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“I gave birth to my first and second child at home, while squatting. My grandmother used to cover my mouth and nose and would task me to push harder. It always felt painful. I got tears in my anus and bled a lot when I was giving birth to my second born,” narrates Teddy Kolibi, a mother of three.

This is the culture in Karamoja. Most mothers who go into labour deliver while squatting or kneeling. According to them, the pressure exerted by the knees and hands that hold the ground, makes it easy for them to push and give birth in a very short period of time.

Clementina Ilukol, the only midwife in Rupa Health Centre II, Moroto, says that the majority of mothers previously did not deliver in health centres.

“We would receive mothers after giving birth. They did not come in for antenatal services at all. Most of them would come running while bleeding after getting tears in the anal canal because they had tried pushing before it was time,” she says.

Dealing with the unfamiliar
“The two times I gave birth on the delivery bed, I got difficulty in breathing. It felt like I was suffocating. I also took long trying to push the baby.

The birth cushion eases everything for me,” the pale Kolibi divulges in Akarimojong, translated by Ilukol.

As for Jane Lariong, a mother of five, giving birth on the delivery bed means she has to expose her private parts which is very uncomfortable for her.

“I know when I lie on the delivery bed, I will not be covered as much as I would be when using the birth cushion,” she reasons, explaining why she is not interested in giving birth on the delivery bed anymore.

The introduction of birth cushions
In October last year, UNICEF introduced birth cushions, so that mothers could give birth in health centres using their preferred method of delivery but with the help of skilled midwives.

A birth cushion is a padded pillow or support that allows a partially squatting position for delivery.

The birth cushion is designed to offer a more comfortable and modified position for mothers giving birth.

Rebecca Kwagala, the programme specialist UNICEF, explains that these birth cushions which are made in Kampala, have increased the number of mothers giving birth at health centres.

“We started with a pilot project in 2012 after realising that pregnant mothers prefer giving birth while squatting or kneeling.

Upon realising that indeed most mothers preferred the birth cushions to the delivery beds, we rolled out the project in the whole Karamoja sub-region. We distributed one birth cushion per health unit,” she explains.

There are 11 health units in Moroto District, each staffed with one enrolled midwife.
Approximately 90 per cent of the mothers coming into the sub-region’s health centres prefer using the birth cushion to the lithotomy position. In the lithotomy position, the mother is lying on her back with her legs up.

Changing times
Before the birth cushions were introduced, Ilukol used to receive only five mothers out of the projected 37, delivering every month.

“The first month these birth cushions were introduced, I received 26 mothers with 21 of them delivering using the birth cushions and five using the delivery beds,” she states.

According to Ilukol, it takes a maximum of ten minutes for mothers to give birth on this soft and confortable birth cushions.

Also, mothers rarely experience post birth difficulties like heavy bleeding after delivery when they use the modified squatting or kneeling position aided by the soft cushion.

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