The midwives bringing life to Nyeri’s Majengo slum

When the distress call of a woman in labour comes, especially at night, many respond with vigour and joy. For them, it is about a new life and a blessing being brought into the world.

The process can, however, be delicate and any small mistake can be fatal for the mother or the new-born. It is worse if the patient cannot get to hospital on time and they are forced to give birth at home.

Agnes Mumbi, born and raised in Nyeri’s Majengo slums has dedicated her life to assisting women in low income areas get the help they desperately need at that 11th hour; when they cannot make it to hospital.

The 41-year-old knows all too well how hard it was for women in her childhood neighbourhood, to give birth in hospitals because most could not afford it.

She was accustomed to accompanying her mother and grandmother as they responded to such cases and found herself offering help in these situations despite her tender age.

“I learnt midwifing from my mother and grandmother who were both midwives,” she says.

In 2010, she responded to her first distress call, on her own.

“The woman was carrying twins and she did not know. By then, there was no Linda Mama (a public funded health scheme that ensures pregnant women and infants have access to quality and affordable health services) and she did not have money to go to hospital. She had never attended any prenatal clinics,” she says.

Road connectivity

Despite the uncertainties, Ms Mumbi stepped up and started the process of helping her deliver since they could not get her to hospital on time.

“Back then, there was no road connectivity in the slum and the houses were built so close to each other that a car could barely come close enough and we had to carry the patient out,” she recalls.

But the babies were here and ready to be delivered so, with fellow women from the neighbourhood, she delivered one baby. To date, she calls it ‘miracle baby’.

“It was a difficult birth and after we got the baby out, I realised her abdomen had not shrunk; that could only mean there was another child in there and by now, we had to take her to hospital,” she says.

“Unfortunately, the second baby did not survive. The doctors told us neither of the twins would have survived had we waited that long,” she adds.

Sad that she was unable to save both children, she contemplated retreating from the work but her natural instincts to help could not allow her.

She decided to train as a community health volunteer (CHV) in the informal settlement.

“In the slums, there are many challenges including women giving birth at home; which is risky as one can experience complications that require hospitalised care,” she says.

So far, Ms Mumbi has successfully delivered at least three children at home, every year.

The mother of five says she is always ready for an emergency and ensures she has all the necessary skills in case she is required to assist.

Her house is always stocked with a new razor blade, cotton wool, gloves, a string and hydrogen peroxide - items she needs when delivering a baby.

“Unlike other supplies you get as a CHV to distribute, these ones I buy myself because we rarely receive them,” she observes.

Delivering children, she says, is not a one person job, but a joint effort and even in the slums, she receives help from other CHVs.

One such woman is Margaret Wamukuria, a 34-year-old, who also lives in Nyeri’s Majengo slums.

Labour pains

“A woman can develop labour pains anywhere and some do not even get the labour pains, so they can start the process anytime, anywhere,” she says out of experience.

The mother of four delivered two of her children at home.

That is why, she says, the first thing the women do when they arrive at the scene is cover the mother up to prevent her from exposure to public eyes.

“You have to because there are children and men who want to see what is going on; so you cover her up with lessos and make her comfortable. If possible, you can rush her to hospital but if it is time, you have no choice but to do it,” Ms Wamukuria adds.

The birth process is almost similar to the one done in hospital, only that here she measures the umbilical cord using her pointing finger before tying with a string and cutting it.

After delivering, the mother and the child are rushed to hospital for specialised care and check-up.

“If the mother or child does not develop complications, they spend the night at home and go to hospital the following day,” she says.

The two women maintain that the hardest births are the first time deliveries since they may develop multiple unforeseen complications, hence the need to work as a team.

“For a first time mother, we do not have any medical history about them and they can have a complication that they too, are not aware of. It is worse if you are dealing with one who has not attended clinic consistently,” she says.

Sex workers

Ms Mumbi also trains expectant women in Majengo, Witemere and Kiawara slums on the importance of antenatal and post-natal clinics. She also offers family planning training.

“I encourage expectant women to spare some money for delivery and encourage them deliver in hospitals. Sometimes I take them to hospital and they do not have money to even pay for the card and I am forced to pay for it myself,” she says.

Ms Mumbi who is also a member of the Kazi Mtaani initiative, is a peer educator at Hope Worldwide Kenya that works with sex workers in Nyeri and issue them with condoms, medication and HIV testing.

For the two women, the satisfaction comes anytime they have a successful delivery.

“I feel very happy when I meet children that I helped deliver, running around, when they are grown. It is fulfilling knowing that you helped save the life of that child and the mother as well,” Ms Wamukuria says.

“My life's mantra is that no child or mother no matter where they come from should die simply because for one reason or another, they could not access the hospital,” Ms Mumbi concludes.

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