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For centuries, pregnancy and childbirth were among the world’s greatest dangers. Over the past 25 years, major advances in healthcare have helped reduce maternal deaths by 40 per cent. But that progress is now under threat.Unprecedented international aid cuts, combined with the highest levels of conflict seen in a generation, are reversing years of hard-won gains. In this powerful new documentary, Bel Trew travels to some of the world's most dangerous places for pregnancy and childbirth, meeting mothers, babies and frontline healthcare workers as they confront the devastating consequences of conflict, poverty and collapsing healthcare systems.The Independent

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00:12For centuries, giving birth was potentially deadly for mothers and their babies.
00:19But over the last 25 years of global efforts, that changed.
00:27Maternal mortality plunged by 40%.
00:38We were on track to stop preventable deaths in childbirth.
00:42I don't know what's going on.
00:53Until now.
01:09Nigeria has had the highest maternal mortality rates in the world for years.
01:14It has repeatedly been labelled the worst place on earth to give birth.
01:20So today I'm joining healthcare worker Atinyada in her rounds of clinics in the north of the country to find
01:28out why.
01:42This struggling primary health clinic is the first and often only port of call for pregnant mothers.
01:48In the waiting room, they share their stories.
01:53Nearly all of them, like Blessing, have lost friends and family to childbirth.
01:58All of them have nearly died themselves.
02:06Blessing gave birth just a few months ago.
02:09It was not easy for me.
02:12I was very scared.
02:14I have a seizure.
02:15All my body is shaking.
02:18To the extent I even collapsed.
02:19They said how they will operate me.
02:22And I started crying because I know my husband cannot afford the money.
02:26My husband started calling his relative to help him for financial support.
02:34And then he died.
02:36Pregnant with twins, Blessing was malnourished and showing all the signs of deadly preeclampsia.
02:42But the hospital bills were the equivalent of two years' salary.
02:47Friends and family frantically crowdsourced the funds, terrified she might die like her sister did.
03:06Why didn't she go to hospital?
03:12I think it's the same financial support.
03:16I was afraid so that the same thing will not happen to you.
03:22You know, when death comes, there is nothing else you can do about it.
03:26You cry later, you have to calm down because you cannot chant in God.
03:34Aside from financial concerns, women in Nigeria struggle to access hospitals.
03:40And even when they get there, there's no guarantee there will be the resources or medics to help.
03:46In Nigeria, on average, there's only one doctor to nearly 10,000 patients.
03:52There's no doubt about those issues that have taken care of.
04:01There's no doubt about it, but we feel guilty.
04:16There's no doubt about it in a year.
04:23The fear is these conditions will only get worse amid unprecedented aid cuts from the
04:29US, the UK and other countries over the last year.
04:33I fear maternal mortality, it will be high and with the children mortality, it will increase
04:40because of the support that we are not getting.
04:48Let's go, we still have a few drugs that we still can manage and give people.
04:53So let's say in the next one year everything will be stopped out and so we're left with
04:58nothing and so the support that we can still offer now will be no more.
05:03So you just have one year left?
05:05It will not reach one year, everything in the store will finish.
05:11Across town, in another clinic, all of these issues are causing a different kind of grief.
05:20Hauer, who is pregnant with her 13th child, has lost seven babies in childbirth.
05:41Asina just lost her baby a few days ago, the third to die in childbirth.
05:53Asina just lost her baby a few days ago, the third to die in childbirth.
06:20And this is all compounded by conflict.
06:33Since 2014, Nigerian security forces have been fighting Boko Haram and other militant
06:39groups.
06:47While hiding from Boko Haram, Dorcas' newborn fell ill.
07:02Today, we met just a handful of women, and among them, 15 babies had died, and at least
07:08two to three of their siblings had died in childbirth.
07:12And that's just a tiny, tiny portion of people in two clinics.
07:18And that just shows you the extent of the problem here.
07:20And it's only going to get worse.
07:25The biggest challenge was the loss of foreign funding Nigeria relied on following Donald
07:31Trump's decision to gut USAID last year.
07:34Hundreds of projects had to close, impacting millions of people.
07:48Donald Trump made it very clear that it wasn't his responsibility to fund global health.
07:54What would you say to that comment that Nigeria should be dealing with this, not any other country?
08:01If we don't address this problem here, it may spill over to other places and it contributes
08:07to global burden.
08:08And our conscience will never be clear.
08:10The fact that there's a problem anywhere, it should be a concern for everybody, everywhere.
08:17Nigeria is just one example.
08:19This is playing out across the world, according to the United Nations.
08:24And while there are no concrete numbers yet, preliminary data is showing a rise in maternal mortality globally.
08:32In 19 countries where we work, already 11 million people lost access to sexual productive health
08:39and to gender-based violence services.
08:41What does that mean for the babies that are being born?
08:43When services get shut down, when maternity wards close, the maternal mortality rate rises.
08:50It's as simple as that.
08:52This will mean that they will have no skilled birth attendants.
08:55They will have no access to medicines that can help them survive childbirth.
09:00It's not fate.
09:01It's not biology.
09:02Women die when funding is cut, when services get shut down.
09:06There were entire healthcare systems that were propped up by USAID.
09:10Obviously that's not a great plan.
09:11Is that a mistake that the world made to rely too heavily on foreign funding and you seeing
09:17a shift away from that kind of model?
09:20Slowly but steadily, some countries were really making strong investments in their own national
09:26health systems.
09:27Just the scale and the abruptness of the cuts, it was just too much, too quick.
09:34We know what works to save women and girls.
09:37We know what works to build resilient health systems.
09:41So my appeal would be invest in innovative solutions.
09:46At this point, we are just afraid that we won't have funds that allow us to continue that
09:52work.
09:56And this is only going to get worse.
10:00Right now, the world is grappling with the highest level of armed conflict since the Second World
10:06War.
10:09This is like the perfect storm gathering.
10:11We have health systems that are stretched to the limit with less funding coming.
10:16It's a very dire scenario for the next couple of years.
10:21That perfect storm is brewing in the Central African Republic.
10:32This is Burau, a town on the country's northern border with Sudan.
10:36We have come here with the UN.
10:39The situation is so tense that we are accompanied by armed escorts and have to stay on a UN base.
10:48This country already had one of the highest maternal mortality rates in the world and was
10:53dealing with its own internal conflict when war erupted in neighbouring Sudan in 2023.
11:00In the only hospital just a few kilometres from the fighting, medics are overwhelmed by the
11:06influx of refugees.
11:12Amna, a Sudanese refugee, was rushed to this clinic a few hours ago.
11:17She has just lost her baby at nine months and nearly bled to death herself.
11:35This is a recurring problem.
11:38Heavily pregnant refugees arrive when it's too late.
11:47Even if they can make it here, the hospital chief says they can barely cope.
11:53Outside the wards, families are camping whilst they wait for treatment.
11:58This is because the entire hospital only has 60 beds, for a local and refugee population
12:04of nearly 40,000 people.
12:06In this life, we have only a sanitary structure, not more than 20 kilometers.
12:12As there was a reduction, the prison cell comes back to every family.
12:17And for every family who has no means, you will see that this lady could not come to the hospital.
12:22She is going to go home and when she is going home, the risk of the child's death, including
12:28the death of the child's death, will increase.
12:29You will realize that the number of children's death will increase, the number of children's death
12:35will increase.
12:36And it will be horrible.
12:38Not only for the life of the village, but for the country.
12:41Aid cuts have meant they've lost multiple members of staff.
12:45All the midwives were let go, piling pressure on Delphine, who's just an assistant, but
12:50now managing all the consultations alone.
13:05Amna and her niece Radia fled slaughter in Darfur on foot last year.
13:11Radia thinks if there were better resources, Amna's baby might have lived.
13:36At Burau's refugee camp, the UN had set up mobile maternity clinics to manage the sudden
13:42influx of refugees.
13:45But they were dismantled when the funding was cut.
13:49Marie Justine, who works for UNFPA, takes us around what is now just piles of rubble.
13:56The sage-femme worked in mobile clinic here.
13:59So they came here and did the consultations prénatales.
14:03They also did the post-natal consultations.
14:05They did the appointments here.
14:07The site here.
14:08And for me, it's also an amertume.
14:11To see that women are going on the risk of wanting to give life.
14:15It's a pain in the heart.
14:16It's a pain in the heart because when we arrived, the women approached me.
14:22They thought that I would come to be able to put in place the service.
14:27Without these mobile and temporary centres, women are dying on their way to hospital.
14:34Basayna and her family fled Darfur three years ago on donkeys.
14:38Armed groups intercepted them on the way, attempted to rape the woman, and murdered Basayna's
14:44husband when he tried to intervene.
14:47Alone, she finally made her way to this camp.
14:50The doof the people...
14:52The police changed a few days later.
14:53They were there because there were quite益ments at the airport.
14:58And then, I got off, over there, even a rent.
15:00The victims die from the airport.
15:02We were there in the airport.
15:07The authorities had aftime mission.
15:10The police were in the airport.
15:15They started flying at night because they had a station.
15:16They took home from the airport.
15:16They took home from the airport.
15:17My family came of Sudan.
15:42Bikita, who was nine months pregnant, fled Sudan just a few months ago.
16:05It just feels like humanitarian crisis layered on humanitarian crisis here.
16:09Even before a war erupted just a few kilometers from where we are, the Central African Republic
16:14was struggling with some of the highest maternal mortality rates in the world.
16:17That's obviously only got worse.
16:20Humanitarians, nurses, doctors, refugees, everyone we've been speaking to today don't understand
16:25why when at the moment where the need is increasing, the support and the funds are decreasing.
16:31And of course, at the sharp end of that, the people who are most impacted are the mothers
16:35and their babies.
16:39The midwives who did run this maternity hospital are now jobless in the capital Bangui, increasingly
16:45frustrated that they are not able to help.
16:47Clara worked as the chief midwife in Burau Hospital with Delphine until 2025, when Trump first
16:55announced the aid cuts.
16:58Since the Sudan war erupted a few years ago, the number of pregnant women needing their services
17:03in Burau more than tripled.
17:07Dr.
17:09Dr.
17:09Dr.
17:10Dr.
17:11Dr.
17:41Dr.
17:41Dr.
17:49Dr.
17:53Dr.
17:59Dr.
18:15Dr.
18:21Dr.
18:46Dr.
18:53Dr.
19:07Dr.
19:08Dr.
19:08and the doctors rushed to try and keep her alive.
19:11But she just died in front of us.
19:13She's been on this earth for just two hours.
19:17It's normal.
19:19It's a part of our daily life.
19:29We've arrived at a stage where we have to fall back.
19:34Because if we fall back, it will be more catastrophic.
19:40And the time to intervene is now, not later.
19:46We've infused a lot of hope that finally the world would be on track
19:51to reach zero preventable maternal mortality.
19:56We know what works.
19:58They will not forgive us for having promised them a world with more dignity
20:05and our failing them.
20:12almost otherwise.
20:12Thank you for watching, and I want to know
20:13and let me know the story of God'sabis on our own time.
20:13Have a good one later.
20:13To be successful, love.
20:13Bye.
20:13Bye.
20:14Bye.
20:14Bye.
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