W.hen Ellen Kaphamtengo felt a sharp 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 any risks. With the help of her mother, the 18-year-old hopped on a motorcycle taxi and rushed to a hospital in Malawi’s capital, Lilongwe, 20 minutes away.
At the Area 25 health center they told her that it was a false alarm and they took her to the maternity hospital. But things quickly escalated when a routine ultrasound revealed that her baby was much smaller than expected for her stage of pregnancy, which can cause asphyxiation, a condition that limits blood flow and oxygen to the baby.
In Malawi, approximately 19 out of every 1,000 babies Dies during childbirth or in the first month of life. Birth asphyxia is a leading cause of neonatal mortality in the country and can mean newborns suffer brain damage, with long-term effects including developmental delays and cerebral palsy.
Doctors reclassified Kaphamtengo, who was expecting a normal delivery, as a high-risk patient. Using AI fetal monitoring software, additional testing found that the baby’s heart rate was decreasing. A stress test showed that the baby would not survive delivery.
The hospital’s head of maternal care, Chikondi Chiweza, knew she had less than 30 minutes to deliver Kaphamtengo’s baby by caesarean section. Having delivered thousands of babies in some of the city’s busiest public hospitals, she was familiar with how quickly a baby’s chances of survival can change during birth.
Chiweza, who delivered Kaphamtengo’s baby in good health, says the fetal monitoring program has been a game-changer for hospital deliveries.
“(In the Kaphamtengo case), we would only have discovered what we did later or when the baby was stillborn,” he says.
The software, donated by the birth safety technology company. PeriGen through a partnership with the Malawi Ministry of Health and texas children’s hospitaltracks the baby’s vital signs during delivery and gives doctors an early warning of any abnormalities. Since they began using it three years ago, the number of stillbirths and neonatal deaths at the center has decreased by 82%. It is the only hospital in the country that uses this technology.
“The time around delivery is the most dangerous for mother and baby,” says Jeffrey Wilkinson, an obstetrician at Texas Children’s Hospital, who runs the program. “Most deaths can be prevented by making sure the baby is safe during the birth process.”
The AI monitoring system requires less time, equipment and fewer qualified staff than traditional fetal monitoring methods, which is critical in hospitals in low-income countries like Malawi, which face a severe shortage of healthcare workers. Regular fetal observation often relies on doctors carrying out periodic checks, meaning critical information can be missed during intervals, while AI-backed programs perform continuous, real-time monitoring. Traditional checks also require doctors to interpret raw data from multiple devices, which can be time-consuming and subject to error.
The Area 25 maternity ward attends to around 8,000 births a year with a staff of 80 doctors. While only about 10% are trained to do traditional electronic monitoring, most can use AI software to detect abnormalities, so doctors are aware of any riskier or more complex births. Hospital staff also say that the use of AI has standardized important aspects of maternity care in the clinic, such as interpretations about fetal well-being and decisions about when to intervene.
Kaphamtengo, who is excited to be a first-time mother, believes the doctor’s interventions may have saved her baby’s life. “They were able to find out that my baby was in distress early enough to take action,” she says, holding her son Justice in her arms.
Doctors at the hospital hope the technology will be introduced to other hospitals in Malawi and across Africa.
“AI technology is used in many fields and saving babies’ lives should be no exception,” says Chiweza. “It can really close the gap in the quality of care that underserved populations can access.”