• Gillian Sims

Pregnant In A Slum

I wrote this post in 2017, during three weeks of volunteer work in the slums of Recife, in northern Brazil. My heart goes out to those women:

After many days of waiting, I finally got an opportunity to speak with some women from a local housing project about what their pregnancy care is like here in Recife, Brazil. With our limited ability to leave the base in safety, I have tried asking many of the Shores of Grace staff about where local women go to have their babies, but getting definitive answers has not been easy. Basically because nobody knows.

Because of this, I was eager to spend time today with two mothers who previously lived in a slum, but had been successful in their applications for a low-income housing project. The apartments were crudely basic, but a mild improvement on the slum we had visited the week before. I met a woman I will refer to as Rosa, who has had eleven children, her youngest is five, and she tells me she has always wanted twins.

Rosa is probably an exception in Brazil (which averages a Cesarean Section rate between 60-90%) because 9 of her children were born normally. Rosa doesn’t remember having any ultrasounds…perhaps one with her middle daughter, but she tells me she didn’t need them anyway, because she already knew what sex her children were going to be. If Rosa wanted pregnancy care, there was usually a local clinic on the outskirts of the slum that sometimes had nurses available, but you have to be at there on the right days, and wait for a very long time with a lot of other pregnant women.

After visiting Rosa, we visited a woman I will call Mariana. I was told that Mariana had 6 children, and that her last one was born in her apartment on the couch, because she did not have time to get to the hospital. Because there was no one in the house at the time except her two year old, Mariana had to ask her toddler for help to pull the baby out. When we arrived at Mariana’s apartment, I was initially overwhelmed by the stench of a bad smell that I did not recognise. Our local contact asked if we could open a window, and so we sat and listened to Mariana, who wondered if she might be pregnant with her seventh baby, but couldn’t be sure. Being a midwife, I was asked if I could help her work it out. I asked Mariana if she thought her pregnancy could be a number of weeks, or a number of months along. She replied she couldn’t be sure of anything. I asked if I could feel Mariana’s tummy, and she lay down on the couch.

As Mariana lifted her shirt the answer was obvious and as I knelt beside her, I explained what she was likely to have already known, that she was definitely pregnant. Mariana‘s face fell, as tears welled in her eyes and spilled onto her cheeks. As I palpated Mariana‘s abdomen, I estimated her baby was approximately 30-32 weeks and asked if she had felt her baby moving. She nodded, but explained she had been hoping that it was only her imagination, because a pregnancy test she had taken a number of weeks earlier had been negative, "although everyone knows those things are unreliable". Mariana wept and wept as we sat with her. She explained her partner was violent, and that she had kicked him out a number of times. The last time she kicked him out, her mother and sister came and helped clean out her apartment, filled her cupboard with food, and gave her some part time work with them, making jewellery. But then her partner had come back, he owed money to some people who wanted to kill him, and he needed to hide in her apartment until it was safe. She wouldn’t let him in, but he sat in her hallway crying, until she gave up arguing and let him in.

When Mariana‘s mother and sister learned what had happened they refused to help her anymore, and have not spoken to her since. Mariana told us she lies awake at night, crying for her family and contemplating suicide. She could not remember the last time she had anything to eat. When we asked if there was anything we could do that would help Mariana she wept and said she only wanted to talk to her mother and sister again. We offered her food and money, and asked if it would be helpful to clean her apartment for her, but Mariana only stared into the hallway and continued to weep silently. The staff member I was with urged Mariana to get to a local clinic, and ask the doctor for something to take for her depression, Mariana said she would think about it. The only thing I could do for Mariana before we left was hug her tightly. She cried and cried on my shoulder and, grief being recognisable in any language, I cried and cried with her.