6 August 2012

“A mother needs to have time and money to provide appropriate care for her children.” - Abdela Abdosh

Shashemene, Ethiopia—In March 2012, a 30-year-old mother of seven arrived at the labor and delivery unit of the Shashemene hospital in southeast Ethiopia with intense labor pains. After her eighth child was born and the nurse brought the baby to the  mother, she turned her head away and sobbed silently.

The midwives on call were worried and confused; most had never seen this happen before. The mother explained that she had no means to care for her newborn child. She described how tragic it was to add another soul a family, all the while knowing that she could not afford to feed and support the baby, and said that her other seven children had never set foot in a classroom, instead spending their days toiling on neighboring farms. “If only I could have prevented this pregnancy,” she lamented.

Abdela Abdosh, a midwife in Shashemene hospital, listened to the mother with empathy, understood her concern, and provided counseling and a family planning method of her choice.

“I always feel empty when I remember that mother. She wanted to use family planning before she came to us, but could not get any. Her story tells me how late we are. It also reminds me of the presence of millions of mothers out there that share her story,” he recalls.

Abdela more than likely prevented the birth of her ninth, tenth  and, perhaps, eleventh child. For the next 12 years, the mother will be safe from unwanted pregnancy through the use of a postpartum intrauterine contraceptive device (PPIUCD).

Twenty-three year old Abdela has worked in the Shashemene hospital for the last two years. He was born to a farmer in Bale in southeastern Ethiopia, and he himself comes from a family of 11 children. Today more than ever before, he believes Ethiopian postpartum mothers are interested in using modern family planning methods.

“The memory of labor pain is still fresh in newly delivered mothers, and they don’t want to become pregnant at least within a short period of time. The postpartum period is one of the best opportunities to counsel them on postpartum family planning (PPFP). I don’t think any health professional should miss that opportunity,” he says.

Abdela’s awareness is in part due to training received from MCHIP. The PPFP and PPIUCD training provides easy to use techniques for PPIUCD insertion and effective counseling methods. In addition to the training, MCHIP provided the hospital with two sets of PPIUCD insertion kits, aprons, gloves, drapes, chlorine solution, soaps and infection prevention buckets.

Today, Abdela provides PPFP counseling for all mothers who deliver at Shashemene hospital and has trained his fellow midwives in the skills he learned from MCHIP. In the one month since the training, the midwives have inserted 10 PPIUCDs.

Despite counseling, many Ethiopian mothers have misconceptions about IUCDs, believing them to damage the body and cause long term side effects. Abdela and his team work hard to dispel these myths and to encourage mothers to share correct information with their neighbors.

To increase uptake of family planning methods among postpartum women more effectively, Abdela continues to orient his colleagues, strengthen linkages with other departments of the hospital (particularly the antenatal care unit), and organize periodic meetings among relevant staff to discuss the progress of PPFP program implementation in the hospital.

MCHIP began its program implementation in Ethiopia in 2010 and started training on PPFP in 2012, during which a total of 47 nurses and midwives were trained on PPFP counseling. Of these, 18 went on to attend a four-day training on PPIUCD insertion techniques. The program is currently being implemented in 16 health facilities in Ethiopia.

“I am grateful to MCHIP for the training that allowed me to share that mother’s pain and respond properly. I hope to do the same for many more mothers,” Abdela says proudly.