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Home Births, A Risky Business

By Leocadia Bongben 

Justine Fege is 30, already has four children, and would have had more had she not lost two of them years ago. 

Justine delivered her last two children in her one-room plank house in the Tsinga Village neighborhood in Yaoundé 1, of the Center Region of Cameroon. All four of her children are home births in the capital city, Yaounde. She has never been to a hospital either for antenatal care or to give birth.

“I have a firm believe that my mother cooked the umbilical cord of the donkey and gave me, the reason I give birth alone to my children easily at home”, Fege says.  A Toupouri tribe in Far North Cameroon believes the Donkey is a stoic and courageous animal that gives birth easily, so they cook the umbilical cord so they can have the qualities they see in the Donkey. This theory has given Fege this false courage to have her kids at home. 

“When I start having labour pains, I arrange all I need, a razor blade and the baby’s clothes among other things besides me. I know once I start feeling the labour pains, it takes me a short time to deliver, ”Fege explains. 

Ignorant of the risk, Fege had heavy bleeding following the birth of her last child.

“When I gave birth to my last baby, I was bleeding profusely, I told my husband that this was not normal because, with my other babies, the bleeding was not heavy. He got a doctor who gave me an injection and drugs for the bleeding to reduce.”

But that was not the only problem.

“My eyes were turning and I fell when I was going to have my bath, was given hot water that revived me”, Fege narrates her ordeal after her last baby. Yet the mother of four has no intention of going to a health facility even if it were for free delivery now that she has developed the habit of giving birth alone to her children at home. 

Superstition-inspired home birth

According to the Cameroon 2018 DHS, one-third of births occur at home. And only 50 percent of births in rural areas take place in a health facility. Like many women who give birth at home, Fege is ignorant of the risks associated with home births or simply thinks some women are unlucky if they develop complications or die. 

Prof. Felix Essiben, Gynaecologist, Centre Region President of the Association of Gynaecologists and Obstetricians of Cameroon states that about 17 percent of women have septic deliveries.

He adds that women who give birth at home do so without any medical supervision and are said to have an unsafe delivery (septic delivery) which exposes them and their babies to many complications. “There is a risk of bleeding due to tears in the genital tract or uterine atony, pelvic infections can compromise subsequent pregnancies. Besides, they risk uterine rupture in the case of a large baby or a pelvis small for the weight of their baby and death if surgery is not performed quickly.”, Essiben states. 

Women risk obstetric fistulas (urine and feces oozing out of the vagina continuously) which can impact their future sexual and social life and for the rest of their lives.

Family planning 

Family planning seems to be a solution for women who do not have money for assisted births as they can plan not to have kids. “Childbirth takes 9 months to prepare. If you don’t have the money you don’t get pregnant. You use a method of contraception,” Prof Essiben advised. 

Fege has been thinking about family planning and knows the value of spacing or not having any more kids at the moment. She is making plans to go for a contraceptive method and desires to stop having any other children. “If I were to have my desire, these children are enough, but the decision is not mine to take as my husband will have a say’, Fege says.

Universal Health Coverage 

In the northern regions of the country, there is a health voucher, and even then childbirth is not free, it is paid for, at a lower cost. The health voucher is a system where a woman pays a sum of FCFA 6000 and is followed up in the hospital for up to 40 days postnatal. This has been a solution in the Northern part of the country, but the rest of the country relies on what Essiben calls, “social solidarity: families, friends. Some hospitals have a social service that works as well as it can.” 

Universal Health Coverage is another solution that may help women have assisted births. “Universal health coverage has just been launched and will cover childbirth,” Essiben states. However, it may take longer for women to actually start benefiting from the scheme.

This article was produced with the support of Sisterspeak237 and the Canadien Fund for Local Initiatives.