"Although many women in Bulangwa place a positive value on fertility and motherhood...pregnancy also appears to be a period of increased stress for women, as evidenced by the negative emotions many admit to feeling while pregnant..."
These cards are like mobile hospital records that are used to identify the category of risk in a woman's pregnancy. The clinic nurse updates the card with vital signs, weight of mother, and growth of baby each time the mother visits the clinic. The card also provides a history of previous pregnancies and births and any health problems that she had during her most recent pregnancy.
Without a prenatal card, many women will be turned away from hospitals or clinics. These cards are used for the referral system created by the Safe Motherhood Act.
A woman first visits a prenatal clinic, if any problems or risks are noted, she is then referred to a high level of care, and it continues up the ladder until you reach a government hospital. This is written on the prenatal card (and a star is put in the corner to warn illiterate traditional midwives of high risk pregnancy)
Unfortunately, this system had a negative side effect in that this restricted care. If a woman was had a high risk pregnancy, she would be told to go to another, higher level care facility. Lack of transportation methods made this a problem, and if this was expressed, they still would not get care. A good example of this is on page 170, when a young woman miscarried in a marketplace instead of miscarrying safely in the hospital, because she was denied access to the clinic.
"Staffing problems, shortages in supplies and equipment, and problems with transportation were identified as key factors that negatively affected the quality of routine care and referral available to pregnant women"
Biomedical and Non-biomedical forms of prenatal care
Women could give birth at MCH clinics, the division health center, the regional hospital, or a mission hospital
The choice on whether to go outside of the home or village to give birth was related to travel cost, hospital cost, and family suggestion
Many women used both biomedical and non-biomedical forms of prenatal care simultaneously.
Biomedical forms of care are often used for prenatal risks of motherhood i.e. real life-threatening problems that arise when a woman becomes pregnant
Non-biomedical forms of care of often used for prenatal risks to motherhood i.e. conditions that prevented them from carrying their pregnancy successfully to term, miscarriage, and infertility.
An unofficial risk associated with biomedical care is harsh treatment some women go through in hospitals and clinics