But, like her fellow TBAs about 6,000 of them in Sierra Leone she does so despite the circumstances. The TBA buys her own cotton wool, the cost of which is incorporated into her fee. In her case, the money goes to improve her delivery room. There are signs to watch out for, such as slow contractions or bleeding. Oedema and headaches may indicate serious complications such as eclampsia and hypertension.
Training also makes the TBAs aware of the importance of using sterile equipment.
I wash my hands and prepare the room. Then I put on my gloves. The TBAs' role is as much one of comfort as service. Many of the women are first-timers, and naturally anxious given the high maternal death rate and the problems financial and physical that can ensue. And these women do not take anaesthetic during labour.