eunice’s children were delivered by a traditional birth attendant.

But now she was at the hospital. It turned out, to her chagrin, that the traditional birth attendant could not remove the retained placenta.

“Eunice’s husband brought her to the hospital today in the morning,” Geofrey Momanyi, Medihep’s chief administrator said.

“When things take a turn for the worse that is when many come to hospital.”

As we left Mukuru, Eunice was still in pain, even though the placenta had successfully been evacuated from her womb at the hospital.

“Ideally, Eunice should have arrived here on Friday – when she noticed leakage. I can’t fully fathom why she didn’t come then,” Geofrey says.

We put the question across to Eunice, who appeared dazed and with nothing to answer back.

Last May, in Nairobi’s Pipeline estate, Faith Munywoki needed immediate medical attention when she started bleeding at 3am.

“I was three months pregnant or thereabouts,” she says.

“There are hardly any facilities that could handle my case.”

Faith called her mother-in-law (her husband was away in Kitale) who had to look for transport  to ferry her daughter-in-law to a private health facility along Lang’ata Road.

“I certainly don’t have the money to go to top-tier facilities such as Aga Khan Hospital. This facility was affordable compared to the good hospitals,” she says.

In other words, money was a factor in her choice of facility, regardless of travel distance

Faith lost her baby. She says, despite being booked in as an inpatient, she was not attended to for the first two days, “only being given painkiller tablets,” she narrated.

Health survey

Meanwhile, the bleeding continued, and a week later, her pregnancy was declared no longer viable.

“My family paid Sh14,000 for hospital bill yet my baby didn’t survive,” Faith, who was planning to give birth to a second born this year, says.

The Kenya Demographic and Health Survey 2014 report aptly captures the women’s suffering. In the survey, women aged 15-49 were asked about the problems they face in seeking medical care. The most cited problem, by 37 per cent of the women, is getting money to seek treatment, followed by distance to health facilities, as attested to by 23 per cent.

Angela Nguku, the Executive Director of White Ribbon Alliance, a lobby group that campaigns for the realisation of safe motherhood, says that this election season both Eunice and Faith have a chance to elect leaders who will prioritise maternal health.

“It is sad that just because one is poor, pregnancy becomes a dangerous thing,” Angela says.

“Our leaders ought to at least guarantee safe pregnancy for both the mother and the baby.”

The Alliance is behind the ‘whatever your political colours’ campaign, urging political aspirants to pledge to work towards maternal and newborn health, and to stay accountable.

Neither Eunice nor Faith believes that the current crop of leadership cares about their health.

“I have just lost a baby. I have experienced so much pain – I could have died. Yet we elected leaders to provide services for us poor people,” Eunice says.

Faith is not convinced that things will change for the better even with new leadership.

“However,” she says, “there is no harm in trying new people.”

The hospital Faith visited never performed an evacuation. To date, Faith is yet to undergo evacuation of the womb, which is critical for her health and in preparation for conception.

Eunice and her husband have been left in a dire situation and could not even afford the Sh1,000 Medihep charged them.

[email protected]