At age 38, Mary Konyo has nine children, including a set of twins. She has been a traditional birth attendant since 1997, before South Sudan became independent, and has helped 23 women deliver children safely women in the last 16 years. Two years ago, she decided to stop having children so she could focus more on helping other pregnant women in distress.
I was touched by Konyo’s story when I heard it at a public forum in Juba (South Sudan’s capital), and I contacted her to learn more about her work to save the lives of pregnant women in her community.
Her personal experiences with childbirth have inspired her. “When I delivered my first child, I bled excessively for three days. I was very weak,” Konyo told me.
A majority of rural South Sudanese women deliver at home, mostly without the help of a midwife, and some of them die from complications. Excessive bleeding after childbirth, or postpartum hemorrhage (PPH), is one of the leading causes of maternal death in South Sudan.
In recognition of her community work, Konyo was among a few women nominated from her community to attend a USAID-funded workshop on reducing PPH. Workshop participants gained knowledge and skills to help them talk with their communities about the importance of using misoprostol — a medicine that can prevent severe bleeding — to prevent PPH. They also learned what to do when a woman experiences PPH.
In addition to practical skills, the workshop emphasized the need for community outreach to help people understand the importance of giving birth in a health facility, where it can be easier to address complications. Konyo returned to her community as a home health promoter and started a door-to-door awareness campaign. She advises pregnant women to regularly attend antenatal clinic to help ensure that they have safe deliveries. “I particularly tell them about the dangers of excessive bleeding after birth,” Konyo said.
She is also able to give pregnant women misoprostol to take immediately after giving birth. But, she added, “I always tell women to deliver safely in the clinic.” Aware of rural poverty, Konyo advises pregnant women to save a little money for their transport to the hospital for delivery. In her community, women in labor are often transported to the nearest clinic on motorbike taxis, called boda-bodas.
Konyo told me she also encourages husbands to accompany their wives to the clinic, adding that men are expected to pay the hospital bills when their wives give birth.
She believes misoprostol will help drastically reduce severe bleeding immediately after childbirth in her community, pointing out that women who take misoprostol regain strength on the third day after delivery and can return to their everyday activities more quickly. Konyo says the men whose wives have used misoprostol are also happy: “Now they are asking for a ‘wonder medicine’ that will reduce birth pangs and hasten childbirth.”