Maternal mortality, maternal and newborn health is an untold matter.

Maternal health is not a matter of gender, but of human beings.

I started my documentary project “BIRTH IS A DREAM” in 2011 in Malawi, where the words for pregnancy in the local language - “pakati” and “matenda” - translate into “between life and death” and “sick”.

Over the years, I have had opportunities to attend many births, I‘ve documented women giving birth in facilities without adequate equipment and services, or having no access when living in rural areas where they give birth at home without any skilled health workers.

I’ve heard women say, “when we start laboring, we don’t know if we are going to survive or not. It’s only God who can help us for a safe delivery”. They are overwhelmed by their worries and they are feeling powerless.

Maternal health is completely different from any other health issue. It’s more of a cultural issue.

Maternity should stand for serenity, joy, happiness, hope.

Unfortunately in Africa it’s not always like that.

I’ve spent hours, days in maternity wards, talking with women, mothers, midwives, and nurses. In hospitals there is almost no privacy, with women delivering just one next to the other, sometimes totally naked with many male medical staff around in the room. You might hear nurses or midwives shouting at women to stop crying too loud.

Women are used to live their pregnancy, till the moment of giving birth, alone, without their partners.

Africa has the world’s highest rate of adolescent pregnancy, a factor that affects the health, education, and earning potential of millions of African girls.

Child marriage and early pregnancy are among main causes for maternal mortality and morbidity in Africa.

Girls who become pregnant have to leave school; this has long-term implications for them as individuals, their families and communities. They have to take responsibilities as adults: girls become women too early, missing their childhood and adolescence.

As always happens when I produce my documentaries, I spent some time with these girls to build a personal connection, before starting using my camera. And the relationship became stronger day after day, so they felt comfortable in sharing their personal and intimate stories with me.

After many years I’ve decided to expand my project outside Africa, to document and convey more attention to the maternal health matter in the United States: US has the highest maternal mortality rate of any industrialized country in the world.

I’ve decided to start documenting stories from African-American women in the US, who are at especially high risk; they are nearly 4 times more likely to die of pregnancy-related complications than white women.

Women of color in US are less likely to go into pregnancy in good health because of a lack of access to primary health care services. They are also less likely to have access to adequate maternal health care services.

Documenting the most private moment in a woman’s life is not easy at all, most of all for a man, a white man with a camera.

Gaining access to such situations for me is really a long process: I have to get in touch with people from the communities I wish to visit, introducing me and my work, asking support in order to produce my stories. When I’m finally in the field, I talk with the women I meet, so to have a personal straight connection with them, so they can feel comfortable in sharing their personal and intimate stories with me.

When I was in Uganda trying to document home childbirth, I spent almost a week together with a TBA (traditional birth attendant), visiting her every day, having long conversations in order to better explain her the aim of my project. And finally I managed to get her to trust me, so she allowed me to document one of her home childbirth, only after we also gained permit from the pregnant women coming to deliver at the TBA’s home.

As a social photographer I always use great attention on how to approach the characters of my stories, using respect for their dignity: when taking pictures of woman in labour I always try to be invisible as much as possible, and mainly to respect the privacy of that moment.

Working on for this project has given me the opportunity to spend hours, days in maternity units, in home based labour wards, talking with pregnant women, mothers, midwives, who shared their stories with me, who made me understand how much important was to give a voice to women and their maternal health stories.

During one of my trip in Uganda I showed some of my pictures to the men of the community where I worked, asking them how they would have reacted if the women in those pictures shown to the public were their wives. I wanted to know if would have bothered them. And they told me that even if the images were strong, there was no lack of dignity and respect for those photographed women and the project shows a theme that nobody talks about and that’s important to be aware of.

One day I received a message from a young girl living in Kenya, telling me that BIRTH IS A DREAM has been eye-opening for conditions women have to face in Africa, where she lives. And thanks to that she has been inspired to create more awareness about maternal health in her community, working towards positive changing.

That’s why I consider my work much more than a documentary project: it has become my social commitment.

Sexual and Reproductive Rights
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