Childbirth in the Bible by Rev Meagan Manas and Helen Gaw. These three Bible studies can be used together or separately. The opening activity can be used before any or all of the discussions.

Improving maternal mortality in rural Afghanistan, as in many parts of the world, means facing multiple challenges.

Signs that labour is near These three signs show that labour is starting or will start soon. They may not all happen, and they can happen in any order. Clear or pink-coloured mucus comes out of the vagina. During pregnancy, the opening to the womb (cervix) is plugged with thick mucus. This protects the baby and womb from infection. When the cervix starts to open, it releases this plug of mucus and also a little blood. Clear water comes out of the vagina. The bag of waters surrounding the baby can break just before labour begins, or at any time during labour. Pains (contractions) begin. At first contractions may come 10 or 20 minutes apart or more. Real labour does not begin until contractions become regular (have about the same amount of time between each one). When any one of these signs occurs, it is time to get ready for the birth: Let the midwife know that labour is starting. Make sure that the supplies for the birth are ready. The mother should: wash herself, especially her…

Using aprons in teaching I would like to contribute an idea to the magazine. We work a lot with children and parents. We run circus performances to educate children, as well as a rehabilitation centre for men. Instead of writing songs, scriptures and health teaching on cardboard, a good idea has been to take plastic aprons, and sew a transparent plastic pocket in size A4 on each one. You can invite someone from the audience up to the front to put on the apron and help with the teaching. Using the plastic pocket on the apron, you can change the subject and hide other papers behind. You can print the text on A4 paper using a printer, you can take photocopies etc. And it is light and easy to travel with, wherever you go. You can either attach the plastic pockets to the aprons upright or sideways, depending on which way round you want to use the paper. It is good to have at least three aprons, if possible in different colours. If you have a good number of aprons, you can write only one…

‘At last the joy of seeing a living child in my lap!’ Maghoo was delighted to have her first baby boy delivered at home by a trained traditional birth attendant (TBA).

As well as the question ‘when?’, a birth plan needs to answer the questions ‘who?’, ‘where?’, ‘how?’ and ‘what?’

One way of learning and improving your work is to ask for feedback from others. These can be people you serve, or your peers, who can give insight into areas you need to change and encouragement about what you are doing well.

Faith Alive, a hospital based in Jos, Nigeria, has deliberately taken steps to involve men in its antenatal services, which include HIV testing for the prevention of parent-to-child transmission of HIV.

HIV and maternal mortality have been called ‘the two intersecting epidemics’ (The Lancet). A pregnant woman who is living with HIV is six times more likely to die in pregnancy or childbirth than a woman who is not living with HIV.

Weakness and tiredness: Weakness and tiredness could be caused by weak blood (anaemia). See Maghoo’s fifth baby survives for more information. Pain in the belly: There are different possible causes for pain in the belly, including ectopic pregnancy (see Saving a mother’s life), miscarriage or problems with the placenta. Swelling of hands and face, or bad headache and blurred eyesight: High blood pressure combined with swelling of the hands and face, or a bad headache and blurred eyesight, can mean eclampsia, which causes seizures (eclampsia is also known as pre eclampsia or toxaemia). Bleeding from the vagina: Bleeding after the first three months can mean that there is a problem with the placenta. Fever: Fever can be a sign of malaria or infection. Pregnant women living in malarious areas should take antimalarials as advised. A woman with any of these signs may be in serious danger and should see a health worker. Some danger signs can only be correctly diagnosed and managed by a…

Previous Footsteps on women’s health Footsteps 3 Family spacing Footsteps 8 Mother and child care Footsteps 24 Women’s health issues Footsteps 69 Breaking taboos (sexual health) Footsteps 86 Article ‘Fatu’s story’ on preventing fistula (a hole in the birth canal that can develop as a result of long or obstructed labour) Where Women Have No Doctor This book is suitable for any woman who wants to improve her health. It is also useful for health workers who want more information about the problems that affect only women or that affect women differently from men. There is a section on pregnancy, birth and breastfeeding, which has been used as the basis for the Safe pregnancy and birth app described opposite. It costs £7.50 when ordered from TALC (see details below). TALC baby Available on four sides of A4 paper. Stick it onto cardboard and cut it out to give a two-dimensional model with which to illustrate the importance of the position of the baby’s head during birth. Download the…

It is tragic when a woman dies in childbirth. The family is changed forever. We need to ask ‘Why did she die?’ Usually there is not just one answer to that question. Often there are lots of problems mixed up together. Imagine many pieces of string tangled up in a ball. We have to untangle the ball to see the different pieces of string. Then the problems are clearer and we can start to see some solutions.

In parts of rural Nepal, cultural and religious beliefs can sometimes mean mothers do not get the health care and support they need.