UNFPA Midwifery Helpline Supports Helps a Midwife Save a Mother’s Life in Remote Village

“It was 7 in the morning and I had not yet started my working day, when Hafsa (not her real name) was brought to the clinic with normal labour pains,” said Mahbooba, 27, an experienced midwife who runs the Aqtash clinic in Sayed Khel District of Parwan Province together with another health worker, a physician.

On that morning Mahmooda attended Hafsa’s delivery and a healthy baby was born later that day, Hafsa’s first child.  Everything was normal until Mahmooda noticed that Hafsa was bleeding heavily and she was starting to show signs of shock. 

One in 14 women in Afghanistan will die of pregnancy or childbearing in their lifetime (AfDHS, 2015). This data shows that maternal mortality is one of the highest in the region.  Furthermore bleeding after child birth, which Hafsa was experiencing is the most common cause of maternal mortality in the world.

At the clinic, Mahmooda, paralyzed by the fear of losing the mother, froze not knowing what to do. She had no one to turn to and did not know how to stop the bleeding.  Suddenly Mahmooda finally remembered the Midwifery Helpline and made a call to get urgent advice.  The Midwifery Helpline is a toll free line established by UNFPA in November 2016 as an innovative project aimed to support midwives in remote areas, who are usually working with little support or working alone.

The demand for qualified midwives in Afghanistan is great and for 100% of this need of midwives to be met; there should be 15,000 working midwives.  However, the country currently has one third of that number. Only recently, in 2015, did the Kabul Medical University, with the support of UNFPA, start to offer bachelor degrees in midwifery. For the first time in Afghanistan 25 midwives obtained this bachelors degree in midwifery. Before obtaining their bachelors, these midwives had diplomas in the profession.

Back in the village the midwife was on the call with Dr. Shayan, a gynecologist and the manager of the Midwifery Helpline.  Mahmooda was asking for help to stop the bleeding and Dr. Shayan soon realized that Hafsa was suffering from uterus atony, a condition which was causes the bleeding.  On the phone Dr. Shayan gave the necessary advice to Mahmooda who managed to stop the bleeding and Hafsa’s life was saved.

“It is a wonderful feeling to know that now with the Midwifery Helpline some preventable labour injuries and maternal and infant deaths can be avoided. Midwives call with desperation and we ensure that they do what is necessary even if that is to tell them that it is time that they refer the patient to a health facility before long”, said Tahira Nazari, one of the midwives staffing the Midwifery Helpline. 

The Midwifery Helpline is staffed by 4 professional health workers; 3 midwives (who work in shifts to run the 24/7 Midwifery Helpline) and an experienced gynecologist and trainer. Dr. Rona Abidi Shayan, 53.

 “Callers to the helpline vary”, Says Dr. Shayan, “Sometimes I receive a call from a midwife who has years of experience, but is in a state of panic. I ask them to calm down first and explain the situation, which would enable me to give them advice. Usually, I follow up with multiple calls or sometimes they call back for more advice. I keep following until I ensure the patients are completely well”.

Established in November 2016, the Midwifery Helpline receives an average of 20 calls in 24 hours. Usually, each call has multiple follow up calls from the caller who are usually a midwife, or a gynecologist faced with a complicated case of delivery or pregnancy and in need of desperate help.

Hafsa was one of the lucky Afghan women who not only had access to a midwife who knew about the Midwifery Healthline.  Although Hafsa is currently anemic, she is doing well and she expressed her appreciation for the midwifery helpline; “Thanks to the midwife and those who helped her over the phone. I have recovered”, Said Hafsa.