By Pauline Odhiambo
Childbirth in Ghana's matrilineal Ashanti community is heralded with a greeting that captures the complexities of maternity like little else can.
"Afri Emo", which means "congratulations on having come out of a difficult situation", is an acknowledgement of what women go through to bring the living, thriving and pulsating joy of a newborn to the world.
Sadly, it's not always a happy ending for some women in rural Ghana, where access to basic maternal healthcare is limited, causing many postnatal deaths.
Edmund Atweri, a 36-year-old community health nurse and executive director of the NGO Divine Mother and Child Foundation, is on a mission to provide critical healthcare to expectant mothers in some of Ghana's more remote regions.
"We travel to rural communities to provide free ultrasound services to pregnant women who can't afford it. In some of these communities, the nearest hospital is several kilometres from where they live," Edmund says.
Armed with a portable ultrasound machine, Edmund often journeys into rural areas in his personal vehicle to check on expectant women.
"The roads leading to these places are quite rough, which means I sometimes have to park off-road when the path becomes inaccessible by car. I then take a motorbike or a boat for the rest of the journey if I go to the island villages," he explains.
"I feel compelled to make such trips because I know the plight of the women there and how desperately they need ultrasound services."
Preventive scans
Ultrasound is used during pregnancy to check on a baby's development, the presence of multiple pregnancies, and potential abnormalities.
Although these scans are not 100% accurate, the advantages of the test are that it is non-invasive, painless and safe for both mother and unborn baby.
Despite the obvious need for preventive scans, ultrasound facilities are unfortunately not common in many underdeveloped regions. Most expectant mothers there rely on traditional methods for their childbirth needs.
According to a 2024 report by USAID, 18% of all deaths in Ghana are preventable child and maternal mortalities.
In 2023, the maternal mortality rate in Ghana averaged 243 deaths per 100,000 women. The figure marginally declined to 240 last year. Projections for 2025 and 2026 are 237 and 234 respectively.
Traditional midwifery
Like many people born in rural Ghana, Edmund counts himself lucky to have escaped childbirth complications.
"I was born in a small village under the care of a traditional midwife. Growing up there, I saw scores of expectant mothers visit the same person. It shocked me that some of those women would go there while bleeding excessively and that some of them died during childbirth," he recalls.
That's what inspired me to study nursing. I want to give women and children a better chance of survival."
While in training, Edmund specialised in community health nursing to eventually provide crucial maternal healthcare to marginalised communities.
Pregnancy complications
During the time he has worked as a professional nurse, Edmund has witnessed first-hand some of the devastating effects of pregnancy-related complications.
"One of the moments I will never forget was when we visited Atiwa district in eastern Ghana. We met a woman who was about seven months pregnant. She had been informed during a previous scan that she was going to have twins. When we checked her, it transpired that the twins had died in the womb. The foetuses had started decaying," he recounts.
The discovery was particularly devastating for everyone because of what preceded it.
"Moments before we did the scan, the woman excitedly informed us how she had already bought clothes for her unborn babies. The raw grief on her face when she found out that the babies had died haunts me."
During labour and even in the early stages of pregnancy, many women in rural Ghana rely on motorbikes for transport. These motorbike rides on rickety roads cause a lot of damage to some women in the early and late stages of pregnancy.
"At about three months into my third pregnancy, I made a trip to the market to buy food and took a motorbike ride on the way back. When I got home, I was bleeding," says 32-year-old Adwoa Boagye.
"The gynaecologist I visited did a scan to ensure the baby was fine. Afterwards, he told me to avoid riding motorbikes when pregnant. I followed his advice and gave birth months later without any complications."
Healthcare blueprint
Edmund is determined to facilitate better maternal healthcare opportunities for women who can't afford it, including safer transport options for expectant mothers in rural Ghana.
He relies on funding from Ghana's ministry of health, individual contributors and associate partners of his NGO.
While he has made significant progress, much is still to be done to bridge the gap in maternal healthcare.
"Even though we provide free ultrasound scans, many women still have to go to hospital to do lab tests and routine monitoring. My plan is to combine all these services for more comprehensive medical reports and also get an official vehicle to help with transportation," says Edmund, who has won multiple awards for his activism.
"I am motivated to do more because I want to make sure the maternal deaths I saw growing up don't happen in this era."
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