Surviving childbirth in Bangladesh - Shefali's story

07 April, 2012
Photo of Shefali in her yard preparing a fire to cook a meal with

Shefali prepares a meal outside her hut in a remote northern district of Bangladesh. Photo: BRAC

Photo of Shefali talking to a community health worker

Shefali discusses her health with a community health worker as part of the maternal, neonatal and child health project run by non-government orgnanisation BRAC, in partnership with UNICEF. Photo: BRAC

by Shahrukh Safi, AusAID

Shefali Begum, 28, lives in a remote northern district of Bangladesh with her husband and two children. Her daughter Hosne Ara Lisa is eight and her son Shamim is three.

The birth of Shamim in March 2009 nearly ended in tragedy.

Shefali fell pregnant with her second child in mid–2008. Her district was covered by an Australian Government-supported maternal, neonatal and child health project run by non-government organisation BRAC, in partnership with UNICEF. This meant that trained health workers visited Shefali during her pregnancy to make sure she and her unborn son were healthy.

On 12 March 2009 she went into labour. A trained childbirth volunteer was with Shefali for the birth at 3am the next morning. Shamim was healthy and everything seemed fine until, after 30 minutes, Shefali still had not delivered the placenta. This worried the childbirth volunteer, who had been trained to identify complications and seek further treatment for the mother. She urged Shefali's family to take her to a hospital, but the family was unble to do so because they did not have the money to pay for medical treatment. Medical care can be expensive in developing countries like Bangladesh, which poor families can't afford.

Shefali's condition deteriorated through the night and at dawn the volunteer called her supervisor from the project, who joined her at Shefali's house. They convinced the family to take Shefali to the nearest health facility—15km away at the Syedpur Hospital—after promising to pay for her treatment. Shefali was transferred to the 50–bed hospital by van. She received emergency obstetric care, blood transfusions and further treatment. After a few days, Shefali was able to return home with Shamim to her husband and her daughter. The health volunteer continues to visit Shefali and her son to ensure that both are healthy.

Shefali said: 'On that day, in my great danger, BRAC and their staff did a lot for me. I do not have any words to thank them. Without their help I would have died.'

In 2009–10, the Australian Government provided $16 million to train and deploy an extensive network of frontline health workers in Bangladesh to provide a range of services to pregnant mothers and children.

Australia also supports UNICEF to work with the Bangladesh Ministry of Health and Family Welfare to improve access to and the quality of health services provided.

In Bangladesh:

  • maternal mortality has fallen from 574 (per 100,000 live births) in 1991 to 290 in 2006
  • use of family planning had risen from 49 per cent of married couples to 56 per cent in 2007
  • from 1994 to 2007, infant mortality decreased from 87 to 52 deaths (per 100,000 live births) and under-five mortality decreased from 133 to 65 (per 1,000 live births)
  • 18 per cent of births are attended by trained health workers and less than 15 per cent of births take place at health facilities.

More information

Australia's aid program in Bangladesh

BRAC [external website]

UNICEF in Bangladesh [external website]

Last Reviewed: 19 November, 2010