Waiting for months …for a stillbirth


Aurola Kasawala was buoyant with joy, the joy of waiting for a baby to cuddle and to nurse and to sing lullabies to.

Falling pregnant is one of the moments many women will cherish.

So those nine months of waiting for the baby to come are a period of high expectation.


They were a period of high hopes for Kasawala.

But that bubble of hope and joy was pricked into a puff of airs of anguish and grief, especially so because she believes that it was caused by people who should have helped her dream to materialise.

Kasawala believes she had a stillbirth simply because of the negligence by medical personnel at the facility she went to seek attention.


“I expected to hold my baby after nine months,” she said in her recollections of what happened.

She was midway through her pregnancy when she got a new job. She therefore travelled to Lilongwe for a five-day orientation meeting.

On the second day of the orientation, she noted she was having some spotting.

“I talked to my supervisor about my condition and that I needed to get medical checkup. I checked in at Bwaila Hospital,” she said.

At Bwaila, she explained her condition to one of the nurses, who in turn asked her to go to the consultation room.

“In the consultation room, I found another nurse who told me to wait as the doctor was not yet in. I waited for two hours but there was no doctor. At that time, my unborn child was still kicking inside me,” she said.

While she waited, her condition worsened, but the doctor was nowhere to be seen and the nurses seemed unwilling to help her in the absence of the doctor.

Another nurse actually told her: ‘We only help those that have been seen by the doctor at the consultation room; not otherwise.’

By that time, the bleeding had worsened.

“I could not sit. I tried to explain my condition but to no avail,” she said.

Desperate, she went to a private clinic where she was put on bed rest before she went to her sister’s home where it dawned on her that she had lost the baby.

She went to Kamuzu Central Hospital for further attention and Kasawala underwent post-stillbirth procedures such as dilation and curettage.

Whether her experience was a result of negligence of medical personnel or not, the fact is that stillbirth is a common occurrence around the world and within the country.

According to statistics by the Ministry of Health, stillbirths at the moment stand at 23.1 per 1000 in Malawi.

Spokesperson for the ministry, Adrian Chikumbe, said causes of stillbirths are many and include infections, deliveries conducted by unskilled birth attendants and other maternal complications.

That stillbirth is a big maternal health matter can be testified by the fact that it was one of the major issues under discussion during this year’s conference on maternal and new born health in Mexico.

Director of International Birth Alliance Jessica Rudiaz, who lost a baby herself, said stillbirth is a big problem that needs to be addressed.

“A child is irreplaceable. That is why parents’ grief can last a lifetime, regardless of the weeks of gestation,” said Rudiaz whose presentation was laced with tears rolling from her eyes.

Rudiaz, whose organisation works to help empower parents and improve care to support their grief, said the first step to addressing stillbirths is to improve information and awareness campaigns so that they focus on prevention of stillbirth as one of the strategic development goals.

She said it is essential that organisations work together to improve care for parents. There should be mental health teams specialised in perinatal bereavement and support groups for parents of deceased infants.

Rudiaz also urged for provision of tools to health professionals.

“We propose the implementation of medical protocols to prevent perinatal deaths and professional training programmes developed jointly between professionals and parent groups,” she said.

She added that proper recording of stillbirth cases would be the first step towards a more respectful sensitivity to the reality of families suffering from these circumstances.

“By valuing these lives we will help parents in their grief and this will help to prioritise the prevention of stillbirth. It is proved that the psychological and social effects for parents can last for decades. Pregnancy loss causes a major existential crisis that requires both understanding and support,” she said.

According to Rudiaz, the consequences of doing nothing and minimising the pain might include psychological disorders, attempted suicides, psychiatric hospitalisations, divorce or problems in raising children who are born after loss.

Here at home, the Ministry of Health is taking modest steps to prevent stillbirths wherever possible.

Chikumbe said government is increasing the presence of skilled birth attendants, community midwives, nurse/ midwives, increasing public awareness on the importance of delivering at a health facility and provision of necessary equipment and supplies –all intended to reduce stillbirth occurrences.

That said, people like Kasawala are battling for answers from their experience.

She said her experience left on her mind so many questions on whether the country is really serious on safe motherhood and infant health.

At the consultation room at Bwaila, she found so many women, some groaning in pain.

“But there was nobody to attend to them,” she said.

She said safe motherhood issues are emergency in nature.

“That is why government is investing so much in infrastructure to accommodate expectant women so that they can be closer to health facility.

“But is it of any help if the health workers themselves do not appreciate this?” questioned Kasawala.

About Kasawala’s case, District Health Officer for Lilongwe Dr Mwawi Mwale said it was not true that nurses failed to assist her.

“In hospitals, we do not rely on one person; its teamwork. Nurses are well qualified and they help patients. There might be some other factors that led to her situation and not negligence,” he said.

Mwale said the case is not in their records.

“If that was the situation, the patient could have reported the matter to the hospital officials for investigations.”

Kasawala did not lodge any complaint with the authorities.

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