UGANDA: Any Woman Could Still Die in Childbirth

by Angela Kintu Rwabose

The Ugandan health system is plagued with many issues, but one of the most glaring for me is linked to education. 

Angela Kintu | Uganda

My name is Angela. I have a university degree and a good job. I am the only wife of a great husband who has never raised his hand to me. I have two healthy children: a 9-year-old boy, adopted, and a 2-year-old girl, at whose birth I almost died.

I am not the poverty-stricken marginalized face of the African woman that usually accompanies the data on maternal and child mortality. But I live in Uganda, East Africa, and the systems in my country—or lack thereof—are just as likely to end my life as they are to end the life of a woman living several kilometers and several GDP points down the road from me. I am not the story you are likely to hear, but I am an African mother.

At 33, I would be considered quite old in the general childbearing age for women in my country. Perhaps this is why when I showed early signs of a difficult pregnancy, it was dismissed as late motherhood issues. I threw up all day, every day from the day we confirmed I was pregnant to the day my child was born. I was told it would pass. It did not. I was told I could control it “if I wanted to”. I could not. I lost weight to the point that I was 10 kg below my average weight by the time the baby came. Eventually it came to the point where I was too weak to walk, let alone work. I spent most days in the dark of my room hooked up to IV fluids.

My workplace at the time was beyond supportive. They paid my salary the entire time and sent me what work they thought I could do from my laptop at home. I wondered how many women in my situation would have the same blessing. We tried and tried to find medical help, but none was forthcoming. I just kept getting the same message: It will pass. Everyone treated me as if I was simply not “tough enough”. Not “woman enough”. Not “African enough”. It especially hurt to hear fellow women dismiss my suffering as though it was self-inflicted. In another setting, my husband would probably have deemed me cursed and abandoned me. In my world, he was my primary support.

Eventually, my husband trawled Google and put a name to my predicament: Hyperemesis Gravidarum. Simply put, I had severe morning sickness. Around the same time, the Duchess of Cambridge, Kate Middleton, was admitted to hospital for the same thing. I would not wish it on any pregnant woman, but in my heart I was glad Kate had it. Somehow it gave my suffering legitimacy. It made hyperemesis gravidarum a real disease. The Internet provided the assurance and counseling all the healthcare workers in my town had failed to give me.

Finally, the morning after my due date, my water broke. Only it wasn’t water: It was thickly clotted blood. We rushed to the hospital, where I was told, “bleeding is normal”, despite my insistence that it was not regular bleeding. “This is your first child, what do you know?” responded the midwife. I was advised to walk around and drink warm black tea. I did that for three hours until a doctor who was a friend of my father decided to check on me. He examined me and immediately ordered that I be taken for an emergency C-Section. My placenta had already detached, my womb was full of blood, and my baby was being choked.

Indeed, when my baby was cut out of me, she wasn’t breathing and had to be resuscitated. Every day I thank God for his faithfulness to me. And I cannot help but wonder: If I had been anyone else, if I had been married to a man with three other wives, if I had not been at the one regional referral hospital in my district, if the doctor had not insisted on examining me despite what the midwife said about my bleeding being “normal”. If, if, if...

The Ugandan health system is plagued with many issues, but one of the most glaring for me is linked to education. Yes, we want girls in school, and it is important that they get an education, but is any education truly better than none at all? In Uganda, when a girl isn’t doing too well in school or there is no money to further her education, she will be forced to consider nursing as an option. Not because she wants to, or because her heart is in it. We train droves of frustrated girls right out of O-level to become nurses because it is a cheap and easy option, and because the jobs are available. No one is saying to these girls that they can become mechanics, farmers, or plumbers. No one is telling them they can start businesses. That is a privilege for boys. Nursing is a safety net to catch the broken dreams of so many girls. And when they are finally shoved into a career of constant giving and nurturing, they do not have the will, the dedication or the aptitude for it.

This is why a nurse on duty in a maternity ward can dismiss my concerns about bleeding and make me wait three hours to see a doctor when I could lose my child and even die in the process. This is why the increase in the number of health staff is not always an increase in the quality of health service provision. This is why so many mothers and babies are still dying. We are limiting the options and the vision of young women and, perhaps inadvertently, not giving maternal health care the importance it deserves. If there is an aptitude test for those intending to join law school, how much more for women intending to become midwives and nurses? Midwifery isn’t a last option; it is a gateway to life.

I know three women, all in the same position as me, who did not fare as well. Two died in childbirth, one along with her baby. The third lost her baby. We were all in hospital, all able to afford healthcare and all in situations that could have been avoided.

If we are going to prioritize the wellbeing of mothers and babies, we must prioritize quality education for the healthcare professionals who handle them—most especially midwives. One committed, well-trained, and emotionally prepared midwife can do more than ten frightened teenage nurses. One well-trained midwife will not tell me my pregnancy worries are imaginary. She can tend to my emotional, medical, and physical needs and I can trust her with my precious baby.

I am not a marginalized African woman. I have choices, I have an income, and I have a voice. I pray someone hears me, because for every woman like me who dies in childbirth, there are hundreds of women less privileged than me who are in so much more danger. 

About this story

This story was written for the World Pulse and No Ceilings Path to Participation Initiative. With this initiative, we crowdsourced stories from World Pulse's global community to help turn the No Ceilings: The Full Participation Report into a blueprint for action on the ground. Click here to browse through the 126 submissions we received from over 30 countries. 

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Your account in its honesty touched my heart Angle. It is deplorable that act so selfless as giving birth has become a life sentence for women especially on our side of the continent, where the health system continues to deteriorate in front of our very eyes. Indeed we need a shift in the health sector in terms of government priorities, personnel and facilities. 

"And the day came when the risk to remain tight in the bud was more painful than the risk to let it blossom".

Thank yo u for sharing your story.

I have lost a loved one due to negligence in the name of its ' normal 'so i perfectly know the pain. some health workers do not seem to even care enough, every time a mother complains they are treated like they are fussing over something they should not.


I'm so sorry for your loss Brenda. I understand exactly what you are talking about.

Being a health worker is a calling. People should not become health workers if their heart is not into it. It costs us lives.

Dear Angela,

I read your story with so much pain in my heart! Nobody should have to go through what you just shared. And I can imagine that this experience happens on a daily basis in many countries around the world.

We must convince girls not to give in to the status quo, that it is possible to aim high and achieve greater dreams. And that what is worth doing is worth doing excellently well! They should never settle for less than the best.

I admire your courage Angela. Thanks for sharing.



Girls. We rule the world.

Mercy, it was a really bad experience, but so much good came out of it. I just keep thinking that if that could happen to me, who is not underprivileged, how much more is it happening to women with no money, no options and no voice?

Thank you for reading.

Dear Angela,

Thank you for sharing your story - you are a really good writer.  I am so glad that you are your baby are ok.  I am a mom of three who had the good fortune to give birth in San Francisco, CA at a top notch hospital.  I was just explaining to my 11 year old son the other day just how dangerous giving birth can be and that many women actually die in child birth all over the world.  It's incredibly sad when you think that many of those deaths could have easily been prevented with quality health care.




Thanks Maggie, 

Childbirth is a miracle, and I love that you're already discussing it with your son. He will grow to be an awesome man!

I agree with you that no mother or child should die needlessly. And it is not a matter of asking for too much - even the bare minimum basic support is still lacking in many of our health facilities.

AFADIwomen's campaign "SAVE THAT MOTHER

AND CHILD IN LABOR" For a woman to die or loose a baby during labor it’s not just the husband alone or her family that loses, but rather the nation itself and the entire world at large because the world and that nation may not witness or value the birth of that child, but it can witness the greatest values and reap a lot from that child when he or she grows up. Through # AFIADIwomen team’s program “SAVE THAT MOTHER AND BABY IN LABOR” we acquired a health center about two months ago from a chapel in Nakaseke, Luweero District with a major goal of alleviating the escalating death rate of pregnant mothers and their babies in labor, women who are unable to work but have healthy problems moreover abandoned by their husbands for some reasons like fistula, women who are unable to support themselves and yet have HIV/AIDS, underage girls are raped mostly in northern Uganda, young girls forced into early marriages at the age of 12, exposed to sex and marital life with all its disasters, all the beatings they go through after all the aged husband gave in a few goats in exchange for the girl, so why would he care? but the one thing AFIADI knows for sure, these same women and girls treated like this are reason why there is generation after generation, the world is nothing without women, you and I both know without a woman there’s no world, and without the world, only earth remains, so why not take action to save that mother and baby in labor, our maternal facilities are inadequate to save that mother and baby in labor, #AFIADIwomen need your help and support to save that mother and baby in labor, you can visit or like our page , or follow us AFIADI @afiaidNGO on twitter, collives@gmail. com

Hi Angela,

I just saw your story now and must say its quite touching yet educational and profound!  I vivdly remember when I gave birth to my 1st son at 21 years old, am not sure if saying I was fortunate enough is the right word  but I could say so in that my family was and still is well known and for me at the time I was given special treatment because of the family name (very sad that it was that way).  I remember  being in my own room at the hospital and I started getting labor pains,  I was wheeled away very quickly in readiness to give birth but when the doctor came around I was told it wasnt time yet and at the time I had even started sweating from the pain, during this time I had 3 nurses taking care of me making sure I was as comfortable as possible, one was rubbing my tummy, another had a wet cloth to cool me down and the other telling me to breath in and out.  as this was happening another woman was wheeled past the room I was in and I could hear she was in so much pain.  As she kept crying for help the nurses told her she was too old to have kids and that she already had kids so she should be used to the pain of child birth and so she must keep quiet and stop crying like it was her first time to give birth.  At that moment I was sad for her and asked myself why she had to be treated in that manner...what makes me even more sad now is that I should have said something instead of keeping quiet about it. I totally agree with you that to be in this line of work is a calling and not a career one takes because they did not have a choice or because it was a cheaper option.  There is a need for who ever applies for nursing training to under go some form of psychometric testing to assess if they have the qualities of being a good nurse, that will definately change the type of nurses we get in the health care industry.  thanks for sharing, this is a food for thought story!!