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Here's What Giving Birth Looks Like — In Two Very Different Worlds

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    Around 800 women die of complications related to pregnancy and childbirth each day, the World Health Organisation estimates.

    Although the overall maternal mortality rate has dropped nearly 50% since 1990, the miracle of life still comes with serious risk in some corners of the globe.

    Tanzania is one of those countries. The East African nation reports startlingly high rates of women dying during childbirth. Nearly one-fifth of all deaths among women ages 15 to 49 in Tanzania are related to pregnancy and labour, the WHO estimates. The country's maternal mortality rate of 578 deaths per 100,000 live childbirths is more than two times the global average.

    In Sweden, home of what's been rated one of the world's best healthcare systems, the statistics and experiences tell a much more optimistic story. The maternal mortality rate there is one of the world's lowest — just four women per 100,000 childbirths, according to the WHO.

    A quick crunching of those numbers suggests that women are more than 100 times more likely to die in childbirth in Tanzania than they are in Sweden.

    Moa Karlberg, a Stockholm-based photojournalist, said she wanted to capture those two very different realities of an experience shared by women around the globe. The resulting photo series, titled Hundred Times the Difference, seeks to show both the beauty and pain of labour and the disparate environments in which women give birth.

    "During their lifetime, the majority of the world's women give birth to at least one child," she wrote in her project's introduction. "Although everybody goes through the same phases physically, the external conditions are fundamentally different."

    Karlberg, who had photographed women in labour in her home country of Sweden for several years, traveled to Tanzania with the help of a scholarship from the International Women's Media Foundation to capture women giving birth there. She chose not to name the subjects or detail their individual stories, instead focusing in her own writing on her overall observations.

    "For me, it is the common experience that I want to emphasise," Karlberg told Refinery29.

    Karlberg shared her photos with Refinery29, as well as excerpts from the project and her thoughts about what can be done to lower the maternal mortality rate in places like Tanzania. She spoke with us from her home in Sweden.


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    What drew you to labour and birth as a subject for your photography?
    "I have always been drawn to authentic human expressions. Early in my career, I worked as an intern at a local newspaper. At the time, there was a baby boom in Sweden, and a reporter and I were sent to a maternity ward to follow a woman through the whole process of giving birth.

    "Being in that small room, sharing such an emotionally intense and crucial moment, made a strong impression on me. It was one of the most real life situations I had ever photographed; I could just go with the flow and capture everything that happened. Everybody in the room focused on the mother and nobody cared about the photographer. During the following years, in my search for authentic expressions, I kept that experience in the back of my head until I could explore it further."

    Photo caption: N., Sweden.

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    How did you first become aware of the issues surrounding maternal mortality rates and disparities in medical facilities and care, particularly when it comes to Tanzania?
    "I had always been aware of the fact that disparities exist, but it was not until I began photographing births in Sweden that I started understanding them on a deeper level.

    "I realised how skilled the midwives and nurses are here, and what great access they have to all kinds of medical resources. I started comparing maternal mortality rates in different countries, and discovered how extremely different they are.

    "Around 20 countries, nearly all of them in sub-Saharan Africa, have rates worse than Tanzania. Still, the situation in Tanzania is really bad; the risk of dying during pregnancy and childbirth is a hundred times higher for a Tanzanian woman than for a Swedish woman.

    "The economic growth in Tanzania has contributed to meet several [United Nations] Millennium Development Goals, but the goal addressing maternal health is still way behind."

    Photo caption: P., Tanzania.

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    Your photos are tightly focused on the face and expressions of the women. Why did you choose to frame the photographs this way?
    "Like many other themes, inequalities in maternal healthcare have been covered by photojournalists before. It's like people know how these photos will look before they even see them. If you want people to react, I think it's a must to change your visual language and methods once in a while. I find this the biggest challenge photojournalists have today.

    "Generally, I like to leave something for the viewers themselves to fill in. For example, these photos show similarities rather than differences. When you look at them and read the text, you fill in the differences yourself."

    Photo caption: K., Sweden.

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    In Sweden, "if something goes wrong, additional staff and specialists show up within minutes. Premature babies end up in a neonatal unit, where they can survive birth as early as week 22," Karlberg wrote in "Hundred Times the Difference."

    Photo caption: S., Sweden.

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    But in Tanzania, "when complications inevitably arise, the lack of equipment and specialised staff becomes obvious," she added.

    "There is no special assistance for premature babies. In a corner of the room marked 'planned premature unit' stands an incubator from a Swedish university hospital. It has been out of order for several years," Karlberg wrote.

    Photo caption: J., Tanzania.