As a young woman not yet initiated into motherhood, I am both excited and frightened by the thought of giving birth.  I can imagine nothing more amazing, and yet I recoil at the thought of labor.  But standing here in Rancho Grande, Nicaragua, I must admit that my fears seem kind of absurd.  After all, if I give birth, I will have the benefits of modern medicine at my fingertips – drugs, experienced doctors and sterile and well-equipped delivery rooms. 

Here, in this lush corner of a country where nearly 80 percent of the population lives on less than two dollars a day, the vast majority of women give birth at home without any medical help.  Often they do it by themselves, alone with their husband, or sometimes overseen by a midwife who isn’t trained and doesn’t have equipment or medicine.  In their earthen-floored homes, many of which don’t have electricity or running water, they are left extremely vulnerable when complications arise.  We heard stories of a woman bleeding to death after delivery; of a 13-year-old girl giving birth with only her mother’s help; and of a woman delivering while on horseback, a situation that ended up killing her baby. 

Women don’t go to the doctor because of poverty.  Women die in childbirth because of poverty.  They can’t afford the transportation to the local clinic, or they don’t have anyone to watch over their other kids or their husbands don’t want them to go.  In Nicaragua, 170 women die per 100,000 live births.  And the mortality rate nearly doubles in some rural areas.  To put this into context, developed countries like Australia and Spain have maternal mortality rates of only four per 100,000 live births.  In Nicaragua and doznes of other countries around the world, CARE is working to give mothers and infants a better chance at life.

One of the women I met was Otellia Hernandez Manzanerez, a fifteen-year-old who had just delivered baby girl Elin Antonia four hours before  at the Dahlia Health Center in Nicaragua. It was Otellia's second child. Otellia was 14 when delivered her first child, at home, with only her mother's help. The baby died. 

This time, Otellia and her mother traveled three hours by bus and foot to reach this clinic, which CARE reburished in 2006 with new delivery room equipment and supplies.

Otellia Hernandez Manzanerez, 15, lays with the baby girl she delivered four hours earlier at the Dahlia Health Center in Nicaragua.  ©Nicole Cappello/CARE

Post by Rachel Murchison