A woman arrives at a health center in Kigoma region, western Tanzania, bleeding profusely. She had given birth at home, but the placenta had been retained—a life-threatening complication—and she was frightened.
“She was in critical condition,” said Magdalena Metta, the Thamini Uhai Birth Companionship Coordinator. But Magdalena and the birth companions based at the clinic calmed the woman, comforting her and helping communicate her needs to the health provider. Instead of enduring a frightening experience alone, she had supportive women helping her relax while the providers did their work.She was saved.
For many women in Kigoma, local medical facilities were a daunting place, particularly during labor and delivery. The environment was stressful, health care providers could be intimidating, and women believed they would receive more comforting care at home—even though their lives and their babies’ lives would be at risk in case of an obstetric complication. But a new project has dramatically shifted how care is provided.
In 2017, Thamini Uhai, a nongovernmental organization based in Kigoma, Tanzania and affiliated with Vital Strategies, launched a pilot birth companionship project. Women in communities surrounding nine public health facilities could have a female companion of their choice stay by their side throughout labor and delivery. Previously, women could only have a health provider with them in the labor and delivery rooms, and a severe shortage of providers in rural parts of Tanzania meant women often labored with little human contact.
Magdalena joined the program in 2016. With a master’s in public health and a passion for maternal health, she saw that the birth companionship project was unique. “I had to be a part of it,” she said.
The Thamini Uhai team worked with the community, health providers, health authorities and international experts to design the program. Women are encouraged to choose their own female companion, or one of the 30 “on-call” companions trained by Thamini Uhai and based at the facilities. Now, more than 80 percent of women delivering at the nine facilities have had a companion with them throughout childbirth, and 30 percent of those with companions brought someone from home.
“The women love having a birth companion with them because they are there to help and comfort them,” Magdalena said. “Once you have a good experience you want someone else to have the same. They tell each other, ‘I’ve been to these facilities and you should try it.’”
She hopes the pilot will be taken on across the country. “Once it gets to scale,” she said, “it’s going to spread like fire.”