Preventing deaths during and after childbirth

The Imani Project is preparing to launch a new Birthing Kits Project to reduce mother and infant mortality and morbidity (illness) in Kenya. In 2013, the Maternal and Child Health committee attended live home births and met with small groups of midwives/birth attendants and obstetric nurses from Malindi General Hospital. We added supplies to the birthing kits based on their suggestions, and we plan to start distributing kits by 2015

Preventable Deaths of Mothers

Worldwide each year, more than 600,000 women die from complications during pregnancy and childbirth. A Kenyan woman has a one in 55 chance of dying in childbirth. The Kenyan maternal mortality rate remains high at 488 deaths per for every 100,000 births. Of these, 15% result directly from maternal pueperal bacterial infections and tetanus. The incidence of sepsis and tetanus can be sigificantly reduced when clean birthing is possible.

Preventable Deaths of Infants

Of the approximately nine million infant deaths that occur each year worldwide, Kenya has 55 to 60 infant deaths for every 1000 live births. According to the World Health Organization, 34% of Kenyan neonatal deaths (deaths during the first 28 days after birth) are attributed to severe infections, sepsis and tetanus. Deaths that take place after the neonatal period are often the result of events occuring before the birth, during delivery or immediately after birth. Clean birthing practices could significantly reduce infant mortality.

How do Birthing Kits Help?

Most births in Kenya take place in the home (56%), particularly in poor and rural areas. Only 44% of live births are attended by a birth attendant or other trained health workers, and most of these are in urban areas. In rural settings, most women give birth with the help of an untrained helper, family member, or no help at all. Babies delivered at home without cleanliness precausions are at high risk for severe bacterial infections and tetanus. Mothers risk death by sepsis and hemorrhage, and other obstetric complications because of unsafe deliverery and abortion practices, untreated hypertentive disorders and obstructed labor. The major purpose of the birthing kit is to provide birth attendants, family members and perhaps mothers with a single use, prepackaged kit with the necessary items for clean and safe deliveries and clean cord care immediately after birth.The kits are designed to follow the World Health Organization guidelines for birthing kits, which states: “The hands of the birth attendant must be washed with soap and water, as well as the perineum of the mother. The surface on which the delivery takes place must be clean. Instruments for cord care (razor blade, cutting surface, cord ties) should be clear and preferably sterile. Nothing should be applied to the cutting surface or to the stump. The stump should be left uncovered to dry and mummify, eventually dropping off.”

The Six Principles of Cleanliness

  1. Clean hands
  2. Clean perineum
  3. Nothing unclean introduced into the vagina
  4. Clean delivery surface
  5. Clean cord cutting instrument
  6. Clean cord care including cutting surface and cord ties

Birthing Kit Goals

  • Promote the use of clean and safe delivery practice
  • Reduce maternal and infant mortality
  • Increase awareness and understanding by villagers about the importance of clean birthing practices
  • Facilitate collaboration and information sharing between women of different villages involved in delivery care
  • Explore training opportunities for traditional Birth Assistants and Midwives

Birthing Kit Contents

  • A square yard of heavy plastic as ground cover to keep the mother and baby above the dirt
  • Soap
  • Washcloth
  • 2 pair of latex gloves
  • Betadine wipes
  • Gauze pads
  • Antibiotic ointment
  • A single-edged razor-blade for cutting the umbilical cord
  • Umbilical cord clamp
  • String as a backup to tie the cord
  • Acetaminophen
  • Receiving blanket
  • Baby hat
  • Cloth drawstring bag