Sera Bonds, Founder of COHI, is a social justice, grassroots activist committed to working towards balancing the scales of access, equity, and availability in women’s reproductive health care. She has training in massage therapy, midwifery, a Bachelor of Arts degree in Women’s Studies, and a Master’s degree in Public Health. Her community organizing background ranges from reproductive rights to violence against women, to welfare and poverty issues to anti-war campaigns. She founded Circle of Health International, as U.S.-based NGO, with the hope of giving voice to conflict- and disaster-affected women’s reproductive health needs on an international scale.
She wants what we all want, what we all deserve: safety for her children, health for her children. Health and safety for herself, too. But now that she is a mother, that is an after thought.
Her eyelids heavy as they slowly open to begin a new day, she thinks almost immediately of her long list of tasks ahead of her. As do you. She rubs her belly, as big and hard as a mountain, she thinks, and places her strong, sturdy feet one after the other gently, quietly on the floor so as not to wake the ones still sleeping. As do you.
This however is where many of our paths diverge from the woman living in the economically developing world. Some of us mamas walk into our bathrooms and turn on a tap that brings us potable water, where we leisurely brush our teeth, wash our faces, and contemplate a new moisturizer. This mama dresses in the dark, and heads out alone for a walk of some distance to wait, with the other women, for clean water. Her baby heavy in her belly, she knows the time is coming for this new one to make its appearance. This thought, while it fills her heart with love, also overwhelms and ignites a candle of fear in her: what if this one is like the last one, she thinks. It lasted so long, it took all she had, and she was scared. She focuses on the way her fingers wrap around the plastic handle of the water container now heavy in her arms as she walks back to her home. I will focus on this load of water, she thinks. This, I can control.
This mama goes through her day, slowly lifting, filling, washing, holding, nursing, and breathing. In and out, she thinks, this I can control. As she lifts her toddler, her breath catches in her throat, her belly becomes tight, her back seizes a bit, and a gush of water pours out from between her legs. It is beginning, she thinks. This I cannot control. She breathes in and out. This I can control.
The midwife is called for, and she comes. She remembers this woman from before. One of her longest laboring women last year, it lasted two full days. She was frightened, she knows that birth is not something she can control. She greets the laboring mama with a warm, calm grin, and begins to attend her. This–the tending, the care, the support–that she can control.
This mama, the midwife thinks, she is already so tired. If this labor is like the last, she may not recover so quickly. She breathes deeply, this breathe, this she can control.
The labor begins to look very much like the last; prolonged, strong back pain during contractions, vomiting. The midwife makes a decision that this mama needs more care than she can provide in the small village where they live. This is a dreaded situation, for so many reasons. But one that before the most recent fighting in the region would have been different. The midwife tells the husband that they must transport her. They both sigh. Heavily.
There are few services available anymore in this war-torn part of the country much less an ambulance, a driver, and safe passage to the closest hospital. Her husband resists this. It will be so dangerous: the check points, the violent targeting of hospitals. The midwife breathes, the mama labors, the husband decides.
The ambulance arrives, the driver and the husband load the laboring mama into the vehicle. Her young children watch as she is taken away, no goodbyes. They are young, but most of them know that this thing, this bringing of babies, it is not something anyone can control. They are scared. Almost as scared of this as they are of the missiles and the rockets. Almost.
The drive is long, two hours, over bumpy roads with lots of stops and starts. Shelling is their soundtrack as they drive. There are two checkpoints. At one checkpoint, the soldiers are kind, they quickly look through the car, and wave them along. The second checkpoint is armed by men who have little empathy for this laboring mama and require her to get out of the car while they ask her husband a long list of questions and look through their belongings. The anxiety this mama is feeling is so high, she weeps, it is all she can do, and continues to breathe. This, she remembers, she can control.
At long last they arrive at the hospital, and find a room recently vacated by a soldier who’d been injured. There is dirt and blood on the floor, but this mama does not care. She is immediately seen by the on-call midwife volunteering with an international organization, and she cannot communicate with her through any language that they share beyond that of labor. The midwife recognizes the delay in labor to be a posterior presentation and has the mama labor on her knees, on all fours, and on her side. She is also able to administer a labor-inducing drug to intensify the contractions and to encourage the baby to move through the birth canal. Within two hours of arrival, the mama delivers a healthy baby girl, the intact placenta follows shortly after.
This mama lived. This we can control through access to transportation and medicine when needed.