Beyond survival — Could Access to Maternal Care Transform a Woman’s Life?

This first appeared on Huffington Post

Childbirth was the moment in my life when I felt the most vulnerable. Physically, emotionally and mentally pushed to my absolute limits. Feeling like everything was at stake, and that despite the support of loved ones and medical professionals, I was alone. It was up to me to stay focused, stay strong, and do what was needed. And what was needed meant pain, blood, and hours of hard work.

It was also the moment of my life that I felt the most powerful. I was joining the ranks of the mothers of the world, about to meet my child for the first time, and I was doing it exactly how I wanted to. I chose the doctor, the hospital, the approach, and who would be by my side. I wasn’t able to decide how long it would take, or what position my baby would be in as he emerged. But I knew that I was the driver of this process, and it gave me strength and a sense of calm. And afterwards, as I recovered and reflected on what had happened, I felt tremendous satisfaction. That was a feeling I know is a great privilege. I was lucky, I know, that everything came together for a safe and simple birth.

Here in the developed world, lack of information or a patient-centric medical system can limit women’s choices around childbirth. Our litigious society often dictates what doctors advise, as they face the risk of lawsuits and tremendous malpractice insurance costs. It’s not uncommon for women to go through birth without feeling a sense of agency. Among my women friends, I’ve seen frustration arise not from what happened during birth — vaginal or c-section, fast or slow, painkillers or no painkillers — but rather from those experiences where they feel that they were treated dismissively or excluded from key decisions. My friends who have positive birth experiences are those that had their wishes respected, whether that wish was for minimal medical intervention or for an epidural, stat!

Of course, all of this is typically overshadowed by the joy of having a new child, and knowing that at the end of the day, everyone involved was working towards a common goal of having a healthy baby delivered.

In the developing world, the option for poor women to have medical assistance of any kind is often absent and this leads to the death of 800 women each day from pregnancy and childbirth. In India, two thirds of women give birth at home, not because it’s their choice, but because hospital births are not available, or because the public hospitals that are available have such abhorrent conditions that they don’t really feel like an option.

So instead of feeling powerful, women feel powerless. About 78,000 women die in childbirth every year in India alone, which is an unacceptable tragedy. Millions more women survive birth, but I think of what it means for so many of these women to go through this experience with no choices around how they gave birth, and often, no support. Many face long term health issues as a result of inadequate maternal care. And beyond the physical aftermath, how might their experience of birth be impacting their lives in more subtle ways?

I believe, as do my colleagues at Acumen Fund, that choice and dignity are inextricably linked. But this became real to me when I gave birth. How can you feel dignified when you are physically reduced to a sweating, trembling aching mess? How can you feel empowered when you are vulnerable to infection, blood loss, and I hate to say it, incontinence? Becoming a mother can be a rite of passage, a moment where you discover something about yourself and about your new capacity to love and care for another human being that you didn’t know. The sense of responsibility that comes with motherhood can be frightening, but can also bestow a deep sense of purpose. Choice in birth often boils down to women being able to do the right thing for their child, even in the hours and moments before the child is born. During my two births, I learned that you can feel dignity even in this moment of uncertainty and vulnerability when you know that you have some control.

It’s why I can’t stop talking about LifeSpring hospitals, a company Acumen Fund invested in in 2007. Because LifeSpring believes that no matter what your income level or what neighborhood you are from, that as a woman, you must have the option to give birth in a safe environment. Not only one where medical attention is provided, but where each hospital is designed to create a sense of comfort and security, with pink walls and smiling personnel. With loved ones who can visit and stay with the mother during her recovery.

LifeSpring is a chain of maternity hospitals in Andhra Pradesh that provides affordable high quality maternal care to low-income women, and they have seen over 200,000 women patients and delivered over 11,000 babies since Acumen Fund invested in them.

I think of the women they’ve served, and wonder if they had a similar sense of being powerful from experiencing childbirth with a sense of control, and a sense of choice.

Who knows how that experience could alter the course of a women’s life? But I can imagine that for a woman, perhaps in her early 20s or late teens, giving birth in a place that lets her know that she matters, that her body and her life and her feelings matter, could make all the difference. It certainly changed my life. Could an empowering or at least secure experience of childbirth transform the lives of women experiencing it for the first time? A woman has a right to survive childbirth, but so should she have the opportunity to go through this experience, with all its vulnerability, and emerge confident, aware of all the power she has to make choices that will lead to a healthy and prosperous future, both for herself and for her new child.

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