10:21pm Wednesday 18 October 2017

Researcher, midwife, mother

Researcher, midwife, mother

Three women, a researcher, a midwife and a mother share their story on motherhood.

A social death

Bouchra Assarag, Researcher ITM ENSP

Physician Bouchra Assarag from Morocco obtained her degree in medicine in 2002 followed by a Master in Public Health (MPH) in 2008. Later that year she took up an assignment in a health centre in a remote mountainous region. There she was confronted with the problems faced by expectant mothers who have little or no follow-up after their pregnancy, and no chance of a Caesarean section. They were often affected by social stigmatisation following long-term health problems.

Following this experience Bouchra was convinced that more research was needed on maternal and child health. She decided to undertake a PhD in maternal morbidity at ITM. If complications during or after pregnancy are not properly monitored, severe (permanent) damage can ensue. “For many women, these conditions mean a social death,” says Bouchra. “The women are at risk of being rejected by their husbands and families-in-law. In addition, the unequal relationship between men and women complicates matters and does not allow for an open dialogue concerning sexual health.”

Bouchra stresses that doctors, midwives and nurses need better training in the human aspect of deliveries. Clear and open communication is essential.

Thanks to Bouchra’s doctoral research, a thorough investigation on the social consequences of maternal complications is being carried out in Morocco for the very first time.

The missing link

Marie Chesnay, student MPH-Disease Control 2014-2015 at ITM

Midwife Marie Chesnay was exposed to the harsh realities of maternal health when posted in Chad. Women too young to be mothers often suffered irreparable damage from childbirth, whilst others living in very remote areas sought medical help too late, with fatal consequences.

However, it was also in Chad that Marie experienced her most powerful experience as a midwife, one day when a troubled young woman was rushed in by her family. The heavily pregnant adolescent was in labour with a dilated cervix, but would not cooperate with the midwife and nurses owing to a psychological condition that afflicted her.

The medical team was forcefully restraining her, afraid that her erratic behaviour was being caused by evil spirits that had possessed her. The situation threatened to end badly because of the lack of communication between staff and patient, when Marie took charge and removed the suffering young woman from the controlling grip of those present.

The family was made to wait outside, whilst Marie created an environment in which the young woman felt safe. Refusing to remain on the delivery table, the patient writhed in pain and chose the ground as her sanctuary. The local nurses watched in disbelief as Marie crouched beside her and safely delivered a healthy baby.

Marie stresses that a midwife is the bridge between the medical and the social, offering non-judgemental support and removing all other stressors so that the woman’s focus can be the carefree birth of her child.

The human touch

Kévine Nkaghere Mbuenbue, student MPH-Health Systems Management and Policy 2014-2015 at ITM

Kévine Nkaghere from Cameroon is a physician, MPH student at ITM, wife and mother of two – the most recent of which was born during her year in Antwerp.

Looking back, her first child was born in a very different context. In Cameroon, families must save up for a birth, as healthcare requires out-of-pocket spending and tipping, if extra services are required. Those who can afford to, opt for an obstetrician to accompany their pregnancy, whilst the less affluent seek the assistance of a midwife. The care received is very hands-on with little distance between the medical professional and patient, which reassures the mother-to-be.

In Belgium, Kévine received excellent pre- and post-natal care, yet felt that she was held at arm’s length. She would have preferred a more human approach amidst the well-planned schedule of appointments and hi-tech equipment. Kévine gave birth to her healthy second child in a Belgian birthing suite, accompanied by her mother and 3-year-old daughter. Had she been in Cameroon, this would have taken place alongside many other women, away from her family.

She stresses that both countries have their pros and cons and has learned a lot from both experiences.

Colloquium on Maternal and Neonatal Health Beyond 2015

24 -27 November 2015, Rabat, Morocco

TheColloquium Maternal and neonatal health beyond 2015 will make recommendations on how maternal health can be improved in an integrated post-2015 development framework. It will explore how we can work towards a vision of a healthy life for all, beyond reductions in mortality, in line with the UN Global Strategy for Women’s, Children’s and Adolescents’ Health.

The conference will focus on three areas:

  • Respectful childbirth
  • Maternal morbidity and its consequences on newborn’s and women’s health
  • Maternal mortality surveillance

Instituut voor Tropische Geneeskunde


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