Maternal deaths and child spacing in the apostolic church

Forty-five year old Bridget Mano from the Marange Apostolic Sect has lost 10 children over the last 30 years. Sitting on a rug, clad in white from head to toe, the woman fidgets as she relates her story.

A group of young, male apostles in Marange.
A group of young, male apostles in Marange.

“My womb carried 20 children, but only 10 of them survived,” she began. When pressed to say why she believed her children died, she attributes it to witchcraft.

“My neighbour is a witch, responsible for the deaths of my children. Whenever I bore a child and they survived, I was sure I would lose the next one to her. They all died in their infancy.”

Madzimai, as women are called in the sect, said she delivered her first child in 1981 when she was 15-years-old. All of her children were delivered with the assistance of midwives, especially commissioned from her church.

“There are older and experienced women in my church who are specially ordained by God to help pregnant mothers deliver their babies safely.”

Largest religious group

An independent consultant (name withheld) who conducted research on ‘How Religion Influences the Utilization of Health Services’, with a special focus on the apostolic sect, established it as the largest religious group in Zimbabwe.

It has an estimated 38% following out of the Christian population in Zimbabwe, but it is the worst at accessing health services.

The research also established that 64% of the sect members are female, with a male-dominated leadership. The founding leaders each have different teaching and prophetic doctrines which are perceived and held with great esteem.

The Union for Development of Apostolic Churches in Zimbabwe Africa Health Programmes Officer, Camillious Machingura, said the belief among sect members was centred on the spirit ‘mweya’. The prophet, a man, is the medium who commands respect through his prophecy.

“The medium, Mutumwa, is not questioned whenever he makes a prophecy because it is believed to attract misfortune in one’s life,” said Machingura. Machingura added that major decisions were made by the prophets, and some sects believed that disease was punishment for sin.

“There are a lot of misconceptions associated with diseases, and they are viewed from a spiritual perspective. The belief in faith healing is prominent and the prophets often discourage the use of medicine and shun hospitals. The more conservative groups encourage their women not to use any contraception. Child spacing becomes a problem, especially for those in polygamous relationships.”

Twenty-one-year-old Rebecca Mangoi said that contraception within the sect was not recommended, and most women within the sect did not use it.

“Most of us do not use it, because if the prophet gets wind of it, spiritually of course, you will be punished. This is why most of the women in the sect fail to space their children,” said the mother of one.

This brings to the fore the issue of child spacing with regards to infant mortality and maternal deaths.

Wait two years

The World Health Organization says unintended pregnancies are often associated with short between–birth intervals, which can have deadly consequences for infants and children. Short birth intervals (below 27 months) are associated with an elevated risk of infant, neo-natal and peri-natal mortality.

WHO recommends that women wait at least two years after giving birth before getting pregnant again. Family planning education, counselling and contraceptive services can help in spacing births at intervals, and it is recommended for the health of the mother and the baby.

According to the Zimbabwe Maternal and Perinatal Mortality Study 2007, maternal mortality levels are at an unacceptably high level of 725 deaths per 100 000 live births.

The Minister of Health and Child Welfare, Henry Madzorera, said the government was committed to the provision of universal access to reproductive health, and aims to reduce the maternal mortality ratio by 75% by 2015. This will ensure the highest possible level of health and quality of life for all the citizens of Zimbabwe.

The Ministry of Health and Child Welfare, as early as 1983, formulated a comprehensive maternal and child healthcare programme policy to address the challenges faced by women.

The package includes the provision of child spacing and family planning advice and services, provision of health education directed at mothers and school-going children, immunization against the six killer diseases, supervision and care of home and institutional deliveries and child growth and monitoring.

The Ministry further asserts that the most important intervention to reduce maternal and neonatal morbidity and mortality is to develop and sustain a strong national family planning programme. This programme would be designed to prevent unwanted pregnancies and encourage child spacing.

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