WHen Ellen Kaphamtengo felt a sharp pain in her lower abdomen, she thought she was in labor. She was in the ninth month of her first pregnancy and was not taking any chances. With the help of his mother, the 18-year-old got into a motorcycle taxi and left for the hospital in the city of Malawi, Lilongwe, a twenty-minute drive away.
At the Area 25 health center, they told her it was a false alarm and took her to the maternity ward. But it quickly escalated when an ultrasound revealed her baby was much smaller than expected for the stage of pregnancy, which can cause asphyxia – a condition that can limit blood flow and oxygen to the baby.
Around Malawi 19 out of 1,000 children die in childbirth or in the first month of life. Birth asphyxia is the main cause of neonatal mortality in the region and can mean that the newborn suffers brain damage, with long-term effects, in delayed development and cerebral palsy.
Doctors have classified Kaphamteng, who anticipate a normal delivery, as a high-risk patient. Using AI-enabled fetal monitoring software, further testing was found to drop the baby’s heart rate. The stress test showed that the baby did not survive the labor.
The head of the mother’s hospital, Chikondi Chiweza, knew she had less than 30 minutes to deliver the baby Kaphamteng by caesarean section. With thousands of rescued children in the overcrowded public hospitals in the city, it was well known how quickly the survival of children in labor can change.
Chiweza, who successfully delivered the baby to Kaphamteng, says the fetal monitoring program was a gamechanger for deliveries at the hospital.
“[In Kaphamtengo’s case]if we had done something later or when the child was aborted, we would have found it.
Program, donated by the safe delivery technology company PeriGen through Malawi’s partnership with the Ministry of Health and Texas Children’s Hospitaltracks the baby’s vital signs in labor, alerting clinicians to any abnormalities. Since they started using this three years ago, the number of miscarriages and neonatal deaths in the middle of the center fell by 82%. The only hotel in the world using technology.
“The time around childbirth is the most dangerous for the mother and the baby,” says Jeffrey Wilkinson, an obstetrician with Texas Children’s Hospital, who leads the program. “Most funerals prevent the baby from being safe during the delivery process.”
The AI monitoring system requires less time, less equipment and less staff expertise than traditional fetal monitoring methods, which is critical in hospitals in low-income countries such as Malawi, which face severe shortages of health workers. Regular fetal monitoring often relies on doctors performing periodic checks, meaning that critical information can be missed at intervals when AI-assisted programs perform continuous, real-time monitoring. Controlled training also requires clinicians to interpret raw data from various devices, which can be time-consuming and error-prone.
Area 25 maternity ward treats about 8000 per year with a staff of 80 doctors. While only about 10% are engaged in traditional electronic monitoring, most can use AI software to detect anomalies, so doctors feel any births are more dangerous or complicated. The hospital staff also say that using AI to take care of important aspects of maternity care in the clinic, such as interpretations on the well-being of the fetus and decisions when to intervene.
Kaphamtengyo, who is an excited new mother, believes the medical intervention saved the baby’s life. “I found they could work hard enough early,” he said, holding his son, Justice.
Doctors at the hospital hope to see the technology introduced in other hospitals in Malawi, and beyond Africa.
“AI technology is being used in many fields, and saving the lives of children should not be an exception,” says Chiweza. “It can really bridge the gap in the quality of care that younger populations can access.”