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Day in the Life of a Midwife in Liberia

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Habibatu Alu, a certified midwife, checks in with a maternal health patient at Pleebo Health Center in Liberia. (Photos by Stephanie Chang for Partners In Health)

Habibatu Alu, a 42 year-old certified midwife, has been working at Pleebo Health Center in southeastern Liberia since 2011. Scroll down for scenes from a typical day.

Habibatu arrives at work by motorbike, the most common form of transportation in this part of Liberia. The ride from her house takes about 15 minutes over bumpy, dirt roads.
Midwife Habibatu has her temperature checked
Like all visitors to the health center, Habibatu first passes through triage. Because of the deadly Ebola outbreak that began in 2014, triage centers have been installed at health facilities throughout the country to identify suspected cases of diseases with epidemic potential.
Her temperature today is 36.8°C. With no fever and no infectious symptoms, Habibatu is cleared for work. She takes all triage requirements, such as hand washing, very seriously. She remembers what it was like to work at Pleebo during the time of Ebola.
She starts the day by counting her stocks of emergency obstetric medications and sterile delivery supplies. As one of two midwives on duty today, she has to be prepared for whoever walks through the door.
Midwife Habibatu stands reviewing a document in the prenatal visit waiting room
Prenatal clinic is held Mondays, Wednesdays, and Fridays from 8 a.m. to 7 p.m. On average, Habibatu sees 50 pregnant patients and attends to at least two deliveries per day.
Habibatu’s first patient of the day is Betty, a first-time mother who is 30 weeks pregnant.
Betty has always been small, and with a height of 4’2”, her short stature may contribute to complications during childbirth. Here, Habibatu measures Betty’s fundal height, or the size and growth of her uterus, to track fetal development.
Measuring the fetal heart rate. At 148 beats per minute, everything is right on target.
Given Betty’s height, Habibatu recommends consultation with a PIH obstetrician at the high-risk pregnancy clinic. Offered once a week at Pleebo Health Center, the high-risk clinic brings specialized maternity care to patients in their home communities.
During a gap between patient visits, Habibatu prepares for her next appointment. She also takes this time to eat. Today’s lunch is shortbread and milk, a common Liberian meal.
After lunch, Habibatu performs an ultrasound on a patient complaining of stomach pains.
Turns out, those stomach pains were more than just cramps — her patient is in labour. Here, Habibatu prepares for delivery with the assistance of her co-midwife, Sophie Chea. It’s a boy!
On April 10, 2019, her patient, Katrin*, safely gave birth to an 8.6-pound baby boy. Here, Habibatu shows Augustine Saylee, a student nurse-midwife, the importance of immediate skin-to-skin contact between baby and mom. *Name changed for privacy
Sophie applies antibiotic ointment for Katrin’s son to prevent common newborn eye infections.
After delivery, Habibatu and Augustine escort Katrin to the three-bed post-partum ward inside Pleebo Health Center. Habibatu is eagerly awaiting the opening of a new 19-bed maternity unit at Pleebo later this year.

Sophie is another of Pleebo’s most seasoned midwives. Last year, she, Habibatu, and four other midwives helped 866 women undergo safe and healthy deliveries. Today, Sophie will monitor Katrin’s vital signs, assess for excessive bleeding, counsel Katrin on post-partum family planning options, and schedule her for a post-partum check-up.
Katrin’s son will receive Vitamin K, umbilical cord care, and his first doses of BCG and polio vaccines as part of the comprehensive routine newborn care offered at Pleebo.
While Liberia has the 7th highest maternal mortality rate in the world, we are proud to say Katrin will not be part of this statistic. There was not a single maternal death at Pleebo Health Center in 2018.
Habibatu admires the construction of the new Pleebo maternity ward, where she and fellow midwives will be able to help more women give birth safely and return home with healthy newborns.

Article originally posted on pih.org


See how the team in Liberia is using Kangaroo Care to help premature infants survive and thrive, despite lacking access to key equipment and reliable electricity.

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