Fri, Oct 06, 2006 - Page 9 News List

Same world, yet worlds apart for giving birth

For mothers in Niger, giving birth to a child is a leap of faith, as they get precious little support from husbands or the healthcare system. The contrast with what's going on in Sweden couldn't be starker

By Joanna Moorhead  /  THE GUARDIAN , LONDON

The mother and baby I meet in Uppsala are Carmen Helwig and her new daughter. Carmen paints a strikingly different picture of new motherhood. She is older -- 38 -- but Tess is her first baby. She was born by cesarean section because of worries over a uterine scar, the result of previous surgery. It might have been fine, the doctors told her, but there was a risk it might rupture.

"Why take that risk?" Carmen says, smiling.

Tess was born three weeks early and is slightly underweight, but she is being carefully monitored at Uppsala, and Carmen knows she will soon be taking her daughter home. Until then, she, her partner Tommy Svedberg, 41 -- who was at the birth and is now taking paternity leave to be involved in his daughter's first weeks -- and Tess are staying at the hospital, in a large, hotel-like double room.

"Once I'm home, I'll be able to phone the hospital with any worries and the midwives will come out to see me every day if I need them," she says.

The other side

Carmen is Dahara's mirror-image, one of the luckiest mothers in the world. The Save the Children report found that while risk can never be entirely removed from the business of becoming a parent, the dangers for Swedish women are minuscule in comparison to the risks for mothers in Niger. Carmen's chance of dying as a result of childbirth over her lifetime is one in 29,800 (Dahara's, remember, was just one in seven).

In Sweden, 100 percent of births are attended by a skilled, trained midwife. Overall, it is the safest place in the world to become a mother.

More than 99 percent of births in Sweden take place in hospital, but it would be a vast oversimplification to attribute the gulf between the two countries' statistics to this fact alone.

Layer upon layer of disadvantage and deprivation, and advantage and blessing, have meshed together to create the circumstances that divide Dahara and Mohammed from Carmen and Tess.

Niger is rated the world's poorest country by the UN. Around 14 percent of its under-fives are significantly malnourished (and in the aftermath of last year's crop shortage and in the face of another shortfall this year, that figure could soon be much worse). Less than half its population has access to safe water.

In Niger, women are more than materially disadvantaged -- they are educationally and physically disadvantaged too. Fewer than one in 10 is literate. Most girls marry early and have many children: the fertility rate, at 7.5, is among the highest in the world. Most of the mothers I talked to had had their first baby at 15 or 16 -- one had had 11 babies before she was 25.

Only 4 percent use modern contraception, and not for cultural or religious reasons -- many of the women I asked said they would welcome advice on spacing their children.

Sweden, by contrast, is one of the wealthiest economies on earth. Its people are healthy and well-fed, its shops well-stocked, its communications excellent and its women well-educated, with virtually 100 percent female literacy. More than 72 percent use modern contraception and the average age for a first birth is 29. The fertility rate is 1.7. It is, in every way, a happier and healthier place to be a woman.

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