The uncertainty, challenge, pain, and joy of becoming a mother is a milestone that the majority of women around the world will experience in their lifetimes. It's estimated that each minute of every day, an average of 267 babies come into the world.
But for some mothers, birth is a harrowing, life-or-death experience. A woman in Tanzania is roughly 100 times more likely to die during childbirth than a woman in Sweden, for example. And around the world, some 830 women per day die from preventable causes related to pregnancy and childbirth, according to the World Health Organization.
It's a global health crisis, and a reality that photographer and filmmaker Paolo Patruno witnessed first-hand while on assignment in East Africa.
"I started my project in Malawi, where the words for pregnancy in the local language — pakati and maenad — translate into 'between life and death' and 'sick,'" Patruno wrote.
Severe bleeding, infections, and high blood pressure before and after birth are just some of the complications that are easily treatable in wealthy countries but are leading causes of death in developing ones. And the risk of death during childbirth is highest for teenage girls under the age of 15, many of whom have been forced into early marriage.
"Girls who become pregnant have to leave school. This has long-term implications for them as individuals, and for their families and communities. They have to take on responsibilities as adults. Girls become women too early, missing their childhood and adolescence," Patruno told Refinery29.
Since 2011, the photographer has dedicated his work to documenting these young women's stories both in Africa and in the U.S. through his project Birth Is A Dream. Using portraits and videos, Patruno hopes to raise awareness about the issues of child marriage, teen pregnancy, sexual health, and maternal mortality worldwide.
Ahead, some of Patruno's stunning portraits of teenagers who were forced to drop out of school, marry, and become mothers too early in a remote part of Cameroon. Patruno's series is produced in collaboration with the Cameroonian nonprofit group Human Is Right.
Photo caption: 17-year-old Morin and her baby. She is just one among the thousands of teenage mothers in Cameroon.
Caption: Rose, 16 years old, is currently breastfeeding her first child of five months. Rose dropped out of school at the end of primary six due to a lack of financial support from her family. She lives in a very remote and rural area in the tropical highland forest in Cameroon, and her family makes their living through farming cocoa. Africa has the world’s highest rate of adolescent pregnancy, a factor that affects the health, education, and earning potential of millions of African girls.
Photo: Paolo Patruno.
How did you first become interested in photographing young mothers in Cameroon?
"Since 2011, I have been working on my long-term documentary project Birth Is A Dream, which aims to document and raise awareness about maternal and reproductive health in Africa. Child marriage and early pregnancy are among main causes for maternal mortality and morbidity in Africa, since girls become pregnant too early, when their bodies are not yet ready for giving birth. That’s why in 2014, I travelled to Cameroon with the intent to document child marriage and early pregnancy for girls [living] in rural areas."
Caption: The father of the baby never came to take his responsibilities, so Rose’s sister is helping in taking care of her baby, as Rose’s mother already passed away.
Photo: Paolo Patruno.
Caption: In the village of Bakumba, and in Cameroon more broadly, girls get pregnant and have their first babies very early, before the age of 18. They become women when they are still too young, taking on responsibilities as adults.
Photo: Paolo Patruno.
Africa has the world's highest rate of teen pregnancy, according to the U.N. Population Fund. What are some of the factors that lead to this?
"The lack of sex education and being unaware of the consequences of unprotected sex often lead to unwanted pregnancies."
Caption: A teen mother and her baby in Bakumba, Cameroon.
Photo: Paolo Patruno.
Caption: Christine, 17, got married when she was 15, and lost her first child when she was 16. Christine dropped out of school in secondary two because of lack of financial support from her family. Now she is seven months pregnant and she is also taking care of her younger sister, 3-year-old Mayron.
Photo: Paolo Patruno.
Caption: Peter, Christine's husband, is 22 years old. They got married when they were 19 and 15, respectively. They lost her first child just three days after he was born, most likely due to an umbilical cord infection.
Photo: Paolo Patruno.
Caption: Christine is also taking care of her younger sister, Mayron, who is 3 years old.
Photo: Paolo Patruno.
Caption: Christine outside her house in the early morning, ready to leave to go farm cocoa in the forest.
Photo: Paolo Patruno.
How did you meet these young women? Was it difficult for you to build trust with them, and for them to feel comfortable sharing their stories with you?
"Working in partnership with the local NGO Human Is Right, I had the opportunity to make close connections with all of the members of the community, which allowed me to tell true stories of life there. As always happens when I produce my documentaries, I spent some time with these girls to build a personal connection before starting to use my camera. And the relationship became stronger day after day, so they felt comfortable in sharing their personal and intimate stories with me."
Caption: Christine, 7 months pregnant, is still doing heavy tasks such as farming cocoa.
Photo: Paolo Patruno.
Caption: Among daily duties, 7-months-pregnant Christine has to provide water for the family, which is used for cooking, cleaning clothes, and personal hygiene.
Photo: Paolo Patruno.
What were the day-to-day lives of the young women you photographed like?
"Waking up very early, preparing meals for the all of the family, collecting water, farming, taking care of the babies, and any other home duties."
Caption: Christine and her little sister carry heavy water tanks on their backs. Girls in Africa too often miss their childhoods.
Photo: Paolo Patruno.
Caption: Christine during an antenatal visit provided by Polette, the local nurse who lives in the village of Bakumba.
Photo: Paolo Patruno.
How can we help support these young women, and help end child marriage and teen pregnancy?
"After more than 10 years traveling in Africa, I think education and empowerment should come first. Moreover, even if in each country we can find different contexts leading to and pushing for child marriage and early pregnancy, we should support…social and cultural change for the role of women and girls.
"[But] we can’t think that easy and fast help can come from outside without a deep involvement from the men inside the communities, and from families."
Caption: Agnes is 15 years old. She is just one among the thousands of teenage mothers in Cameroon.
Photo: Paolo Patruno.
Caption: Girls drop out of school, usually before the end of secondary school, and start working in the home very early. Many also become women too early, totally missing their childhoods.
Photo: Paolo Patruno.
Caption: Anita is 15 years old and pregnant.
Photo: Paolo Patruno.
Caption: Many girls in the village drop out of school early, have sexual relationships, and get pregnant before the age of 18. The elders of the village say that was not happening in their times, but has mostly happened in the last decade due to civilization and modern times.
Photo: Paolo Patruno.
What is your advice to other young women who want to use photography as a vehicle for social justice and human rights?
"Photography is a great vehicle for social change. The main advice I can share is to find a good story, a story you love to tell. The camera is just a tool, but the story always comes first. Use your passion and empathy, try to build a strong connection with the character of your story."
Caption: 16-year-old Foebe and her baby in Bakumba, Cameroon.
Click here to read more about how two women, Danedjo and Mairamou, are fighting back against child marriage in Cameroon.
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