Imagine giving birth in a remote village or by the side of the road, miles from the nearest medical care. That is the reality for many pregnant refugee women in the Democratic Republic of the Congo (DRC) – one of the riskiest places in the world to give birth.

Every year in the DRC, 96,000 newborns die before the end of their first month of life. Up to half of these babies don’t survive their first 24 hours.

Since 2015, millions of Congolese women have been displaced by conflict and some 540,000 refugees have crossed from neighbouring countries into the DRC in search of safety. The majority are women and children.

Intervention during the 'golden hour' - the first 60 minutes after birth - can literally mean the difference between life and death.

Living in isolated settlements or in camps without maternal health facilities puts pregnant women and their unborn babies at huge risk. They are unable to access the care they need to give birth safely and keep their babies alive.

Newborns are most at risk during the first ‘golden hour’ of life. Breathing difficulties, hypothermia and infection are the three big killers. ©UNHCR/Colin Delfosse

Low cost, high impact health measures in the first 24 hours of life – the ‘golden hour’ – can mean the difference between life and death for refugee newborns. ©UNHCR/D. Azia

Malnutrition and anaemia, diseases like malaria, and prolonged stress also increase the risk of premature birth and potentially life-threatening complications during labour.

In war-torn places like the DRC, UNHCR is responding to the maternal health crisis with programs focused on the ‘golden hour’ – the first 60 minutes after birth – and the health measures that can literally mean the difference between life and death.

By training local health workers in three simple courses of action in the baby’s first hour of life, infant mortality can be reduced – by up to 30 per cent in some cases.

These ‘golden hour’ actions are:

  • resuscitation techniques to help newborns with breathing difficulties;
  • skin-to-skin contact (Kangaroo Mother Care), which can be as effective as an incubator in regulating a baby’s body temperature; 
  • cord care using a safe antiseptic to avoid infection through the umbilical stump.

Without these simple healthcare measures and a birth attendant trained in maternal and neonatal care, the outcome can be tragic. Severe bleeding after birth can kill a healthy woman within hours if she is unattended. A premature baby whose body temperature plummets after birth will struggle to survive.

UNHCR is in the DRC providing care to pregnant refugee women and newborns, and supporting local health centres. But without greater access to healthcare services and a major increase in staff trained in the ‘golden’ hour interventions, these preventable newborn deaths will continue.

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Sandra, a refugee from CAR, recently gave birth at Inke refugee camp in the DRC. Maternity services are limited but unlike refugee women living outside of camps, Sandra had access to trained staff during her labour and delivery. © Australia for UNHCR

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