Urban to Rural: Choosing the Road Less Traveled for a Birth
Angela and her daughter.
There is a growing awareness among women around the world about the importance of adequate maternal healthcare and how best to ensure the well-being of themselves and their infants. Given a choice, many women from rural areas in Tanzania opt to travel to urban areas to deliver their children, as rural areas often struggle with limited access to quality healthcare. This scarcity can significantly impact the quality of maternal healthcare in rural areas and puts both the mother and child at risk.
This is the unconventional story of a mother who traveled from Dar es Salaam, the largest city and financial hub of Tanzania, to Karatu in rural Tanzania to deliver her child at FAME, going against the long-held belief that specialized medical personnel and expertise are only available in the cities.
Angela* is 22 years old and lives with her husband in a bustling neighborhood in Dar es Salaam, 530 miles from FAME. She grew up in Karatu before her family moved to Dar es Salaam a few years ago; however, her mother-in-law lives in Karatu and she visits her often. She just gave birth to her first child!
“When I was 12, I was very sick and brought to FAME. I remember receiving good care that even impressed my parents, who were trying to raise money to take me to a hospital in Arusha. That experience remained with me. When my family moved to Dar es Salaam shortly after, I kept in touch with my friends, who always mentioned FAME and how it’s helping them and saving them from traveling long distances to seek quality healthcare. During one of my visits to see my mother-in-law, I was in my early weeks of pregnancy. I visited FAME and talked to them about childbirth at FAME, the support I would receive during and after delivery and how they could deal with emergencies. I was very impressed with what I learned and saw and after this visit, I decided to deliver at FAME. It helped that my mother-in-law was very happy with my decision and welcomed it!”
However, Angela, a hairdresser in Dar es Salaam, needed to seek permission from work to travel. Legally she is entitled to three months of maternity leave, but since she was coming to Karatu, she wanted to be here for six months to ensure the baby was healthy and strong before returning to work.
“My boss was confused when I asked for a long maternity leave. He asked why I would go from Dar es Salaam to give birth in the village. I told him my heart was set on Karatu and I was ready to resign if that was the only way I could go. Seeing that he couldn’t change my mind, he agreed and has been supportive!”
Her biggest challenge? Telling her mother, who also lives in Dar es Salaam, that she would give birth to her first grandchild miles away.
“My mother was very sad. She was looking forward to supporting me through labor with my first child. I think she also didn’t like that my mother-in-law got to experience this with me. However, I made her understand that without the very best maternal health, her support, as much as it was valued, would not help me. In the end, she understood and gave me her blessings.”
Angela also had to let the hospital where she went for prenatal care know she would not be giving birth there.
“I did all my prenatal classes in Dar es Salaam but told the hospital the truth from the beginning, that despite my prenatal classes there, I would deliver my baby in Karatu. I don’t think they believed me! They kept saying nobody leaves a big town to deliver a baby in the village.”
Angela came to FAME for her last prenatal check-up just before delivery. She was happy to have been received well and that FAME did not give her a hard time for not doing all her prenatal visits here. Angela delivered a healthy baby girl and said the service was better than expected.
“The nurses at FAME have been very respectful and kind to me, which was important as I didn’t want anyone to mistreat me when birthing. Some friends have had nurses shouting at and demeaning them during childbirth and I was terrified of this happening to me. So my biggest advantage of birthing at FAME has been the support and understanding I have received from the staff and the doctors.”
“I am very happy to be a mama. It’s a good feeling. I have a name for my daughter that I love, but I haven’t shared or discussed it with my husband yet. I’m waiting for him to meet the baby and then hopefully, he will be too distracted to oppose the name! Until then, I’m keeping it a secret.”
FAME continues to bridge the gap in maternal healthcare services between rural and urban areas, ensuring that all women have equitable access to quality healthcare regardless of where they come from. According to Angela, the presence of skilled healthcare providers at FAME, trained in handling various complications during childbirth, made FAME her preferred choice for delivery. Being a well-equipped medical facility with advanced diagnostic tools, modern operation theaters and a well-equipped special care nursery (SCN) convinced her that FAME had the resources to manage and address potential complications that might arise during childbirth.
*The patient's name has been changed to protect her privacy and permission was secured to share her story. The quotes have been translated from Swahili to English.