Day in the Life of a Midwife in Liberia

Habibatu Alu, a 42 year-old certified midwife, has been working at Pleebo Health Center in southeastern Liberia since 2011. Scroll down for scenes from a typical day.

Posted on Dec 17, 2019

Midwife in Liberia checks in with maternal health patient
Habibatu Alu, a certified midwife, checks in with a maternal health patient at Pleebo Health Center in Liberia. Photos by Stephanie Chang for Partners In Health

midwife arrives at Pleebo Health Center by motorcycle

Habibatu arrives at work by motorbike, the most common form of transportation in this part of Liberia. The ride from her house takes about 15 minutes over bumpy, dirt roads.

midwife has her temperature checked before starting work

Like all visitors to the health center, Habibatu first passes through triage. Because of the deadly Ebola outbreak that began in 2014, triage centers have been installed at health facilities throughout the country to identify suspected cases of diseases with epidemic potential.

washing hands before beginning work

Her temperature today is 98.2 degrees. With no fever and no infectious symptoms, Habibatu is cleared for work. She takes all triage requirements, such as hand washing, very seriously. She remembers what it was like to work at Pleebo during the time of Ebola.

checking instruments in the delivery room before work

She starts the day by counting her stocks of emergency obstetric medications and sterile delivery supplies. As one of two midwives on duty today, she has to be prepared for whomever walks through the door.

women await prenatal appointments at Pleebo Health Center in Liberia

Prenatal clinic is held Mondays, Wednesdays, and Fridays from 8 a.m. to 7 p.m. On average, Habibatu sees 50 pregnant patients and attends to at least two deliveries per day.

patient sits for prenatal checkup with midwife in Liberia

Habibatu’s first patient of the day is Betty, a first-time mother who is 30 weeks pregnant.

midwife takes measurements during a prenatal checkup

Betty has always been small, and with a height of 4'2”, her short stature may contribute to complications during childbirth. Here, Habibatu measures Betty’s fundal height, or the size and growth of her uterus, to track fetal development.

taking the fetal heart rate during a prenatal checkup

Measuring the fetal heart rate. At 148 beats per minute, everything is right on target.

midwife consults with patient following a prenatal checkup

Given Betty’s height, Habibatu recommends consultation with a PIH obstetrician at the high-risk pregnancy clinic. Offered once a week at Pleebo Health Center, the high-risk clinic brings specialized maternity care to patients in their home communities.

lunch break at Pleebo Health Center in Liberia

During a gap between patient visits, Habibatu prepares for her next appointment. She also takes this time to eat. Today’s lunch is shortbread and milk, a common Liberian meal.

midwife provides an ultrasound exam for a woman in labor

After lunch, Habibatu performs an ultrasound on a patient complaining of stomach pains.

midwife aids mother in active labor in Liberia

Turns out, those stomach pains were more than just cramps — her patient is in labor. Here, Habibatu prepares for delivery with the assistance of her co-midwife, Sophie Chea. It’s a boy!

newborn receives skin-to-skin contact with mother

On April 10, 2019, her patient, Katrin*, safely gave birth to an 8.6-pound baby boy. Here, Habibatu shows Augustine Saylee, a student nurse midwife, the importance of immediate skin-to-skin contact between baby and mom. *Name changed for privacy

baby receives antibiotic ointment to prevent eye infections

Sophie applies antibiotic ointment for Katrin’s son to prevent common newborn eye infections.

new mother settles into delivery recovery bed in Liberia

After delivery, Habibatu and Augustine escort Katrin to the three-bed post-partum ward inside Pleebo Health Center. Habibatu is eagerly awaiting the opening of a new 19-bed maternity unit at Pleebo later this year.

Sophie is another of Pleebo’s most seasoned midwives. Last year, she, Habibatu, and four other midwives helped 866 women undergo safe and healthy deliveries. Today, Sophie will monitor Katrin’s vital signs, assess for excessive bleeding, counsel Katrin on post-partum family planning options, and schedule her for a post-partum check-up.

newborn swaddled in recovery room at Pleebo Health Center

Katrin’s son will receive Vitamin K, umbilical cord care, and his first doses of BCG and polio vaccines as part of the comprehensive routine newborn care offered at Pleebo.

newborn and mother rest in delivery recovery room

While Liberia has the 7th highest maternal mortality rate in the world, we are proud to say Katrin will not be part of this statistic. There was not a single maternal death at Pleebo Health Center in 2018.

new construction rises near maternity ward at Pleebo Health Center

Habibatu admires the construction of the new Pleebo maternity ward, where she and fellow midwives will be able to help more women give birth safely and return home with healthy newborns.


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