Email updates

Keep up to date with the latest news and content from BMC Pregnancy and Childbirth and BioMed Central.

Open Access Research article

Complications of childbirth and maternal deaths in Kinshasa hospitals: testimonies from women and their families

Eugénie Kabali1, Catherine Gourbin2 and Vincent De Brouwere3*

Author Affiliations

1 Institut Supérieur des Techniques Médicales de Kinshasa (ISTM/KIN), B.P 774, Kinshasa XI, Democratic Republic of Congo

2 Centre de Recherche en Démographie et Sociétés, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium

3 Institut de Recherche pour le Développement, UMR912, F-13500 Marseille, France and Institut National d'Administration Sanitaire, and Institut de Médecine Tropicale, Nationalestraat 155, B-2000 Antwerpen, Belgium

For all author emails, please log on.

BMC Pregnancy and Childbirth 2011, 11:29  doi:10.1186/1471-2393-11-29

Published: 15 April 2011

Abstract

Background

Maternal mortality in Kinshasa is high despite near universal availability of antenatal care and hospital delivery. Possible explanations are poor-quality care and by delays in the uptake of care. There is, however, little information on the circumstances surrounding maternal deaths. This study describes and compares the circumstances of survivors and non survivors of severe obstetric complications.

Method

Semi structured interviews with 208 women who survived their obstetric complication and with the families of 110 women who died were conducted at home by three experienced nurses under the supervision of EK. All the cases were identified from twelve referral hospitals in Kinshasa after admission for a serious acute obstetric complication. Transcriptions of interviews were analysed with N-Vivo 2.0 and some categories were exported to SPSS 14.0 for further quantitative analysis.

Results

Testimonies showed that despite attendance at antenatal care, some women were not aware of or minimized danger signs and did not seek appropriate care. Cost was a problem; 5 deceased and 4 surviving women tried to avoid an expensive caesarean section by delivering in a health centre, although they knew the risk. The majority of surviving mothers (for whom the length of stay was known) had the caesarean section on the day of admission while only about a third of those who died did so. Ten women died before the required caesarean section or blood transfusion could take place because they did not bring the money in time. Negligence and lack of staff competence contributed to the poor quality of care. Interviews revealed that patients and their families were aware of the problem, but often powerless to do anything about it.

Conclusion

Our findings suggest that women with serious obstetric complications have a greater chance of survival in Kinshasa if they have cash, go directly to a functioning referral hospital and have some leverage when dealing with health care staff

Keywords:
maternal death; emergency obstetric care; childbirth; DR Congo