Mothers at risk as free maternity care ends in Congo

In a maternity ward in eastern Congo, Irene Nabudeba rested her hands on her bulging stomach, anxious about giving birth in a city now under rebel control. The conflict that escalated earlier this year has stranded medical supplies beyond the front line and crippled essential infrastructure like running water. In Goma — once the region’s humanitarian and commercial hub — the local economy has collapsed, and with it, one of the last lifelines for expectant mothers.

Until June, the Congolese government had been offering free maternity care, a program that many women depended on for safe deliveries. But after authorities failed to renew the initiative, access to healthcare has plummeted sharply. Freddy Kaniki, deputy coordinator of the M23 rebel movement, told the Associated Press that the free maternal care “was not renewed because it was a failure.” Congolese officials have not responded to questions regarding the program’s termination.

For women like Nabudeba, the consequences are immediate and devastating. “I am seeing many women giving birth at home now because they can’t afford it. They don't know how to get to the hospital to deliver because they ask for a lot of money,” she said. “I just found a small opportunity to come here for prenatal care because before, I gave birth by C-section and I paid a lot. I came only for this consultation, but I am almost due, and I don’t know where I will get the money to pay.”

Health workers say the loss of the free maternity program has undone years of progress. At the Afia Himbi Health Center, head nurse Franck Ndachetere Kandonyi recalls how transformative the initiative had been. “It was a good project, because it even helped us boost our maternity statistics,” he said. “At the time, we were handling between eight and five deliveries, but with the project, we went up to 20 deliveries per month. We noticed it was a good project for us, because it helped women come give birth at the health centre without difficulty, since they knew that by going to the hospital, everything would be provided for free.”

Now, however, attendance has fallen sharply, and many women are left with no choice but to give birth at home.

At the Rehema Health Center, expectant mother Ernestine Baleke — three months from her due date — says she fears the costs she cannot afford. Pregnant with her ninth child, she wonders how she will bring another baby safely into the world amid rising hunger and instability.

The humanitarian situation continues to worsen. Earlier this year, the M23 rebel group seized Goma and Bukavu in a major escalation of the conflict. Since 23 January 2025, intensified fighting between the Congolese armed forces and Rwanda-backed armed groups has displaced more than 700,000 people, according to the UN Office for the Coordination of Humanitarian Affairs. Public institutions have collapsed, and essential services remain severely disrupted.

Aid agencies warn that maternal mortality typically surges in conflict zones, particularly when emergency obstetric services fail and women cannot reach hospitals in time.

For Nabudeba, the crisis has reduced childbirth to a matter of survival — and money. “When I go into labor, I wonder where I will find the money,” she said.