In a move that could transform childbirth procedures in Rwanda, Chinese doctors at the Masaka District Hospital in Kicukiro have successfully facilitated natural birth by a woman living with HIV. This milestone marks a significant step towards safer and more accessible childbirth practices in the country. 

Wu Peng, then director general of the Department of African Affairs in China’s Ministry of Foreign Affairs, lauded the achievement, emphasising that the woman’s successful delivery signifies a major breakthrough in maternal health care. Wu said that the mother was treated “just like anyone else,” reassuringly dispelling fears of HIV transmission from mother to child during childbirth. 

The service to the HIV-positive woman was part of an initiative spearheaded by Chinese medical experts to introduce painless deliveries at the Masaka District Hospital with an aim to fundamentally overhaul childbirth practices in Rwanda. The procedure, also known as “painless normal delivery” or “delivery with labour analgesia (epidural),” aims to provide a smoother and less painful birthing experience for mothers. 

Maternal well-being 

Wang Hui, a Chinese gynaecologist involved in the initiative, emphasised the importance of reducing delivery pain, calling it one of the most severe pains that humans experience. The technique, already in use in Rwanda albeit sparingly due to its cost and limited awareness, holds immense potential in alleviating the physical and psychological stress associated with childbirth. 

Su Nan, a Chinese anaesthesiologist and member of the medical team, underscored the benefits of painless delivery in preventing postpartum depression among mothers. By significantly reducing the pain associated with childbirth, the procedure aims to promote maternal well-being and enhance the overall childbirth experience. 

One of the key barriers to widespread adoption of painless delivery in Rwanda has been its cost, with prices reaching up to $300 in local hospitals. However, with the support of the Chinese government and its medical experts, the procedure is now accessible to more women through Mutuelle de santé, Rwanda’s universal health insurance scheme, at significantly reduced rates. 

Ester Bugingo, a beneficiary of painless delivery, expressed gratitude for the affordability and effectiveness of the procedure. Previously forced to undergo costly Caesarean sections due to unbearable labour pain, Bugingo called the introduction of painless delivery a game-changer for pregnant women across the country. 

Before the introduction of painless delivery by Chinese medical professionals in Rwanda, many women often avoided natural birth due to the fear of the associated pain, preferring Caesarean section instead. The painless delivery service was previously available in select hospitals but was mainly accessible to the wealthy, as it was not covered by the Rwandan universal health insurance scheme. 

Bugingo, a mother of two, had personally experienced the challenges of labour pain, necessitating a Caesarean section during her second delivery. However, for the third one, she discovered an alternative at the University Teaching Hospital of Kigali, where doctors introduced her to an anaesthetic drug that made the delivery painless.  

Reflecting on her experience, Bugingo expressed amazement at the effectiveness of the drug, noting that she felt no labour pain and successfully delivered her son within two hours. However, this method came at the significant cost of approximately 400,000 Rwandan francs (about $350), causing financial strain, particularly as her family’s income had decreased. 

Bugingo and other women have welcomed the introduction of painless delivery services by Chinese doctors at the Masaka District Hospital as well as the inclusion of these services under the universal health insurance scheme as a significant development in the country. Expressing gratitude to the Chinese government and its medical experts, Bugingo highlighted the affordability of this essential service, marking a positive change for expectant mothers in Rwanda. 

Natural labour 

Elaborating on the birth procedure, Anaesthesiologist Su said painless delivery is achieved during natural labour through the administration of anaesthesia to an expectant mother to relieve pain. It is a good option for women with low pain-endurance capacity who would otherwise consider a Caesarean section. 

Women who are exhausted from pushing or are brought to an emergency room are also given the option of painless delivery. 

The procedure uses the epidural continuous injection of low-dose drugs, which greatly reduces the pain in the process of delivery. Epidural anaesthesia is administered through an injection in the lower back of the mother and works by numbing the pelvic region while the mother remains conscious. 

The procedure allows her to sit still with her back arched and it enables her to focus on the delivery while being relaxed throughout the process. The drug takes about 10-15 minutes to be effective. Besides relieving pain, it increases the success rate of natural delivery as it helps the baby to descend easily by relaxing the pelvic and vaginal muscles. 

Moreover, painless delivery reduces the risk of post-partum complications since the birth occurs with very little stress to the mother. The exhaustion and irritation experienced by most women during childbirth is greatly reduced. 

However, ChinAfrica learnt that the procedure has some side effects including trouble in urination after childbirth, prolonged labour and severe migraine-like headaches due to epidural leakage into the spine. It also causes numbness in the entire lower body and it may be a while before a mother can walk. In extreme cases, an emergency Caesarean section may need to be performed if the mother’s blood pressure goes down and lowers the baby’s heart rate as well. 

Despite these side effects, the success of painless delivery at the Masaka District Hospital signals a new era in maternal health care in Rwanda. With Chinese expertise and support, more women can now access safer and more comfortable childbirth experiences, marking a significant stride towards improving maternal health outcomes in the country. 

The annual aid programme initiated by the Chinese government has been instrumental in fostering cooperation in the health sector between China and Rwanda since 1982. Over the years, Chinese medical experts have treated over half a million patients, displaying the enduring commitment to enhancing health care delivery in Rwanda.

African Times published this article in partnership with ChinAfrica Magazine