Regina Patricia Pepa: Central African Republic midwife taking on challenges to help women in

Bangui-For more than 30 years Regina Patricia Pepa, a midwife and president of the Central African Republic's Midwives and Birth Attendants Association, has supported thousands of women throughout their journey to motherhood and become a reference for many generations of caregivers, while remaining grounded by the challenges and realities of childbirth. In her long carer she has combined hands-on experience with teaching, heading the Bachelor's programme in Nursing Sciences at Bangui University where she lectures.

Inspired from childhood
It all began in her childhood, seeing her grandmother, a traditional birth attendant, helping women. But it was the emotions that women went through during labour and childbirth that struck her most, sparking the desire to help. She understood early on that behind every birth lies a story, a vulnerability, but also immense strength. With time, this desire grew stronger. Despite many opportunities after high school, she chose to become a midwife.

Creating the right connection
In her work, one priority stands out: how women are received. Taking the time to talk, ask questions and understand each patient's experience builds trust and reduces stress, even in difficult situations. This makes significant difference in labour and childbirth in the country where lack of adequate health care resources in an emergency context pose great challenges. For Regina, care is not simply having technical knowledge. It also entails essential relational aspects, creating bonds well beyond the maternity ward. She also stresses that caregivers must set aside personal challenges. "Patients come above all to seek support and relief," she says.

Learning from experience
One defining moment in her career came early on, when she faced a difficult birth of a baby with high birth weight, alone. Thinking she could manage, she delayed referring the case to a more equipped facility. Gradually, complications arose. The mother grew exhausted and the delivery became complicated. She recalls the stress, doubt and her prayers at the time. The baby required prolonged resuscitation. Both mother and child survived. But the episode left a deep mark. It shaped her practice and guides her teaching today: knowing one's limits and organizing referrals in time.

Daily challenges
Today, Regina's commitment remains strong despite the challenges. The lack of medicines and resources complicates care and strains teams. Some women arrive without the means to pay for treatment. In such cases, doing nothing is not an option. "When you have nothing, you become ineffective," she points out. She believes pregnancy monitoring and birth spacing are essential to protect the health of mothers and children. The need for midwives is also critical. "We need more midwives. We are understaffed," she says, encouraging young people to pursue the profession.

Finding meaning in work
Despite the constraints, certain moments remind her why she chose this path. The baby's first cry remains powerful. "Seeing the mother and the child healthy gives meaning to all my efforts," she says. Beyond these moments, it is also the relationship with women that sustains her commitment. The bond created at birth often continues beyond the maternity ward. Some keep in touch, share updates even years later. These signs of trust and gratitude show that her role goes beyond immediate care to accompany, reassure and be present at the critical moments. These aspects give her work true value, she says.

A shared responsibility
Maternal health is a collective effort. Regina's experience has taught her that much is decided long before arrival at the hospital. The timing of care is crucial, and delays can limit intervention.

"If a woman is kept at home for too long before coming to deliver, what can the midwife do?" she says. For her, the outcome of childbirth depends on many factors, often linked to early decisions. She emphasizes the need to anticipate better, improve care and strengthen skills. Above all, she insists on a simple priority: ensuring women arrive in time and receive appropriate care in the right conditions.