When Judith Nande gave birth to her youngest son in June 1998, her sisters were openly resentful towards her decision to have her ninth child at 44 years of age.

Having become pregnant at the tender age of 16 and moving on to deliver eight children in quick succession, they found this delivery rather worrying. 

“It was a terrifying moment because I didn’t feel like my body was strong enough for this delivery, having delivered my last child more than 10 years before.’’ Says Judith. 

Her anxiety proved solid when the rigorous process of delivery hit her even more than she had anticipated. 

Judith adds that “Being a mother of eight, labor pains were nothing new but the pain I experienced with the seventh pregnancy was horrific,” 

“I felt as if death was beckoning and I remember wondering what would become of my other children once I was gone.” 

After her stormy delivery, Judith says that her health took a turn for the worst and for about three years, she suffered spells where her body was too weak for her to even get out of the bed. 

“I couldn’t even attend to my baby, when she cried at night, too weak to sooth her, I would place her mouth next to my breast and hope it would content her,” Judith adds sadly.

Worse still, she was also struggling with anemia which meant she had to eat a special diet which was not easy to implement due to her humble economic status.

Judith’s story is unfortunately not peculiar and indicates serious health implications that women in Kenya continue to grapple with.

“Anemia is common with these women because not only do they lose a lot of blood during their frequent delivery, they don’t counteract that impact with good nutrition,”

Says F.X.O Odawa of the Kenya Medical Association. 

“Their economic status don’t allow them to feed properly, being malnutrition then makes their body too weak for disease resistance causing them serious morbidity.” 

In emphasize, Judith says that “It was a hard time for my eldest son who had to cater for me as well as his wife and two children with the little money he makes as a casual laborer.”

Dr Odawa said that these are some of the hardships these women go through besides giving birth “when they are too early and before their bodies are fully developed to cope with the process of delivering a baby.” 

 “The frequent closely spaced births do not also give the body time to recover which means that their bodies remain weak for the rest of their lives,” Dr Odawa explained. 

Dr N. M. Murugu of Marie Stopes Kenya said that “They give birth at a tender age, in quick succession which leads to many gynecological problems throughout their lives.”

Although there are many gynecological conditions associated with women in this situation, Dr Odawa emphasized that they vary from person to person but urine incontinence remains the most common. 

“Urine incontinence is a condition where by a woman has no control of her urine flow, this can be due to too many deliveries where the tissues responsible for controlling urine are destroyed,”

“The tissue might also be destroyed in a situation where the baby is too big and the subsequent pressure too much,” Dr Odawa expounded.

Mary Akinyi has been suffering from urine incontinence for many years now and she says that it is very uncomfortable.

“Sometimes when I sneeze, urine just leaks and you can imagine how embarrassing it can be in public,” says the 42 year old mother of seven.

 “When the condition begun, I shared it with a friend who advised me to go to the clinic and tell them that I have the “problem of poor women.”

Dr Odawa said that the phrase might have stemmed form the fact that women who are economically empowered deliver under health care providers, and seem not to be afflicted by it.

This is because the women are advised on the kind of exercises to do and how to do them, as well as critical information on family planning.

 “Sometimes when a baby is too big, doctors can cut the vagina to allow easier delivery,

they then stitch the woman carefully and advice on what to do in order to facilitate full recovery,” said Lucy Kiama , a mother of two.

“When you deliver at home, you cannot access the same good care. If a baby is too big, you will continue pushing not knowing what kind of damage that might cause.”

Information and direction are some of the key issues women who deliver at home may not have access to which further leaves them vulnerable.

Experts have also expressed concern with regard to a great percentage of women delivering without the help of qualified health care providers.

Statistics show that only about 45 percent of women deliver in hospitals while the rest chose to deliver at home.

“The irony is that about 80 percent of women will consistently attend clinic through out their pregnancy but they would rather give birth at home,” Dr Odawa explained.

This leaves a lot to be desired seeing that the actual process of delivery is very critical in determining the general good health of a mother.

Judith Nande for instance delivered seven of her nine children at home with the help of friends, and she says that she would just rest for a few days before she begun undertaking her strenuous chores.

“There are many reasons why women prefer to give birth at home, some socio-cultural, where it is demanded that the placenta be buried according to tradition,” Dr Odawa explained.

In addition, Dr Odawa said that other reasons might be due to the state of our public hospitals where the attendants take care of many other women.

A woman may therefore prefer the tender loving care of the traditional birth attendants (TBA) and relatives.

 Experts say that this unfortunate poor health can be attributed to issues such as hardships experienced in their child bearing years which relates to too early and too closely spaced births.

Lack of spousal support has also been a negative factor in the general wellbeing of these women who are left to their own devices by the men in their lives.

In addition, many women in Kenya, especially those living in the slums and other hardship areas suffer effects of inadequate access to basic services such as food and nutrition through out their lives.

Those in the rural areas, the Interactive Population Service report that their poor health is also a consequence of smoky kitchens, polluted water, and pesticides

In developing countries, many older women suffer from chronic health problems caused by years of neglect, discrimination and hardship.

According to a report by Interactive Population Centre, although women live longer than men, they experience much more ill health than men.

The report further indicated that “The health and circumstances of women in their older years are to a great extent the cumulative outcome of reproductive and sexual health during the earlier years.”

An AWC Feature