Home Deliveries among Maasai mothers

Statistics from the Ministry of Health show that maternal mortality rate in the country is one of the highest in the world standing at 488 deaths per 100, 000 live births every year.

The deaths which could have been avoided have been attributed to inaccessibility to healthcare in many rural areas and sheer refusal by many mothers in some communities insisting on giving birth at home without the care of a professional birth attendant.

This prompted the Jubilee administration under President Kenyatta to come up with free maternity services in all public health facilities.

The Maasai community on its part is popular in the world due to its ability to have preserved most of its culture for a long time.

Despite the Western civilization having swept away some traditional cultures among other communities, the Maasai who occupy Narok, Kajiado and part of Laikipia County and parts of Tanzania still hold onto their unique traditional culture which they are proud of.

However, some aspects of the cultural practices that the community still holds dear, seems to have become a stumbling block to the progress of the community and to a larger extent endanger human life.

Among such cultures is home delivery, where mothers avoid maternity facilities and prefer to deliver at home with the help of traditional midwives.

This practice puts the life of pregnant women at risk since there is no proper and professional medical care givers and the mid wives are untrained on how to deal with certain complications which arise during delivery.

This tradition has sparked outcry from all stakeholders in the health sector in an attempt to rescue the Maasai community from the deaths that occur as a result of home deliveries.

According to 2013 data from the ministry of health on Narok County, the county records 191 maternal deaths in every 100 000 births.

However, data from the Christian Aid places it at 435. All this is attributed to the cultural practice that prefers home births over hospital deliveries and modern science and medicine.

Ngoto Rusi, who has been helping women deliver in Trans Mara area for more than 30 years says she has to do the job of helping the women due to lack of health facilities around the area and those that are there are far flung.

Health facilities are far and some time the private hospital charges a lot of money for the delivery, Rusi says. But it is worth noting that deliveries in public hospitals are currently free.

I learned midwifery from my mum. I can tell from looking at someone and tell whether one is going to have a boy or a girl. I am sharing what I have and some of my daughters who got married several years ago also do midwifery which they have learnt from me.

There are times I get more than three pregnant women a day coming to me in need of my help while I am doing my chores and I have to stop what am doing and attend to them because what I am doing is a calling to the society, she adds.

She however says, of late because of her, whenever she was called to deliver a baby she only advises the woman to visit the nearest clinic for delivery.

Despite the presence of several health facilities in Narok currently, few women from the Maasai community attend antenatal clinics and deliver in the health facilities.

Some have to get permission from their husbands to attend clinic. If the man is not satisfied as to why the woman should attend, they turn down the requests, said a source at Narok Referral Hospital who declined to be named.

The source added that, despite the communal rigidity, women are still being encouraged through sensitization campaigns to attend clinics for antenatal care and this has started bearing fruits.

But Narok County Director of Health Dr. Francis Kiio says to counter this, they have been holding several sensitization campaigns in the area in an attempt to make the women realize the benefits of antenatal care and delivering in hospitals.

He says they have been involving men in these campaigns and they are now bearing fruits as you will see women and their spouses line up at the ante and post -natal clinics and even at maternity wards to give their women moral support.

This has resulted in the number of women deliveries in hospitals increasing slightly as many abandon the rigid Maasai culture.

The health personnel in the county are also working with various stakeholders to give the mothers who give birth in health facilities incentives to encourage them and motivate others to do so.

Traditional birth attendants too, are given basic skills in delivery and encouraged to refer their patients to the nearest health facility.

Dr. Kiio is advising all mothers in the county to deliver their newborn babies in recognized health facilities under the care of a professional birth attendant.

I call upon all mothers to consider delivering in hospitals and avoid the traditional methods of delivery that endanger the lives of both the mother and the unborn baby, said Dr. Kiio.

The medic says many women lose their lives during child birth or lose their babies due to lack of professional care when they deliver at home.

The director of health notes with concern that maternal mortality rate in the county currently stood at 435 for every100, 000 live births which is one of the highest in the country and added that this can only be avoided if mothers shun home deliveries where Traditional Birth Attendants (TBAs) are not health experts and hence cannot attend to nay complication or emergency that can arise.

Dr. Kiio reveals that only 40 per cent of mothers in the county deliver in a health facility and this exposes the remaining 60 per cent who deliver at home to infections and various dangers which often result in complications, disabilities and even death.

He attributed this high number to ignorance, illiteracy and culture.

Dr. Kiio also notes there was need to involve all stakeholders in information dissemination for all campaign on health to have positive impact on the society.

Despite the sensitization the government having made maternity services free in all public health facilities, campaigns and equipping the hospitals with equipment for antenatal care, the community still has reasons as to why a woman should deliver at home as opposed to hospital.

According to Mrs. Naisula Lepore, the Maasai people believe that delivering at home under the care of the traditional midwives is a practice that the community has held on to from the past and she is aware of the benefits, by the fact that she has delivered all her seven children under the care of the traditional midwives

The community fully trusts the midwives with delivery since we consider them experienced and having the right skills to deal with all kinds of birth complications, says Naisula.

Despite a government initiative to give incentives to the traditional midwives to take expectant mothers to hospitals for normal deliveries, all has proved futile with the community fully opposing the initiative and husbands making sure they take guard during the process of delivery to ensure their wives are not taken to hospital for delivery.

According to a traditional midwife who spoke to the media on grounds of anonymity, the culture of home births is deep rooted in the county and they are forced to turn down tokens offered to them by the government lest they risk losing their jobs.

No one will call you to perform the delivery process on their wives once they discover that you receive tokens from government agencies to take their wives to hospitals for delivery, she said, adding that some midwives have even ended up being beaten up once they are discovered to be doing so.

According to the Maasai culture, a woman who delivers at home under the care of the midwife is pure, the blood is clean and the child is blessed.

The community considers it pure when the traditional midwife is in touch with the blood of the woman than with the modern midwives whom they consider impure.

They also believe that any woman who dares to go for maternity at the hospital is cursed in the community since it’s believed she is not circumcised and has rejected the Maasai community. And is disowned by the whole community because of delivering in public in Hospital in the presence of strangers (read medical personnel) which the community does not approve.

Any girl who is found pregnant before circumcision and marriage is disowned by her people. She will be referred to as Entaapai, which is an abusive word in their culture.

The community will also disown her or come up with a way of cleansing the young girl so that she will be reaccepted by the community and local midwife at her next time of delivery.

The Entaapai will be looked down upon for her act of bringing shame to her clan and the Maasai community at large. Moreso, the child of Entaapai will be considered impure since her mother has already committed a communal felony.

Such a child will be referred to as Olturpa for a boy and Enturpa for a girl. The child is never accepted as a member of that community and hence discrimination.

Such a rejected member of the community will have no role to play in the community.

The whole process of delivery, despite its acceptance to the community, is a health risk since a single midwife deliver more than 10 women in a single day using the same surgical equipment without sterilizing them which contributes to the spread of infections.

The fact that they are not sterilized poses the danger of spread of infections and other diseases that are spread through sharing of surgical equipment and mixture of body fluids such as HIV/AIDS.

To date, Maasai community still adores this culture as the rest of the world embraces modern developments in the health sectors which has helped save lives and lengthen lifespan of humans.

Technological advancement has brought proper and advanced methods of delivery and failure by this community to accept these changes because of rigidity has led loss of deaths which could otherwise been avoided.

Dr. Kiio says more sensitization needs to be done to enlighten the community on the dangers of home deliveries.

Source: Kenya News Agency

Home Deliveries among Maasai mothers

Statistics from the Ministry of Health show that maternal mortality rate in the country is one of the highest in the world standing at 488 deaths per 100, 000 live births every year.

The deaths which could have been avoided have been attributed to inaccessibility to healthcare in many rural areas and sheer refusal by many mothers in some communities insisting on giving birth at home without the care of a professional birth attendant.

This prompted the Jubilee administration under President Kenyatta to come up with free maternity services in all public health facilities.

The Maasai community on its part is popular in the world due to its ability to have preserved most of its culture for a long time.

Despite the Western civilization having swept away some traditional cultures among other communities, the Maasai who occupy Narok, Kajiado and part of Laikipia County and parts of Tanzania still hold onto their unique traditional culture which they are proud of.

However, some aspects of the cultural practices that the community still holds dear, seems to have become a stumbling block to the progress of the community and to a larger extent endanger human life.

Among such cultures is home delivery, where mothers avoid maternity facilities and prefer to deliver at home with the help of traditional midwives.

This practice puts the life of pregnant women at risk since there is no proper and professional medical care givers and the mid wives are untrained on how to deal with certain complications which arise during delivery.

This tradition has sparked outcry from all stakeholders in the health sector in an attempt to rescue the Maasai community from the deaths that occur as a result of home deliveries.

According to 2013 data from the ministry of health on Narok County, the county records 191 maternal deaths in every 100 000 births.

However, data from the Christian Aid places it at 435. All this is attributed to the cultural practice that prefers home births over hospital deliveries and modern science and medicine.

Ngoto Rusi, who has been helping women deliver in Trans Mara area for more than 30 years says she has to do the job of helping the women due to lack of health facilities around the area and those that are there are far flung.

Health facilities are far and some time the private hospital charges a lot of money for the delivery, Rusi says. But it is worth noting that deliveries in public hospitals are currently free.

I learned midwifery from my mum. I can tell from looking at someone and tell whether one is going to have a boy or a girl. I am sharing what I have and some of my daughters who got married several years ago also do midwifery which they have learnt from me.

There are times I get more than three pregnant women a day coming to me in need of my help while I am doing my chores and I have to stop what am doing and attend to them because what I am doing is a calling to the society, she adds.

She however says, of late because of her, whenever she was called to deliver a baby she only advises the woman to visit the nearest clinic for delivery.

Despite the presence of several health facilities in Narok currently, few women from the Maasai community attend antenatal clinics and deliver in the health facilities.

Some have to get permission from their husbands to attend clinic. If the man is not satisfied as to why the woman should attend, they turn down the requests, said a source at Narok Referral Hospital who declined to be named.

The source added that, despite the communal rigidity, women are still being encouraged through sensitization campaigns to attend clinics for antenatal care and this has started bearing fruits.

But Narok County Director of Health Dr. Francis Kiio says to counter this, they have been holding several sensitization campaigns in the area in an attempt to make the women realize the benefits of antenatal care and delivering in hospitals.

He says they have been involving men in these campaigns and they are now bearing fruits as you will see women and their spouses line up at the ante and post -natal clinics and even at maternity wards to give their women moral support.

This has resulted in the number of women deliveries in hospitals increasing slightly as many abandon the rigid Maasai culture.

The health personnel in the county are also working with various stakeholders to give the mothers who give birth in health facilities incentives to encourage them and motivate others to do so.

Traditional birth attendants too, are given basic skills in delivery and encouraged to refer their patients to the nearest health facility.

Dr. Kiio is advising all mothers in the county to deliver their newborn babies in recognized health facilities under the care of a professional birth attendant.

I call upon all mothers to consider delivering in hospitals and avoid the traditional methods of delivery that endanger the lives of both the mother and the unborn baby, said Dr. Kiio.

The medic says many women lose their lives during child birth or lose their babies due to lack of professional care when they deliver at home.

The director of health notes with concern that maternal mortality rate in the county currently stood at 435 for every100, 000 live births which is one of the highest in the country and added that this can only be avoided if mothers shun home deliveries where Traditional Birth Attendants (TBAs) are not health experts and hence cannot attend to nay complication or emergency that can arise.

Dr. Kiio reveals that only 40 per cent of mothers in the county deliver in a health facility and this exposes the remaining 60 per cent who deliver at home to infections and various dangers which often result in complications, disabilities and even death.

He attributed this high number to ignorance, illiteracy and culture.

Dr. Kiio also notes there was need to involve all stakeholders in information dissemination for all campaign on health to have positive impact on the society.

Despite the sensitization the government having made maternity services free in all public health facilities, campaigns and equipping the hospitals with equipment for antenatal care, the community still has reasons as to why a woman should deliver at home as opposed to hospital.

According to Mrs. Naisula Lepore, the Maasai people believe that delivering at home under the care of the traditional midwives is a practice that the community has held on to from the past and she is aware of the benefits, by the fact that she has delivered all her seven children under the care of the traditional midwives

The community fully trusts the midwives with delivery since we consider them experienced and having the right skills to deal with all kinds of birth complications, says Naisula.

Despite a government initiative to give incentives to the traditional midwives to take expectant mothers to hospitals for normal deliveries, all has proved futile with the community fully opposing the initiative and husbands making sure they take guard during the process of delivery to ensure their wives are not taken to hospital for delivery.

According to a traditional midwife who spoke to the media on grounds of anonymity, the culture of home births is deep rooted in the county and they are forced to turn down tokens offered to them by the government lest they risk losing their jobs.

No one will call you to perform the delivery process on their wives once they discover that you receive tokens from government agencies to take their wives to hospitals for delivery, she said, adding that some midwives have even ended up being beaten up once they are discovered to be doing so.

According to the Maasai culture, a woman who delivers at home under the care of the midwife is pure, the blood is clean and the child is blessed.

The community considers it pure when the traditional midwife is in touch with the blood of the woman than with the modern midwives whom they consider impure.

They also believe that any woman who dares to go for maternity at the hospital is cursed in the community since it’s believed she is not circumcised and has rejected the Maasai community. And is disowned by the whole community because of delivering in public in Hospital in the presence of strangers (read medical personnel) which the community does not approve.

Any girl who is found pregnant before circumcision and marriage is disowned by her people. She will be referred to as Entaapai, which is an abusive word in their culture.

The community will also disown her or come up with a way of cleansing the young girl so that she will be reaccepted by the community and local midwife at her next time of delivery.

The Entaapai will be looked down upon for her act of bringing shame to her clan and the Maasai community at large. Moreso, the child of Entaapai will be considered impure since her mother has already committed a communal felony.

Such a child will be referred to as Olturpa for a boy and Enturpa for a girl. The child is never accepted as a member of that community and hence discrimination.

Such a rejected member of the community will have no role to play in the community.

The whole process of delivery, despite its acceptance to the community, is a health risk since a single midwife deliver more than 10 women in a single day using the same surgical equipment without sterilizing them which contributes to the spread of infections.

The fact that they are not sterilized poses the danger of spread of infections and other diseases that are spread through sharing of surgical equipment and mixture of body fluids such as HIV/AIDS.

To date, Maasai community still adores this culture as the rest of the world embraces modern developments in the health sectors which has helped save lives and lengthen lifespan of humans.

Technological advancement has brought proper and advanced methods of delivery and failure by this community to accept these changes because of rigidity has led loss of deaths which could otherwise been avoided.

Dr. Kiio says more sensitization needs to be done to enlighten the community on the dangers of home deliveries.

Source: Kenya News Agency