Damiris Castro, expecting her third child at age 22, rests while on her first night at a casa materna in Jinotega. Throughout the country, the Red Nacional de Casas Maternas (Maternity Homes National Network) offers rural mothers medical checkups, food, education and a temporary place to stay near a hospital where they can give birth safely.
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After working on an assignment on Costa Rica earlier this year, I took a personal trip for a few days to northern Nicaragua to learn more about issues of maternal health, adolescent pregnancy and reproductive rights among rural women. The story, with the help of reporter Kristy Heim and editor Kathy Treisch, published in late November in Pacific Northwest Magazine. (Thank you ladies, for all of the time and support.)
I visited several of the country’s casas maternas, which offer rural mothers medical checkups, food, education and a temporary place to stay near a hospital where they can give birth safely. Many campesinas in northern Nicaragua live a considerable distance from a health care center. If these women have complications at home, instead of a casa materna, they may have to travel hours by boat, bus or by foot to reach medical attention. They may not be able to reach help in time.
The casas maternas offer a relatively inexpensive but effective way to help rural women have babies safely. The homes were created to address the lack of health services in rural parts of the country, especially when women couldn’t leave their communities during the conflicts of war.
Mostly women spearhead these efforts, and almost all of their staffs are Nicaraguan.
Casas Maternas national coordinator Francisca del Carmen Espinoza Ortiz, 61, has helped establish 79 maternity homes around Nicaragua. The United Nations Population Fund honored her work in 2009, and last year, under her supervision, the casas maternas admitted 14,700 women.
They work on a shoestring budget. The Ministry of Health provides all medical care and an average of about 75 cents a day to each woman for basic nutrition. However, it takes about $5 a day to fully provide for each mother, Espinoza said.
Volunteers and employees bring food from home. Mothers may need to sleep two to a bed or on pads on the floor. Espinoza believes that prevention and education are essential to changing women’s lives, but they do not have the financial resources to carry out the programs.
Adolescent pregnancy rates are also high — some of the highest outside Africa. And on average, rural women here have more pregnancies than women in developed countries, making their risk of dying in pregnancy or childbirth over the course of their lives seven times greater than it is in the United States.
And in rural Nicaragua, where husbands are typically in charge of family decisions, women generally don’t have the choice or the ability to plan when to start having a family or when to stop. Husbands sometimes object to their wives being seen by male medical professionals or taking birth control. And, a 2006 law criminalized abortion in all circumstances, even to save the life of the mother.
Rape and domestic violence are prevalent; one in three women is abused. In some cases, girls give birth as early as 9, and women have children well into their 40s.
As an outsider, it’s obvious to see how Espinoza and her colleagues do a lot of work with minimal resources. But, what was also apparent was how much women believe in the importance of helping one another.
Margaritia Quintanilla, Nicaragua program leader for the Seattle-based health organization PATH, learned these lessons from her mother and grandmother. She works to improve the welfare of women, introduce health technology and build bridges between that work and supporters here in the Northwest.
Efforts to improve rural women’s health will not work unless they address the underlying issues of inequality, says Quintanilla.
Quintanilla, who has three daughters of her own, says being able to decide, “by themselves, about their lives, about their bodies,” is a right they need to have. Having opportunities and the ability to do what they want — to study, to get married or not — that, she says, “is huge.”
Each day, around the globe, an estimated 1,000 women die from pregnancy or childbirth-related complications, many of them preventable.
Kitty Madden, a volunteer social worker at Casa Materna Mary Ann Jackman, says it’s important for women in developed countries to turn their attention to parts of the globe where the challenges are greater. “What affects any woman of the world affects all of us,” she said.
Here’s the link to The Seattle Times story – It takes more than villages to keep mothers safe
HOW YOU CAN HELP:
Red Nacional de Casas Maternas: casamaterna.jinotega@yahoo.es
Mothers at Risk: www.mothersatrisk.org
PATH: www.path.org
Casa Materna Mary Ann Jackman: www.casamaterna.org
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A mother holds her newborn at the casa materna in the town of Jinotega, Nicaragua. The casa materna asks for only a small payment or contribution such as raw food to help cover expenses. Most of the time the mothers are unable to contribute, but no woman is turned away.
Juana Esmeralda Castro, 33, third from left, walks from church with other women at Casa Materna Mary Ann Jackman. Kitty Madden, a volunteer social worker, says it’s important for women in developed countries to turn their attention to parts of the globe where the challenges are greater. “What affects any woman of the world affects all of us,” she says.
If you have some time — here is link the story.
Martha Lorena Florez Hernandez, 31, a mother of five, left, talks with Corina del Tercero at Casa Materna Mary Ann Jackman. The maternity home, a nonprofit financed by organizations outside the country but staffed by 15 Nicaraguans, received its 15,000th mother in June. The casa has reported just two maternal deaths since receiving the first mother in October 1991.
Since the start of the global economic downturn, funding for women’s food and basic services that formerly came from European countries has dramatically decreased at Casa Materna Mary Ann Jackman, an internationally funded nonprofit. The cost of staples such as rice and beans has increased, and many of the expectant mothers who come to the casa materna arrive malnourished.
Since the start of the global economic downturn, funding for women’s food and basic services that formerly came from European countries has dramatically decreased at Casa Materna Mary Ann Jackman, an internationally funded nonprofit. The cost of staples such as rice and beans has increased, and many of the expectant mothers who come to the casa materna arrive malnourished.
In rural Nicaragua, travel between towns can be difficult because of a lack of infrastructure and isolation. It can take hours to reach communities to by bus, hitchhiking, boat and even canoe.
Fatima del Rosario Gonzalez Polanco, 13, rides from the casa materna in the town of La Dalia to the hospital. Without help, the journey is a perilous one for many. Casas Maternas national coordinator Francisca del Carmen Espinoza Ortiz noted the case of a pregnant woman with complications who had to be carried in a hammock, put on a boat, then driven by bus to reach a health-care center.
Juana Partora Martinez, 45, lives with her husband, a corn and bean farmer in the country outside Matagalpa, Nicaragua. She was expecting her 12th child. In rural Nicaragua, poverty, a lack of infrastructure and violence, as well as cultural traditions prevent many women from getting adequate health care.
Nurses measure a mother’s belly during health checkups at the casa materna in Jinotega, Nicaragua.
Women play games and exercise at Casa Materna Mary Ann Jackman in the city of Matagalpa. The women later took turns singing for one another before an education session. A sense of community is often formed among the women. Younger mothers watch out for older mothers, and the veteran mothers counsel first-timers.
Marllini Paola Martinez Chavarria, 13, attends a daily checkup at Casa Materna Mary Ann Jackman. Chavarria, who has nine brothers and sisters, says her mother also gave birth to her first child at the age of 13. Darlene Omeir, Nicaragua program officer for the United Nations Population Fund, says studies show that women who have one child before age 19 are likely to have another child in the next two years.
Juana de Dios Lopez Hernandez’s daughter, Candida Rosa, 12, holds her little sister, Mayra, outside their home. According to a recent report from the Seattle-based nonprofit PATH, 73 percent of rural households have an unsuitable water supply and 20 percent of children under 5 suffer from chronic malnutrition.
Juana de Dios Lopez Hernandez tends to her kitchen in rural Jinotega, a region known for its coffee, vegetable and cattle production. Juana recently recuperated at the Jinotega casa materna after a cesarean delivery.
Expectant mothers from Casa Materna Mary Ann Jackman go on a morning walk as part of their daily prenatal exercises. Each day, around the globe, an estimated 1,000 women die from pregnancy or childbirth-related complications, many of them preventable.
A mother rests after her daily medical appointment at Casa Materna Mary Ann Jackman.
The small mountain town of Jinotega is a gateway to Nicaragua’s central highlands.
A mother sleeps with her daughter at the Jinotega casa materna. Many families travel from far rural communities for the opportunity of a safe birth. During busy times, women have to sleep two to a bed or on pads on the floor.
Often, in rural Nicaragua, poverty, culture and politics decide the fate of women and girls. Most must travel long distances to give birth in a hospital. Cervical-cancer rates are high. Adolescent pregnancy rates are also high — some of the highest outside Africa. A 2006 law criminalized abortion in all circumstances, even to save the life of the mother.
Juana Partora Martinez, 45, center, prepares tortillas at Casa Materna Mary Ann Jackman in Matagalpa, Nicaragua.
Mothers hand wash their clothes at Casa Materna Mary Ann Jackman.
Eva del Carmen Gonzalez, 19, prepares to sleep on the floor with a pad and makeshift pillows at Jinotega’s casa materna. The maternity-home network, which receives some funding from the Nicaraguan Ministry of Health, admitted 14,700 women during 2010. But even with assistance, most of the casas maternas run on a deficit and are trying to establish businesses like cafeterias to become self-sustaining.
Just before her baby was born, Rosibel Barreta Gomez, 31, stayed at a casa materna in La Dalia, Nicaragua. Throughout the country, the Red Nacional de Casas Maternas (Maternity Homes National Network) offers rural mothers medical checkups, food, education and a temporary place to stay near a hospital where they can give birth safely.
Life for many rural Nicaraguan women is difficult. Even at the casa maternas, volunteers sometimes need to bring in food from home to help feed the women.
The maternity-home network, which receives some funding from the Nicaraguan Ministry of Health, admitted 14,700 women during 2010. Many families travel from far rural communities for the opportunity of a safe birth. During busy times, women have to sleep two to a bed or on pads on the floor.
