From Richmond County to Sudan, Africa: Tackling the threat to mothers’ lives after childbirth

Mohamed Ibrahim, M.D.

ROCKINGHAM – For most mothers in the U.S., giving birth is joyous, not dangerous.

However, that’s not true in the Republic of Sudan, where FirstHealth obstetrician and gynecologist Mohamed Ibrahim, M.D., spends weeks every year.

“Sudan has one of the highest death rates of mothers after birth,” he says. “Hemorrhaging (excessive bleeding) is the main cause.”

He recently returned from one of a series of medical mission trips to help change that.

In Sudan, 311 mothers out of every 100,000 die after giving birth to a live baby, according to the United Nations. In the U.S., the rate is 14 out of every 100,000 live births.

“Compared to the U.S. and those of us here in central North Carolina, this rate is alarming,” says Dr. Ibrahim, who serves as the director of the women’s health program of the Sudanese American Medical Association, or SAMA. So SAMA has initiated several programs to improve mothers’ health.

“We’ve been able to do so thanks in part to donations from individuals and organizations,” he says. “But there’s much more we need to do.”

In much of the U.S., where more than 99 percent of women give birth with the help of skilled healthcare workers, only 25 percent have that advantage in Sudan. In rural areas, the number is worse.

“Village midwives are at the front line in the rural areas, where most babies are born,” Dr. Ibrahim says. “Without training, sterile tools and medicines, it is very difficult for them to conduct safe deliveries. Because of that, today, the number one cause of death of women after childbirth there is excessive bleeding, either at home or on the way to the hospital.”  

The SAMA program focuses on training these midwives to prevent this major health concern.

“The midwives should be able to conduct safe deliveries and to know when to transport a mother to the hospital without delay when dangerous issues arise,” he says.

The SAMA programs bring physicians, including Dr. Ibrahim, plus supplies and equipment to Sudan twice a year for direct training of midwives and physicians on these issues. They also conduct “train the trainer” education by introducing a midwifery-training module to Sudan, called the “Jhpiego Help Mothers Survive Bleeding after Birth" training (Jhpiego is an international non-profit affiliated with Johns Hopkins University in Baltimore). This education greatly expands the knowledge base in the country, since trainers who are in-country can continue the work after SAMA volunteers leave.

“We’ve been offering this training for five years, and the midwives have been very receptive to it,” he says. “You can see the results already. Classes are almost always full.”

To date, SAMA has trained 725 midwives plus dozens of trainers, who will conduct more classes.

“We want to train all village midwives by the end of 2020,” he says. “That’s a minimum of 1200 women in specific rural areas, who deliver most of the babies there.”

SAMA has a second project to help prevent women’s deaths from cervical cancer, as well, by training Sudanese physicians and providing equipment to diagnose it earlier. For the cervical cancer arm of the program, 135 obstetrics/gynecology physicians have completed training.

“We have created a large and growing team to do the training in Sudan, and efforts like these are making a difference in women’s health,” Dr. Ibrahim says. “Our biggest challenge today is funding.”

Dr. Ibrahim will return to Sudan in August to continue this work. For information on the SAMA program, visit https://www.sama-sd.org/mhp.

Mohamed Ibrahim, M.D., is a board certified physician providing care at FirstHealth OB/GYN located at 921 South Long Drive, Suite 205 in Rockingham.