Last updated December 2008
Women in sub-Saharan Africa face the risk that something can go wrong in a pregnancy or childbirth many times over during the course of their lives. Serious complications, such as obstructed labour leading to an emergency caesarean section, can have devastating consequences for women and their families. Emergency medical care may save their lives, but their health and ability to work afterwards may also be affected, and the high costs of the unexpected hospital treatment can cause great financial difficulties, pushing families into poverty. Very few studies have documented the impact of such physical and financial ‘shocks’ and how families cope or struggle in these situations, and the only information currently available is on the impact in the short-term.
Our study takes a unique opportunity to explore the impact of maternity and its complications on economic, social and physical well-being, and to examine whether such events lead to sustained impoverishment in the longer term (3-4 years). It will build on a recently completed longitudinal study of 1,014 women in Burkina Faso which investigated the health, economic and social consequences of severe (“near miss”) complications and normal facility based births up to one year postpartum. This time we will contact the participants again in their 3rd and 4th years postpartum, and include an additional contrasting group of women who delivered around the same time and live in the same community as the near-misses. Specifically, we will look at the impact on household income, belongings, debts, and consumption; on women’s and physical health and social situation; on their ability to earn money, work in production and in the home, the survival and development of the children, and on decisions about future pregnancies. Any effect of ongoing ill-health on the rest of the family, especially older children’s schooling and work responsibilities, will also be explored. The coping strategies that households use over time and the factors contributing to resilience and to vulnerability in different situations will be described. Our analysis will focus primarily on the disturbance from a severe complication and what follows it, but will also acknowledge the normal changes in women and families’ lives which follow uncomplicated childbirth.
Véronique Filippi, email@example.com
, London School of Hygiene and Tropical Medicine