Childbirth and Maternal Mortality in Morocco: The Role of Midwives

Amina, a 20 year-old woman, living in a small rural village of Morocco, is expecting her first baby. Her labour started when she was at term while her husband was far away; her mother-in-law was assisting her. After almost 24 hours of difficult labour, seeing the distress that Amina was going through, the mother-in-law called for her second son in order to help for a transfer to the nearest village birthing center. After a few hours, Amina’s brother-in-law was able to bring her to that center using a neighbour’s tractor, as the sun was setting; the only midwife on duty had already left. Two hours later, after much search, the midwife arrived and diagnosed an obstructed labour. She requested that Amina be transported to the hospital, which was far away; darkness and lack of gas in the truck made them wait for the next day’s once daily public transportation. Amina suffered a haemorrhage. When they got to the hospital, the gynaecologist was not available; the members of the staff were impatient, increasing the level of anxiety and pain that Amina was experiencing. By the time the gynaecologist arrived, Amina’s uterus had ruptured. Amina and her baby girl died. Amina’s story is not unique and happens unfortunately way too often in developing countries. At the beginning of the third millennium, every minute, a woman dies because of a complication related to childbirth (Cook et al. 2005).