“Please, please don’t yell at me in a language I can’t understand!” Safiya was clinging to my shoulders and trying to block out all the loud voices around us.

I encouraged Safiya that she was doing well and then switched to the local language to address the hospital staff. “I can coach Safiya. Shouting in a language she doesn’t know won’t help.”

Safiya and her husband had arrived in the Balkans in the early part of her pregnancy. They didn’t speak the local language and were feeling overwhelmed and afraid of birthing their first child so far from home without any support system. We met only a few weeks after Safiya arrived, and we could communicate well between our shared languages. I am a licensed midwife in my home country, but we are still working to navigate the very different system in this part of the world. I didn’t have hospital privileges to deliver Safiya’s baby, but I could provide some prenatal care and attend her birth as a translator and support person. We spent many hours together over the next few months, talking about what to expect in labor and teaching her husband massage techniques to soothe her pain. The three of us were a team, closely bonded and ready for the arrival of Safiya’s first baby.
Soon after Safiya’s water broke, we arrived at the hospital together, excited to meet her little one. I struggled to translate detailed medical concepts and discussions about medications and tests in a language that I don’t yet speak very fluently, but we managed to get through it.

Safiya did very well throughout her long and tiring labor. The nurses and midwives were quite happy to let the foreign midwife handle things at first and left us alone until it was time to push. When that point arrived, the difference in how they handled births became apparent.

Even though Safiya’s baby was completely stable, the hospital staff began to shout at her in the local language she didn’t understand. She understandably began to panic, and I had to climb into the bed and place my forehead on hers to keep her focused and calm and listening to my voice. Eventually, after I asked that they stop shouting at Safiya, the older hospital midwife directed the nurses to leave us alone until the baby was crowning.

When Safiya’s baby was almost ready to be born, I called the doctor, and we moved Safiya to the delivery room. While I expected the local hospitals to be a bit outdated in their equipment and training, I was unprepared for what happened next. Safiya’s legs were tied to stirrups on the bed, and a nurse brought a stool to the bedside and climbed onto it. As Safiya pushed with each contraction, the nurse used her full weight to press her forearm into the top of Safiya’s belly, forcibly shoving the baby down. This obsolete and dangerous technique to speed up delivery is condemned by the World Health Organization and is associated with intracranial hemorrhage in the baby and fractured ribs, uterine rupture and other severe physical injuries to the mother.

I was so shocked to see this treatment that I froze for a moment until Safiya’s voice reached my ears. “No, no please stop! You’re hurting me! Make them stop!” I turned to the doctor. “Please, she doesn’t want this. If you think a faster delivery is necessary, could a safer option like vacuum extraction be tried?”

The doctor pushed me aside. “This is how we do things here.” Despite the baby’s heart rate being normal and without any medical reason to rush delivery, the forceful treatment continued. The intensity of the fundal pressure (pushing down on the belly) was so extreme that it shoved Safiya down off the end of the bed despite having her legs tied to the stirrups, and I had to repeatedly pull her back up to keep her legs from being hurt. The doctor reached for the scissors and cut a very severe episiotomy, and a few minutes later Safiya’s baby came into the world.

Safiya was stunned, shaking, silent and wide-eyed as her baby was examined and wrapped in a blanket. I whispered encouraging words into her ear and told her how beautiful her baby son was, how hard she’d worked and how proud I was of her, but I’m not sure she heard a word of it. She was deeply traumatized by the aggressive treatment at the hands of strangers in a place far from her home.
Safiya’s new baby boy was fine, but Safiya was far from it. She could barely move for days, and bruises covered her abdomen. She had the largest number of stitches I’ve ever seen in my life (and I’ve attended hundreds of births), and she still suffers from complete urine incontinence due to the injuries she sustained.

Safiya’s story is not unique. Women around the world are going through this same type of experience. The trauma that refugee women can experience on their journey to safety, and often once they’ve arrived, can cause many to suffer from severe mental health issues. Many women have no family members or community around them during pregnancy, labor and the crucial weeks after the birth. This can be a terrifying and lonely experience for any new mother, magnified by the language barriers that most face. Many pregnancies are a result of sexual exploitation or violence. In many cases, their journeys will take them through places where medical care is outdated and sometimes even violent. A recent UK study discovered that women from a migrant background are three times more likely to die in childbirth and four times more likely to suffer severe postnatal depression than other women.

I am blessed to be able to serve some of these mothers through prenatal and postpartum support, speaking to them in a language they understand and caring for both their physical and mental wellbeing. This upcoming Mother’s Day, please remember these mothers and their difficult journeys in your prayers and consider making a donation in the name of a special mother in your life. Whether it is a one-time gift or much-needed monthly support, your gift can touch the lives of mothers in extremely difficult circumstances.

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