Things might have turned out differently had Shashitu delivered a month earlier. Things might have turned out much worse.

We didn’t get the chance to meet Shashitu, a 28-year-old Ethiopian woman who lives in Genssa Kebele, a rural area about 60 miles from Bahir Dar, the closest city in the Northwest region of Ethiopia. But our Ethiopian IntraHealth co-workers told us about her. Like many girls and young women in Ethiopia, Shashitu married young. She had her first baby by cesarean when she was 18. Three weeks ago, Shashitu was nearing the end of her second pregnancy. Because she delivered her first child by cesarean, she made the long trip to Bahir Dar to a private clinic for a check-up. For reasons that are not clear, the clinic staff told her to come back in ten days, but before the week was out, Shashitu had gone into labor.

Shashitu knew Bahir Dar was too far away, so she went instead to the Yenak Health Center, a clinic near her home. After examining her, the clinic staff knew that Shashitu needed emergency care they were not equipped to provide. So they did the only thing they could: referred her to the Dangla Health Center, another 15 miles away. By then, it was nighttime. There was no car or bus to take Shashitu to the health center, so her family loaded her onto a stretcher and carried her on their backs through the night until they reached the clinic. By the time they arrived the next morning it was 10 a.m., and Shashitu had been in labor for over 15 hours.

At the Dangla Health Center, the staff acted quickly and delivered Shashitu’s baby by emergency cesarean. She gave birth to a healthy baby boy, and we hear she and her son are doing well.

But this story could have ended so many other ways.

When Shashitu arrived at the Dangla Health Center, it had been offering emergency obstetric services for only ten days. She was the third patient to receive these services and only the second woman to receive an emergency cesarean at the Center.

It is exceptional that in a country where women face a 1 in 40 lifetime risk of dying from complications related to pregnancy, Shashitu was able to get the care she needed. These terrifying statistics reflect the fact that very few Ethiopian women deliver with a skilled birth attendant present or have access to other essential reproductive health services they need such as contraceptives, prenatal and postnatal care, and postabortion care.

The recent expansion in services at the Dangla Health Center is one step towards meeting these needs. Through a successful collaborative effort between the Amhara Regional Health Bureau, Addis Ababa Fistula Hospital, Ethiopian Society of Obstetricians and Gynecologists, and IntraHealth International, a portion of the Dangla Health Center was renovated to accommodate a scrub area, operating and delivery room, recovery room with toilet, and a sterilization and storage room. It was also equipped with essential surgical equipment and supplies. Addis Ababa Fistula Hospital also supplied the Center with its own ambulance. The Center now has two health officers who are trained to perform cesareans and three midwives that can offer basic, emergency obstetric care and act as surgical assistants.

The details about the clinic and its staff may seem unimportant, but it is these details that enabled the Center, in week two of operation, to save Shashitu’s life and that of her new son.

IntraHealth’s support to this unit has been made possible through two USAID-funded projects: the Extending Service Delivery project, led by Pathfinder, and the Fistula Care project, led by EngenderHealth.