Sierra Leone is the most dangerous country to give birth in. In 2010, the statistics for their maternal mortality rate was 847 in 100,000. (Rau, 2015) Culturally, it is more common for women to opt for a homebirth instead of giving birth in a medical facility.  (Rau, 2015) Also, most births occur in rural areas with little access to proper healthcare. At home births, the aide is not usually a medical professional.

Another source says women often do not have a choice to receive medical attention during labor if they want it. Traditionally, the husband must give permission before his wife can go and do anything, some of the denial may be for financial reasons. (Some Traditional Practices May Affect Maternal Health in Sierra Leone, 2009)

A majority of births in Sierra Leone, although it is changing a little, are attending by a midwife, also called traditional birth attendants or “Grannies.” (Milton, 2018) Though there has been an increase in medical facility births, it is very small compared to the rest of the world. Sierra Leone is very behind in all areas, but especially birth. Most women do not even have a choice to have a medical facility birth. Tradition and culture say that they should stay home and be assisted by a “Grannie.” Traditional birth attendants are trained, but not enough to be able to intervene in case of emergency. It is common that the entire family be outside the door waiting for the new arrival. (Milton, 2018) The husband usually anxiously waits directly outside the door with the expecting mother’s parents and any siblings the couple has.

If a “Grannie” is not available, women have been known to deliver their own babies in their homes. (Milton, 2018) Many healthcare workers find this to be idiotic and infuriating, reasonably so. (Jordon, 1992)  Innovation tries to get rid of “Grannies” all together, instead of respecting culture and trying to incorporate midwives into safer practices. They, often, refuse to see the benefit in anything other than medical professional supervised works.

In other parts of the world, midwifery births are growing in popularity. Theses midwives are usually nurses with experience and master’s degrees in midwifery. It can be extremely beneficial to have different environment options for women as they prepare to give birth. However, the options need to be known to expecting mothers, but they often are set on a narrow course with little wiggle room.

This is exactly what is happening in Sierra Leone. Many women think traditional birth attendants or independent labors are their only option. The rising medical options are trying to do the exact opposite and tell women they can only give birth in hospitals. Realistically, it may be smarter to try and improve training and education for “Grannies” so that tradition and culture can still be valued. With more education and training, homebirths could be safer and more sanitary. Another option would to bring “Grannies” into the hospital in case of medical emergency. That way, a doctor can be present for emergencies. Each side likes to make the choice black or white, but there are actually many other compromises to think about.

Bibliography

Jordon, B. (1992). Authoritative-Knowledge. Institute for Research on Learning.

Milton, B. (2018, January 24). Sierra Leone News: Traditional Birth Attedants… The unsung heroes. Awoko.

Rau, A. (2015). Maternal Mortality in Sierra Leone. The Borgen Project.

Some Traditional Practices May Affect Maternal Health in Sierra Leone. (2009, December 15). VOA News.