It all started when, Otieno, a fisherman, was out on his usual business on Lake Victoria.His pregnant wife, Victoria went into labour.  She did not know what to do since she had never had any antenatal care and advice.

There was no clinic close by. The nearest hospital at Homa Bay was too far for her to reach under the circumstances.

In any case she had no money to pay for transport or the fees at the hospital since her husband kept the money and she did not even have his permission to go to the hospital. She would have to wait till he got back from the lake. 

But then delivery became imminent and her mother-in-law took the matter into her own hands and called in the old lady in the neighbourhood who was known to assist women in labour and indeed who had delivered Victoria’s two previous children.

Unfortunately, during this particular delivery complications developed which the well-meaning old lady was not equipped to handle. 

The result was a tragic end. Both mother and baby died from the complications of obstructed labour - a condition, which can only be dealt with by trained health care providers in a properly equipped health institution. 

The dead mother was only twenty-eight years old — in the prime of her life, and she also left behind her two children aged 5 and 3 years.

Victoria’s story is so common in most of our communities in this country for many reasons including a lack of knowledge and access to safe motherhood and other reproductive health services.

Many have resigned to the situation and look to prayers for good outcomes in the absence of these essential services to ensure safe delivery.

Adverse pregnancy outcomes like in the case of Otieno’s wife are preventable and avoidable. Unfortunately, policies and services are not in place to prevent the majority of these deaths.

According to the 1998 Kenya Demographic Health Survey (KDHS), for instance, only 12 per cent of births in Western province were attended to by a doctor or trained midwife. The figure is about 30 per cent in Nairobi, Coast, and Rift Valley Provinces. These are dismal figures by any standards.  

Information coming from the on-going 2003 KDHS indicates that new statistics on maternal health might not be impressive compared to those obtained five years ago. In other words maternal deaths have been increasing over the years.