A photographer from Stockholm, Moa Karlberg, has captured incredibly intimate photographs of women’s faces during childbirth. Her intention is to shed light on the contrasting healthcare experiences of expectant mothers in Europe and Africa.
For her series titled “Hundred Times The Difference,” Moa Karlberg documented labor processes in both Sweden and Tanzania. She stayed with the mothers throughout these pivotal moments, ranging from as short as ten minutes to as long as 18 hours.
In Europe, the mothers had access to painkillers, nitrous oxide, and a continuous stream of medical assistance. However, in Tanzania, the women found themselves in clinics that lacked essential medical supplies such as blood and formula. Moreover, they were often located too far away from trained midwives.
A woman grimaces in agony during childbirth in one of a series of intimate black and white shots capturing mums-to-be during labour
Swedish photographer Moa Kalberg captured a woman in Tanzania as she closes her eyes during childbirth
One photo from Karlberg’s series Hundred Times The Difference sees a woman lie in a bed, with a gentle frown as she has contractions
But despite the dramatically different circumstances, Moa told FEMAlL: ‘I was struck by the many similarities of women’s expressions. Everybody goes through the same physical phases, even though Swedish women use painkillers and nitrous oxide that most Tanzanian women don’t have access to.
‘It is when complications arise that the external disparities become more obvious. Many Tanzanian clinics lack resources and equipment like specialists, anesthesia, blood supplies, premature care and infant formula. Some women are just too far from any clinic or skilled birth attendant. These are leading factors causing maternal deaths.
The pictures are incredibly personal but Moa observes: ‘These photos show only faces – no private body parts, blood or any other revealing details. I find it interesting that people, including myself, find photos of faces even more intimate than naked bodies. A facial expression tells a lot, and most people can identify with that.
‘When I took the photos it felt less invading to focus on the women’s faces than other body parts. A birth is a private moment that most people only witness when their own children are born.
A mother appears calm despite being in active labour in Moa Karlberg’s striking set of photographs of women in childbirth
Karlberg noted that Swedish women took nitrous oxide and painkillers and could make more noise as they were in private rooms
Karlberg says that despite the huge disparities in women’s lifestyles in Sweden and Tanzania she was struck by the similarities in their facial expressions
The photographer says that the women and their partners could have asked her to leave at any point but never did
‘As a photographer I have the possibility to enter spaces and meet people that I otherwise never would have seen. This is what I like the most about my job. I always try to act as respectful as possible, not to be in the way and not to shoot too many exposures. Sometimes, not only when photographing child births, I feel like invading private moments.
‘This can be both scary and fascinating, but if the people say yes it means they actually expect me to take the photos. The parents in this project could tell me to leave at any time, but no one did.’
In many of the photos, the Tanzanian women look calmer and more relaxed than their Swedish counterparts, which Moa says could be about the stage of their labour – and whether the women had a room of their own.
Karlberg hopes her series will help provoke discussion about the huge disparities in healthcare for women around the world
Karlberg shot her first childbirth as an intern at a Swedish newspaper when she found herself sharing that ‘intense and crucial moment’
She said: ‘The photos are taken in different stages of labour. The only two taken during the very last pushing phase are Swedish.
‘I think the differences on this level are mostly individual, but from the ones I photographed it seemed like the Swedish women were acting out and screaming more. Perhaps because everybody has her own room in Sweden, whereas Tanzanian women normally share a room with many others.’
The origins of Moa’s fascination with the capturing labour began as an intern at a Swedish newspaper when she was sent with a reporter to follow a woman through the process of giving birth.
She said: ‘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. Years later, I started this project out of curiosity to explore these authentic expressions deeper.
The Swedish births Moa witnessed, the more lucky she felt Scandinavian women especially compared to less-resourced hospitals around the world, including the clinics of Tanzania
Tanzanian women often go into childbirth without the option to take pain relief, let alone blood supplies or infant formula
‘I started in 2012 in Sweden by contacting mothers who would let me photograph them giving birth. Out of the ones that said yes, I missed a whole lot due to practical circumstances. You cannot really schedule a birth.
‘Many times I was out of town or busy with another assignment when it was time for the women to go to the hospital. After a few births I got tired of the project and took a long break from it. I wanted to stop the project completely, but couldn’t get it out of my head. So I gave it another try.
‘After witnessing several births, I realised how lucky Swedish women are to give birth in this country with access to top quality healthcare and extremely low maternal mortality rate. I think it is extremely unfair that not all women in the world have the same possibilities. Giving birth in safe circumstances should be a human right, one shouldn’t risk dying for it.
Karlberg said that: ‘It is when complications arise that the external disparities become more obvious’ as Swedish hospitals have everything needed to attend to a medical emergency’
A woman wears an expression of intense concentration on her face as she goes through the stages of labour in Tanzania
A woman, who appears to be little more than a teenager, is captured appearing to gaze into a point in the far distance
Karlberg discovered that maternity wards in Sweden didn’t mind her being there to capture the experience as long as she respected staff
‘I came up with the idea of raising awareness about this issue by taking similar photos in a country with a significantly higher maternal mortality rate than Sweden. I contacted various NGOs before I found one that was able to help me.
‘There are around 20 countries, most of them in Sub Saharan Africa, that have worse mortality rates than Tanzania, but still a Tanzanian woman is a hundred times more likely to die during pregnancy and childbirth than a Swedish woman.’
Despite the growing craze for pictures and even video during labour, Moa stresses that many women she approached wanted to keep their labours private.
‘The ones that said yes were more relaxed or did not care if there was an extra person in the room. They would also like to have the photos afterwards, it’s a unique document of a big life event,’ she said.
‘In Sweden, I got in touch with the mothers well in time before giving birth, and then they called me when it was time to go to the hospital. The maternity wards didn’t mind as long as I respected the staff and the ones who didn’t want to appear in pictures.
Karlberg says she doesn’t want to raise awareness by providing facts and numbers, ‘What I want is to provoke real feelings and identification’
One mother-to-be is seen with an acupuncture needle in a pressure point between her brows to help ease the pain of childbirth
Karlberg gained access to clinics where Tanzanian women came to have their babies through NGOs and sympathetic translators
“In Tanzania, I was unable to dedicate enough time to apply the same method. Instead, I sought assistance from a non-governmental organization (NGO) that connected me with various clinics. With the help of a compassionate translator, I approached women on the spot and asked if they were willing to participate. Surprisingly, most of them agreed.
My hope is that this work will ignite discussions about the significant disparities in healthcare for women across the globe. I aim to go beyond presenting mere facts and figures, as many people already possess theoretical knowledge on the subject.
What I strive for is to evoke genuine emotions and foster identification. Ultimately, I hope this will lead to concrete actions, both on an individual and political level. Many countries have fallen short of achieving the Millennium goals, so let us hope that the new sustainable development goals can expedite improvements in global maternal health.
In the meantime, I continue to document births through my website www.forlossningsfoto.se. I still consider it a profoundly special event to capture, as the range of emotions surrounding the arrival of a new life is exhilarating for a photographer to witness.”