Guinea-Bissau is considered one of the worst places in the world to be a mother. The small West African country has soaring infant and maternal mortality rates, and consistently ranks at the bottom of economic, development and health surveys. But these bleak figures could change thanks to a place called the House of Mothers - a haven for pregnant women that provides life-saving pre-natal care.
Kadiatou Barry, 20, is glowing with her first pregnancy. She looks plump and healthy, but she also suffers from high blood pressure and anemia, two danger signs for pregnant women in Guinea-Bissau. Many expectant mothers in this country's remote interior do not react to the danger signs until it is too late. But Barry was referred to the House of Mothers as a high-risk case and has benefitted from the early care and support.
Barry says the House of Mothers is a good place. It is important because there is so much support here for women. She says mothers arrive here in really difficult situations, but then they stay for a while and get food and treatment.
One in 13 women in Guinea-Bissau die from complications during pregnancy and childbirth. Only a third of babies are born in hospital. And one of every five babies born will die within a few weeks of birth.
Here in Gabu, a region 200 kilometers northeast of the capital, maternal and infant mortality rates are the highest in the country. The House of Mothers here consists of a clean, one-story building in the regional hospital's compound, just a few paces from the maternity ward. Currently, there are 17 women at various stages of pregnancy living here. Each woman has a bed, a mosquito net and three meals a day. Together with regular pre-natal check-ups these expectant mothers are getting the treatment they need to survive the grim statistics.
Serifo Embalo is coordinator of Maternity Without Risks, a project run by Catholic Relief Services in partnership with the aid organization, Caritas, and Guinea-Bissau's Ministry of Health.
Embalo says The House of Mothers cares for pregnant women with the most severe complications from all over the region. They all show signs of risk, he says, such as anemia, edema, hypertension, back-to-back pregnancies and child marriage.
Women with such complications stay at the house for anywhere from one month to nine months or until they give birth, depending on the severity of the case.
Guy de Araújo is the representative here for the United Nation's Population Fund. He says the key to lowering mortality rates is to get women with dangerous complications to equipped hospitals early enough to save both the mother and her baby.
Araujo says, normally no woman should die as she gives birth to a new life. But women wait until it's too late after the first sign of complications, he says, to get treated. Araujo says traditionally childbirth happens at home in Guinea-Bissau and the woman often needs the consent of her husband and family before she can go to a hospital. This causes delays that can be life-threatening, he says.
Pregnant women often work in the fields right up until they feel labor pains. Poor transport and ill-equipped regional clinics cause further delays.
In the maternity ward of Gabu's only hospital, a young woman waits for a caesarian-section. She has spent three months at the House of Mothers before moving to the maternity ward to give birth.
Dr. Minkibam, the hospital's director, says there is a big difference between the women who come from the House of Mothers and those who come from elsewhere. He says women normally have no supervision over the nine months of their pregnancy and so they often arrive too late and with too many complications. They are the ones, he says, who lose their babies.
In the next room, four women lie on cots, listless and staring into space. All of them arrived with advanced complications and three have recently undergone emergency caesarians. None of their babies survived.
Across the hospital compound at the House of Mothers, Kadiatou Barry munches on a mango. She says things have changed since her mother's time.
Barry says her mother did not have the same opportunities as she has. Her mother, she says, stayed at home during pregnancy and gave birth to all her children at home.
The House of Mothers not only provides essential medical supervision and nutrition to at-risk mothers. It is also a place where pregnant women get the rare chance to rest and relax, and escape from the physical stress of rural life.