FREDA and son in a morning of storytelling about maternal mortality organized by Global Call to Action Against Poverty (GCAP) Philippines and Woman Health in Quezon City.

Freda Atienza knew giving birth to her second child will be difficult. Three months into her pregnancy, her husband left her and their 8-year-old daughter for another woman.  She’s also been diagnosed as having a cyst in the right ovary.  She’s been in and out the hospital for excessive bleeding. According to her, she has mastered the art of enduring and suppressing her pain.

On September 21, 2008, at around 11:30 in the evening, her water bag broke. Accompanied only by her daughter, she sought help from the Ramos General Hospital in Quezon City. She was told there was no bed for her. After three hours, she was referred to the nearby Sioson General Hospital.

Having had a previous caesarian operation, the 37-year-old Freda was told that the hospital has no available anesthesiologist. The hospital also asked for a P10,000 deposit, but Freda said she did not have the full amount. The staff of Sioson Hospital then advised her to go the Quezon City General Hospital (QCGH), but to first go back to Ramos Hospital to ask a nurse to accompany her.

The pain had by then taken its toll on Freda. At this point, she admitted that the staff of the two hospitals were virtually dealing with and giving instructions to her eight-year-old daughter.

Her daughter decided to go home to ask help from their landlady. She even climbed the terrace leading to the unit of their landlady’s house to wake her up.

Her landlady, Nelia Pagulayan, 42, accompanied Freda to Quezon City General Hospital, where they were told that it was a Sunday, and there is no available operating room for her. There were talks about her being sent to yet another hospital.

But Pagulayan insisted that she be treated in QCGH. Freda was bleeding profusely at that time and Pagulayan feared that she might die on arrival at the next, if there is indeed another available hospital without an excuse to treat her.

Still half-conscious at that time, Freda learned from conversations between the doctor and the staff who brought her to a delivery room that theirs is a 40-60 chance.

One of them asked her to pray for a miracle.

“Misis, magdasal ka na kung marunong kang magdasal. Doktor lang kami. Diyos na ang may hawak sa buhay mo [Ma’am, pray if you know how to. We are just doctors, but God holds your life in His hands],” Freda recounted.

A few more minutes later, the doctors were almost ready to give up on her.

“Patay na ako para sa kanila. Pero sinabihan nila akong lumaban alang-alang sa baby ko. Dahil lumalaban siya [For all intents and purposes I might as well have been dead to them. But they told me to fight on, because they said my baby was fighting],” Freda said.

At 4:45 am the following day, she gave birth to a boy. She would later learn that the doctors actually forced the baby out of her just to save him.  They stayed for several more days in the hospital to ensure that both Freda and her child are safe.

Child carrying a child

AT the age of 13, Ellen (not her real name) is already carrying a child.  When Ellen first sought prenatal checkups from a lying-in clinic in Quezon City, she was refused.  The staff explained that their policies require them to give prenatal checkup to expecting moms who are at least 20 years old.

She was able to get two checkups at the government-run QCGH.

Unlike Freda, Ellen went directly to the QCGH after experiencing pain. Unlike Freda, Ellen was with her husband, who was also a teenager.  Fortunately, her parents were with them.

At the hospital, instead of immediately addressing her pain, the staff required her to first get a blood test and a urinalysis.  Ellen was also given a list of medicines and things they would need in giving birth.

“Bilhin daw muna bago ako manganak [They told us to buy those things first before I deliver],” she said.

Ellen’s companions were able to buy some of the things they needed.

“Kulang pa daw sabi nila. Mabuti na lang naawa iyong isang doktor sa amin [They said we hadn’t gotten everything they listed. Fortunately, one doctor took pity on us and gave clearance for the procedure],” she recounted.

Ellen was told to stay in a labor room, which they later learned has to be paid for P200.

The doctor told Ellen that she needs to deliver by C-section, since she is not yet fully developed as a woman who can give birth.

“Maliit daw ang sipit-sipitan ko. Hindi daw kakayanin ng normal [They said my pelvic canal was small; a normal delivery won’t do],” Ellen said.

She gave birth to a boy.

The hospital, however, told them that both mother and child cannot leave the hospital until they settle all the bills.  Aside from what they already bought, they were to pay the hospital P7,000 for the medicines and another P11,000 for her C-section delivery.

Fortunately, the Department of Social Welfare and Development shouldered the payment for the C-section. Ellen’s family paid for the remainder of the bill.

A month after the delivery, Ellen’s teenage husband left her and their son.

Freda’s and Ellen’s cases punctuate two alarming situations involving maternal mortality and adolescent pregnancy.

“Maternal deaths in the Philippines contribute to 14 percent of the total deaths of women aged 15 to 49,” said Mercedes Fabros of WomanHealth Philippines.

Figures in a paper Fabros wrote in April 2008 showed that four-fifths of maternal deaths are accounted for by pregnancy complications, hemorrhage, severe infection and unsafe abortion, including septic abortion and dystoxia.

“Simply put, each day 10 Filipino women die from pregnancy and childbirth-related complications.  These are all preventable if poor women are given access to correct health services,” Fabros said.

According to Fabros, access means access at the time when help is needed. “It is fortunate that Freda survived her sure death at that time. In her condition and accompanied only by a child, she should have been helped at the least by the two semiprivate hospitals that refused her for various reasons,” Fabros explained.

WomanHealth and the Global Call to Action Against Poverty (GCAP) recently launched a campaign that will document a tapestry of stories and experiences concerning maternal mortality and adolescent pregnancy.

The sharing of stories started recently in barangay Bago Bantay in Quezon City. “We will bring this to other barangays in Metro Manila, where maternal mortality and teenage pregnancy cases are high,” said Joel Saracho, national coordinator of GCAP Philippines.

Saracho said Ellen would not have suffered too much if QCGH staff exerted the better part of their time assisting her than worrying how to replenish their medical stock. There are more stories, probably worse than what happened to Freda and Ellen.

“We want to give the issue a face.  We want our national government and local government units to listen. Something must be done to curb maternal mortality. No woman, no mother deserves to die while giving life,” said Saracho.  

*Mr. Aboga is a campaign officer of the Global Call to Action Against Poverty.

Maternal Mortality

Freda Atienza knew giving birth to her second child will be difficult. Three months into her pregnancy, her husband left her and their 8-year-old daughter for another woman.  She’s also been diagnosed as having a cyst in the right ovary.  She’s been in and out the hospital for excessive bleeding. According to her, she has mastered the art of enduring and suppressing her pain.

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