This is a testimony of a 28-year-old mother of two, narrated in her own words. The data were collected during an in-depth interview in November 2019 in Fitche town, north of Addis Ababa. The interview was audio-taped using a digital voice recorder. The woman was invited to share her personal experience during facility based childbirth. The interview was transcribed and translated verbatim from the local language, Amharic, to English. Both transcript and translated version of the document were cross-checked with the original interview by an experienced linguist.
This interview was conducted as part of project examining disrespect and abuse of women during facility based childbirth in Ethiopia. While conducting a focus group and discussing the issue of abandonment or denial of care, I noticed some of the participants gave one another a surprise glance. On further enquiry, they told me that their neighbor is a woman with a traumatic experience of care. In fact, they said “her life was never the same since the incident. We can see the sorrow in her eyes you know.” Following the focus group, I invited the participants to speak to their neighbor and ask if she would like to share her story with me for the project. I was invited to her house the following day. She was recruited in line with the ethical approval.
Abandonment or denial of care
Upon our meeting, Aisha (name changed) welcomed me to her house and started narrating her story in a deep sorrowful voice after taking a deep breath. “I have fresh memory of it. It was afternoon when I arrived at the hospital, they (care providers) kept me in the waiting room without any checkup till the night shift workers came. The night shift checked me only once as I spent the whole night laboring. Early morning, as I felt the urge to push down the baby, the doctor left me with interns, instructing them to attend me. The baby was coming out but the doctor didn’t wait, he abandoned me. I screamed out of helplessness and overwhelming pain, nobody cared. The interns neither helped me nor did they call for help. They denied my very basic right, the care I came for.”
“A couple of hours later, the reckless doctor came back very relaxed after I was exhausted by the prolonged labor. I was worn out and couldn’t push anymore; he noticed a problem and rushed to a procedure. He cut my genitalia (episiotomy) without any explanation while I was in the waiting room. He was not careful when he cut my body without my consent. Then, two men hold my legs and other two my arms and took me to the delivery room. They put me on the delivery couch like a trash. What are they going to lose if they give me a tiny respect and took me on stretcher? They didn’t utter a word all this time, they just did what they think was right and took the baby out. After all who can question them? I gave birth about 24 hours after my admission.”
Aisha went silent for a while “…The baby didn’t cry at birth and I thought I lost him. The doctor dashed to the bed at the corner. He was pumping something to my baby’s mouth and one of the interns was compressing his chest. Seeing my first born like this traumatized me. Still now, thinking of that moment gives me stab on the chest. I laid on that couch naked in humiliating way and bleeding till one of them came remove the placenta and stitch the tear they made down there, as if he was sewing a piece of cloth. The suturing was no more less than a labor, they didn’t gave me any anesthesia. The wound took more than two months to heal. For a couple of weeks sitting was impossible. I turn from one side to the other on bed with so much pain. I was having less amount of meals than I should thinking of the misery during defecation. During that period only Allah knows what I went through. I have to ask my mom traditional wound care practices to prevent infection because they neither advised nor gave me antibiotics on my discharge.”
“They transferred me to the postnatal room and kept my child behind. Though I was drained by the prolonged labor I couldn’t rest because of my child’s circumstance. None of this could have happened to me if that devil doctor was around. He could have shortened my suffering. I knew my baby was in trouble but nobody, nobody said a word to me, let alone reassuring me. They even yelled at me for crying out loud “don’t make our work difficult already, act like a grown woman”. My husband and family who were waiting outside the ward the whole time heard my cry and interfered. Only then, one of the interns told them that the baby was suffocated (asphyxiated) and is on oxygen (being resuscitated).
“After a long resuscitation, my baby cried and they gave it to me. They didn’t tell me how to proceed with nursing or any precaution with the illness that my baby had. They just told me I am ready to go off within 3 hours. I wonder how many lives went wrong in their reckless hands. They are accountable for my darkened life. The baby was not breathing well, let alone sucking breast when I left the hospital and they didn’t care at all, they just wanted me to get out of their sight. The doctor said ‘your child is ok and will start sucking breast any time soon’. He was not sorry that he abandoned me at that critical moment with students who were supposed to work under his supervision and now he rushed me to leave the hospital. I don’t know what I did to him to deserve this, he just watched me when I took home a sick baby. I believe someday Allah will punish him the way he deserves. He made me hate all care providers and the entire health care system.” Aisha couldn’t talk any longer, and started crying. I gave her as much time as she desired to recover.
Taking sick baby home with resentment
After a while Aisha took a breath and continued “I left the hospital three hours after giving birth as per his (the doctor) decision though the baby was still unable to suck breast. We waited till next morning and even tried canned milk but he couldn’t take it. We returned to the hospital after 24 hours when the baby’s breathing difficulty got worse. Another team of care providers received us and told us that the baby was not breathing well and shouldn’t have left the hospital on the first place. They checked and admitted him (to neonatal intensive care unit) for ten days. They were even planning to refer him to Addis Ababa but later changed their mind and kept him. Nobody updated me about my child’s circumstance. Imagine staying in hospital separated from your sick newborn baby that long, thinking they will hand me over his body sooner or later. As a mother that was the worst time of my life.”
“We went home after 10 days, my baby was on spoon feeding still unable to suck breast. They told me that was the maximum they can do. As I was told, I tried to breast fed him, but didn’t succeed. My life changed from that day on, he cries day and night. I have to carry him at all times, I can’t take rest during the day or sleep at night. I have visited referral hospitals in Addis Ababa and got nothing except wasting my time and money. Finally, one specialist told me his brain was irreversibly damaged because of the prolonged labor without intervention/help. He told me the poor prognosis of my child: that he may encounter developmental delay, speech problems, not dressing by himself…soooo many disabilities. He is five years old now and still looks like a newborn, couldn’t sit and feed himself. I have to change his position as he can’t move his head. He take only milk (bottle feeding) and I have to widen the opening of the bottle because he can’t suck. I have tried to diversify his food but he couldn’t take them. As to his friends he was in kindergarten but he never left the bed by himself. They disabled my child and took away his future”
Aisha is still very angry towards her care providers “This problem could not have happened to my baby if that doctor has some humanity in him. I feel bad when I think of hospitals now, I have a negative memory. He considered my cry as a joke and abandoned me. My families believe the baby is disabled because of my abandonment during labor. Nobody anticipated this to happen to my child. Since it was my first pregnancy I was curious and had full antenatal care follow up. I had payed attention to every detail they (care providers) told me. I have never been said my pregnancy has a problem. My relatives and neighbors were all preparing to celebrate Allah’s gift with my family. Now, some people say it was a bad luck but, I will always say he (the doctor) put an end to my child’s life before it even started. What is the fate of my child, till when he is going to stay in bed? She became very emotional and cried but continued to tell her story. “I always live with a grief when I see my child in bed unable to talk and feed himself. He follows me with his eyes in the room and this breaks my heart most. My life turned upside down, I can’t sleep at night or leave home during the day.” Aisha cried again. “I am hopeless creature. What did I sin to get such a punishment?”
She wiped her tears and continued after a long sigh, “…First, it is a job they are paid for and above all it is a matter of life and death for us. If they don’t like the profession they should change it, otherwise it is not decent to play with our lives. Why are they in a white coat if they are not keen to help others? I would have stayed home if I could manage it alone; it broke my heart when they abandoned me.”
Loss of trust on care providers
“When I gave birth to my second child six months ago, I carefully chose the facility where my relative works and she took good care of me. If not for her, I would have given birth at home. I didn’t allowed any staff came near me except her. How can I trust care providers and give birth in their hands after all what they did to me? Look, I am an educated urban woman and understand well the risks of home birth. Likewise, I had bad experience in hospital; the care providers were very mean to me. Their bad attitude deters women from seeking skilled attendants at birth. How can you go there knowing they will degrade you from humanity? They treat you with respect only if they know you. So, it is not wise to visit a random health facility for a childbirth or else, you may regret it. I advise women of my community to visit health facilities where they have a relative or at least a friend.”