[ti:Fearing COVID, Some Malawian Women Skip Prenatal Medical Care] [by:www.51voa.com] [00:00.00]更多听力请访问51VOA.COM [00:00.04]The medical services for pregnant women at the health clinic [00:04.96]closest to Monica Maxwell's home in Malawi were free. [00:10.36]The cost to get there, however, [00:13.48]was more than Maxwell could pay for. [00:17.48]Because of the pandemic, she was earning less money than usual [00:22.12]selling tomatoes at a local market. [00:25.76]Her husband's earnings had also dropped. [00:29.80]"It was the most difficult period of our lives. [00:33.32]We had no money for our daily survival," [00:36.84]the 31-year-old Maxwell said [00:39.76]as she waited to be seen by a medical midwife. [00:43.48]It was only her third visit to the medical center during her pregnancy. [00:49.12]She was 36 weeks pregnant. [00:52.92]In Malawi, many hospitals have so little equipment [00:57.16]that women are expected to bring their own tools [01:00.68]to cut their babies' umbilical cords. [01:04.52]The deepening poverty brought on by the COVID-19 pandemic [01:08.92]has made things even riskier for women giving birth. [01:12.92]Officials say far fewer pregnant women in the country [01:17.00]are getting the health care they need. [01:20.84]At the Ndirande Health Center, about 100 women visited each day [01:27.24]for prenatal services before the pandemic. [01:32.32]When COVID-19 began, that number dropped by half. [01:37.56]Now, as few as 15 to 20 patients visit the clinic, [01:43.64]said Jacqueline Kolove, a nursing officer at the clinic. [01:49.68]Many families cannot pay for treatments at medical clinics. [01:54.68]Or, like Maxwell, they do not have the money to get there. [02:00.04]Money is not the only reason women are not coming to the clinic. [02:05.80]Pregnant women may fear they will get the coronavirus in a medical center. [02:13.32]Because of this, more pregnant women are depending only [02:17.32]on traditional birth attendants. [02:20.00]Birth attendants provide women with emotional support [02:23.88]and offer traditional plant treatments. [02:27.76]The government bans attendants from delivering babies [02:31.56]because they lack formal training. [02:34.16]The ban is rarely enforced. [02:37.88]Today, Malawi risks losing the gains it has made over the past 10 years [02:43.76]to lower the number of deaths among pregnant women. [02:48.48]Malawian women face a 1-in-29 lifetime risk of death [02:53.60]related to a pregnancy or birth. [02:56.56]That information comes from the United Nations Population Fund. [03:01.20]The country has 439 such deaths per 100,000 live births. [03:07.60]That number is down from 984 per 100,000 in 2004. [03:15.92]At Ndirande and other clinics, nurses, aides [03:20.60]and medical midwives give pregnant women ultrasounds [03:25.28]and use equipment to examine the mother and baby. [03:29.68]A woman can undergo an operation [03:33.16]called a cesarean section if needed, [03:36.96]and medications are available to stop severe bleeding. [03:42.28]Traditional birthing attendants learn from elders [03:46.08]who pass down knowledge through generations [03:49.48]and use little or no medical equipment. [03:53.24]They listen to women's stomachs by placing their ears there [03:58.44]and use herbs to cause labor. [04:01.32]Lucy Mbewe is a birth attendant. [04:05.56]She is 56 years old and estimates [04:08.84]she has delivered 4,000 babies since 1983. [04:14.32]She says the attendants' work is important for women [04:18.56]who cannot pay for anything else. [04:21.76]Some medically trained midwives say the increased use of attendants [04:28.00]has caused a rise in complicated deliveries, [04:31.76]with women going to the hospital only once it is too late to save them. [04:37.64]Midwives and health officials also say they are fighting against [04:43.24]misinformation about the virus and vaccines [04:47.80]that lead women to not seek necessary medical care. [04:52.72]Nurses and midwives say some women fear they will secretly [04:57.56]be given the vaccine if they deliver at a medical center. [05:03.12]Malawi did not have a full lockdown. [05:06.44]It has seen a major rise in coronavirus cases. [05:10.84]Concern about the vaccine is widespread in the country. [05:17.20]Five months into her pregnancy, [05:19.76]Margret Kosamu has yet to visit a health clinic. [05:23.76]Instead, the 30-year-old has turned [05:26.84]to a traditional birth attendant for just two visits. [05:30.92]Her family's earnings from farming have dropped. [05:34.16]But for her, it is not only an issue of money. [05:38.16]She fears that visiting a medical center that could kill her, not save her life. [05:44.28]"One is more likely going to contract the virus at the hospital than here," [05:50.04]she said of the attendant's care. [05:53.32]Patricia Gunde is 26 years old. [05:56.72]She has not received any prenatal services during her pregnancy. [06:01.88]She chooses instead to receive the herbs her attendant says [06:06.40]will keep her healthy and make childbirth go more quickly. [06:10.80]Gunde has no plans to get a COVID-19 vaccine. [06:15.24]"I am afraid," she said of the vaccine. [06:18.60]"I have heard many stories about it." [06:21.84]I'm Ashley Thompson. [06:23.72]And I'm John Russell.更多听力请访问51VOA.COM