wattWhen Ellen Kapamutengo felt severe pain in her lower abdomen, she thought she might be in labor. It was the ninth month of her first pregnancy and she didn’t want to take the chance. With the help of her mother, the 18-year-old girl climbed into a motorcycle taxi and rushed to a hospital 20 minutes away in Malawi’s capital Lilongwe.
At Sector 25 Health Center, they told her it was a false alarm and took her to the delivery room. But things quickly escalated when a routine ultrasound showed her baby was much smaller than expected for this stage of the pregnancy, which could lead to asphyxiation — a condition that limits the baby’s blood flow and oxygen.
In Malawi, about 19 out of every 1,000 babies die during childbirth or within the first month of life. Birth asphyxia is the leading cause of neonatal death in the country and can mean newborns suffer brain damage with long-term effects including developmental delays and cerebral palsy.
Doctors reclassified Kapamutengo, who was expected to have a normal delivery, as a high-risk patient. Using artificial intelligence-enabled fetal monitoring software, further testing revealed the baby’s heart rate was dropping. Stress tests showed the baby would not survive the birth.
Chikondi Chiweza, the hospital’s head of obstetric care, knew she had less than 30 minutes to deliver Kaphamtengo’s baby via caesarean section. Having delivered thousands of babies in some of the city’s busiest public hospitals, she is familiar with how quickly infant survival rates can change during childbirth.
Chiweza, who delivered Kapa Mtengo and the baby was in good health, said the fetal monitoring program was a game-changer for hospital deliveries.
“[In Kaphamtengo’s case]we only find out in hindsight what we did, or the baby was stillborn,” she said.
The software, donated by birth safety technology company PeriGen through a partnership with Malawi’s Ministry of Health and Texas Children’s Hospital, tracks a baby’s vital signs during delivery, giving clinicians early warning of any abnormalities. The number of stillbirths and neonatal deaths at the center has dropped by 82% since it started being used three years ago. It is the only hospital in the country using this technology.
“The time around delivery is the most dangerous for mother and baby,” said obstetrician Jeffrey Wilkinson of Texas Children’s Hospital, who leads the project. “Most deaths can be prevented by keeping babies safe during delivery.”
AI monitoring systems require less time, equipment and technical staff than traditional fetal monitoring methods, which is critical for hospitals in low-income countries like Malawi that face severe shortages of health workers. While regular fetal observation often relies on doctors performing periodic check-ups, which means critical information can be missed in between, AI-powered programs allow for continuous, real-time monitoring. Traditional exams also require doctors to interpret raw data from various devices, which can be time-consuming and error-prone.
Area 25’s maternity ward has 80 doctors and handles approximately 8,000 deliveries each year. While only about 10% of people are trained to perform traditional electronic monitoring, most can use artificial intelligence software to detect abnormalities so doctors can be aware of any higher-risk or more complicated births. Hospital staff also say the use of artificial intelligence has standardized important aspects of obstetric care at the clinic, such as interpretation of fetal health and decisions about when to intervene.
Kapa Mtengo is delighted to be a new mother and believes doctors’ intervention may have saved her child’s life. “They noticed early enough that my baby was in pain and they could take action,” she said, holding her son Justice.
Doctors at the hospital hope to see the technology introduced in other hospitals in Malawi and across Africa.
“Artificial intelligence technology is being used in many fields, and saving the lives of babies should not be an exception,” Chiweza said. “It can really bridge the gap in the quality of care available to underserved populations.”
