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This weekend marks International Day Of The Midwife. Fabulous meets the British nurses delivering babies in some of the most dangerous places on earth

Cradling sleeping baby Moses in her arms in a bloodstained tea towel, Anna Kent’s face is a mixture of joy and relief. And it’s no wonder. His weak and starving mother, Nyachou, 20, walked for three days in the blistering heat across the plains of Sudan, searching for help. She arrived at Anna’s clinic by night, and it was the midwife’s job to deliver the baby, aided only by the beam of a torch, with no electricity or running water.

Anna, from Market Drayton in Shropshire, is a midwife. But her work is as far removed from the scenes on Channel 4’s One Born Every Minute as you can imagine. In the UK, we probably spend more time worrying about if we are able to conceive than what will happen at the birth.

Only one in 4,700 British women will die during pregnancy or childbirth*. However, in the countries Anna chooses to work in – ranging from Sudan to Haiti and Bangladesh – no woman is guaranteed to survive it.

“There’s a saying in Sudan: ‘A pregnant woman has one foot in the grave’,” says Anna, 31. “The country has one of the highest maternal mortality rates in the world – one in 32 mothers will die giving birth. I don’t want the women I work with to become another statistic.”

Anna worked as a midwife in Bangladesh last year

This time, both Nyachou and baby Moses – born weighing 5lb 8oz – were able to leave the clinic after 24 hours. But a safe delivery is far from the norm. British women like Anna work to change that.

Lives in danger

She is employed by Médecins Sans Frontières (known as MSF or Doctors Without Borders), to work in some of the world’s most deprived countries – risking her own safety to help others.

“Having a baby is a natural thing and yet in some parts of the world it can be life-threatening,” says Marc DuBois, executive director of MSF UK. “Every day, British midwives are working to save the lives of mothers and children in war zones, refugee camps and places where there is no health-care system.” And to do so, they often endanger their lives.

Medic Dr Karen Woo, from Stevenage, who specialised in maternity care, was shot dead in Afghanistan in August 2010,
along with nine colleagues. They worked for Christian charity the International Assistance Mission (IAM). The Taliban has claimed responsibility for the murders, saying the group were killed because they were Christian missionaries, but the IAM insists they weren’t doing missionary work.

Cases like these are on Anna’s mind when she accepts postings. “You have to weigh up the risks, but MSF takes staff safety very seriously.”

And she has been in some scary situations.

“During a mission to Haiti in November 2010, after the devastating earthquake, my colleagues and I were trapped in a hospital for a week because the building was surrounded by an armed mob,” she says. “The streets were a no-go zone, as violent protests against ongoing elections were happening outside.

“In between shifts, we slept on the floor on sheets with cotton wool in our ears to try to block out the noise. There were guards outside the hospital, but our greatest protection was the patients themselves. No one wanted to come into a cholera hospital. But I had to push my fears aside and just get on with my job.”

It’s not just terrorism and civil unrest Anna contends with. Poverty and disease make her work incredibly challenging.

“When I first arrived in Haiti in October 2010, the cholera epidemic was causing huge problems as it can bring on early labour,” she says. “So I was caring for premature babies who were often very sick. We didn’t have incubators, and if the babies did survive, sending them home was heartbreaking.

“At that time 1.5 million people were homeless, so ‘home’ was often plastic sheets on the street. Watching the babies leave, strapped to their mothers, I hoped they would be OK. But not knowing what shelter or food they’d have was awful.”

Emotional experience

Anna first started specialising in midwifery in 2007 after qualifying as a general nurse at Nottingham University.

“My interest grew from my first mission with MSF to southern Sudan, when I delivered triplets,” she says. “They were delivered by torchlight in a mud hut and the experience was so emotional. All of them survived – two girls and a boy – and although it was nerve-wracking, it felt amazing seeing them in their mum’s arms. That’s when I decided to come back to the UK and get my midwifery qualifications, which have allowed me to help people all over the world.

“When I’m in the UK, where I also work as a midwife in between missions, I face questions about the best pain relief and birthing plans. Whereas the mums I see in the course of my MSF work worry about whether they’ll survive the birth and if they’ll have a live baby,” says Anna.

“These inequalities motivate me. Why should giving birth be a joyous occasion for one woman and a terrifying ordeal for another? I now divide my time between MSF and the NHS in Nottingham.”

Taking its toll

Anna’s currently single and admits her job takes its toll on her personal life.

“I was in a relationship when I went to Sudan, but we were far apart and living different lives. My job was my focus and I didn’t have space for anything else.”

And working in countries where the maternal and infant mortality rate is among the highest on earth, Anna has faced heartbreaking situations most midwives here couldn’t contemplate.“When I arrived in Bangladesh in January 2011, much of my work involved delivering babies who were dead, because their mothers came to us too late. It’s the norm for women to give birth at home, so they would only seek help when they were really desperate, perhaps after days spent in labour. By that stage many were too weak or the baby too distressed to deliver safely.

“It’s horrendous delivering a dead baby. It makes you question whether you did everything you could to save them.
But as word spreads about the birthing unit we work in, more women are seeking help, and the live birth rate is rising.”

Anna has received counselling to help her cope with the horrors she’s seen. She says: “I’ve had nightmares about dead babies. But when you’re out in the field, you have to bury your emotions and get on with the job. So it helps to deal my emotions when I come home.”