Rose stares at Hesta and the new mother takes in her tiny daughter with a profound sense of relief.
Both are lucky to have survived the journey.
Hesta's birth, on a sheet of black plastic, within the stained walls of the Port Moresby General Hospital, is a blue-ribbon maternal experience by Papua New Guinea standards. But it is a world away from the pregnancy and birth experience of an average Australian woman – even though the countries are just 150 kilometres apart.
Women in Australia almost never die during childbirth, and even our largest maternity hospitals might have such a loss only every couple of years. For mothers in PNG, where most women give birth in their village, the lifetime chance of dying in childbirth can be as high as one in 19. Many women have their babies alone, with no trained help.
Rose considers herself lucky to have given birth with medical supervision even though her hospital stay would shock the average Aussie mother.
For one thing, the tidal wave of births in Port Moresby means an average of 45 babies are born each day – completely overwhelming the supply of 26 six metal beds bearing worn vinyl-covered mattresses which line the torn linoleum corridor that makes up the labour ward.
Hygiene is basic and blood on the wall indicates past traumas which may not have ended well.
Women sit silently on a wooden bench enduring their labour while they wait patiently for their turn to give birth.
Far from the noise of childbirth that is the Western experience, PNG mothers hold their agony inside.
While an Australian mother can begin accessing early maternal health check-ups and screenings from the day her period is overdue, such care is a luxury in PNG and generally reserved for a small proportion of lucky women living in Port Moresby.
Antenatal visits are more likely to be rushed words with an overworked nurse in a hot, crowded room than the sort of one-on-one reassuring appointments Australian women look forward to.
Pregnancies in PNG are generally left to run their course and cloak mothers-to-be under a pall of uncertainty. Childbirth often kills.
In most school classrooms there, at least one of the girls will be expected to die in pregnancy.
While the death rate is due to a combination of factors – including poverty, entrenched gender inequities, lack of access to family planning and the decaying state rural health services – women in PNG die giving birth because of medical complications that are, in the Australian setting, entirely avoidable.
Haemorrhage during labour is the No.1 cause of maternal death in PNG but having someone there during the labour, with even the most basic medical training, can prevent this.
Simple things save lives – knowing how to remove the placenta properly, using sterile gloves and instruments, and reacting quickly to bleeding. Even access to antibiotics can mean the difference between life and death.
Rose has come prepared. A well-worn plastic bag from home contains a sheet, a towel, her own sanitary items, nappies for the baby and her own supply of toilet paper. A tin plate wrapped with a dish towel holds food from home to provide sustenance during her stay.
Other mothers arrive with nothing, not even a scrap of food for nourishment during or after labour. There are no hospital meals, barely any supplies and no canteen on site for women and their families. As is customary, those who have food share with the mothers who do not.
Bars of soap are sliced into slivers to sit on each sink.
Bottles of gentian violet are poured into Cottee's jam jars to share around each room as an antiseptic for umbilical cord stumps. Sometimes surgical gloves are washed and reused. Sometimes they just run out.
Amidst all of this, running between the beds to assist as many babies safely into the world as he can, is Professor Glen Mola.
Mola has dedicated 44 years of his life to reducing the toll of maternal deaths in his adopted country.
He works in a team of six local and expatriate specialists at the Port Moresby General Hospital, which cares for more than 15,000 women each year who come for a supervised birth. Similar numbers of women in Australia would typically require the services of between 50 and 60 obstetricians.
Mola has the added responsibility of training the next generation of local obstetricians and midwives.
His working week is a punishing schedule of managing the overstretched maternity ward while conducting outreach to the region and trying to empower a local health workforce to roll back the tide of maternal mortality.
He has trained generations of doctors, midwives and birth attendants over his career. Not many people know he is also on permanent iron tablets to help him recover physically from the frequent blood donations he makes, prior to taking labouring women into surgery for complicated caesareans.
Mola has also mentored Aussies desperate to help, such as Dr Barry Kirby, a legend around the Milne Bay province where he accesses some of the most remote terrain by boat in order to single-handedly combat some of the highest maternal mortality statistics in the Pacific region.
Each day the two men confront an enormous task – while the number of women dying in childbirth globally fell by a third between 1990 and 2008, the number actually doubled in PNG over the same time period.
Kirby found the plight of women in PNG so stark, he embarked on a midlife career change.
Working as a carpenter and project manager in the remote province of Menyamya in 1990, Kirby assisted a woman by the side of the road who was gravely ill – possibly as a result of AIDS.
She was shunned by her village and left by the kerb to die. Kirby drove her to a health centre and went back the next morning to check on her. But she was gone.
It was a turning point for the knockabout Aussie, who made the profound decision to return to Australia and enrol at medical school. He sold everything he owned and spent 12 years at the task, emerging as a 52-year-old doctor with $50 in his bank account.
He headed straight back to PNG and got stuck in on the frontline of saving women, taking on a known killer – childbirth.
Kirby meticulously researched the circumstances surrounding maternal deaths of women in and around Milne Bay, confirming what he already knew. If a woman is alone, or in her village, there is little that can be done to save her should something go wrong.
But why don't women make their way to their regional health centres when they are due – where basic medical assistance is at hand and access to transport to more sophisticated interventions is at least an option?
Poverty, cultural resistance and tradition are the main culprits. Women reported that they felt ashamed by their poverty, their lack of supplies for their newborns and their lack of money or food for travel.
The $5 equivalent cost of birthing at a health centre was beyond many.
Kirby devised a system of baby bundle gifts as a way of enticing women towards medical assistance during birth, as well as providing useful support for new mothers and their babies. The bundles, which began being distributed about two years ago, include a plastic baby bath full of basics.
Nappies, clothes and a blanket for baby, and T-shirts and sanitary supplies for the mother, are accompanied by the money to pay for a health centre delivery and enough to cover a small amount of food while the women are away from their village.
Just being at a health centre – rudimentary as they are – quite often means the difference between surviving childbirth and bleeding to death.
It's early days, but Kirby is confident his small-scale intervention is having the desired effect and will soon publish a follow-up report on his work.
The small remote island communities of Nimoa and Sehulea usually record around four maternal deaths a year but, over the past two years, no deaths have been recorded "touch wood and a silent prayer" says Kirby.
"Supervised delivery rates have increased by up to 100 per cent in some centres so we are tackling the culture of village births head on and maternal deaths must drop," he said.
About 2000 baby bundles have been delivered to 15 health centres Kirby supports. The bundles, accompanied by training health workers to cope with the new demand, means fewer women are dying and more babies are growing up with their mothers. It is exactly the outcome he hoped for.
*Both Dr Mola and Dr Kirby are financially supported by an Australian charity Send Hope Not Flowers. The charity uses a simple idea to raise funds for a range of maternal health projects across the Pacific. When a new mother in Australia gives birth, Send Hope Not Flowers encourages friends and family to mark the birth with a donation to their maternal health programs rather than by sending flowers to the hospital.
Mothers' Day cards are also available so family members of Australian mums can make a donation in their honour which could help save the lives of other mothers around the world. Because flowers die but women giving birth shouldn't. sendhope.org
Fairfax journalist Emma Macdonald is a co-founder and board member of Send Hope Not Flowers.
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