Congo's Young Mothers: Pregnancy without Dignity

28/7/2010 - For millions of women giving birth in the Democratic Republic of the Congo, labour will be a tragic affair in which their child will die and they will lose their dignity because of economic contraints to adequate health care provision.

In the Democratic Republic of the Congo (DRC) four women die every hour from complications of pregnancy. One of the most deadly complications for unborn children and that most commonly stripping women of their dignity is the obstetric fistula.

An obstetric fistula occurs when a “hole” develops between the rectum or bladder and the vaginal opening. It generally happens when sufficient medical attention is not accessible so nobody notices and acts on the problem.

Fistulas come about during several days protracted labour when the baby is squeezed too tightly in the birth canal, putting a troublesome amount of pressure on the tissues around the genitals. However, fistulas can also be caused by abortions and female genital mutilation.

Once a fistula has developed, the consequences for women are horrific. It affects all spheres of their well-being: physical, social, emotional and economic. Without treatment—usually in the form of a caesarean section—the women will be left incontinent. Moreover, the baby’s life cannot often be saved. Unable to control her bladder or bowel movements, the woman faces ostracism from her husband, family and community. She will be unable to find work and forced to live as a dependent on the farthest margins of society, dependent upon the goodwill of others for her very survival.

The United Nations Population Fund notes that too many women giving birth in the developing world suffer from obstetric fistulas when delivering—up to 30 women for every maternal death in the Congo. Globally, this complication accounts for roughly 8% of all maternal deaths, according to the World Health organization (WHO).

Poverty and economic constraints continue to restrict progress in the health sector. Of the $60 million that’s needed to bring it up to scratch, the DRC only has the capacity to allocate $6 million to health care. Without the right medical equipment, anaesthesias and trained medical staff to attend births and spot the symptoms of a fistula, it is unlikely any significant improvement will be seen.

The risk of developing an obstetric fistula is increased many times over in child or teen pregnancies. More than of the DRC’s total population of women (35 million) give birth before they’ve reached their nineteenth birthdays. They will give birth, on average, to 6.2 children each.

Not only do young mothers have their own lives jeopardized, but these early, multiple and closely-space pregnancies have a tendency to cause undernourishment among young children. The first five years of life are a struggle. The first year of childhood is especially lethal. Indeed, the DRC's infant mortality rate has actually risen since two years ago, climbing from 2% to more than 81 deaths per 1000 live births.

Many children in South Asia and sub-Saharan Africa do not live past their fifth birthdays either. In 2007, the child mortality rate in the DRC was among the worst in the world with about 205 children per 1000 live births not living past the age of five.