While social documentary photographer Paolo Patruno was living in Malawi for six months, a midwife introduced him to the maternal health problems in Africa. Here, he had to opportunity to visit public and private hospitals in rural areas, attend trainings for midwifes and nurses, and even visit pregnant women and mothers in their rural villages. Birth is a Dream began as an entirely personal endeavor, inspired by these combined experiences that heightened his awareness of the complex issue of reproductive health in Africa. Since 2011, Patruno has been documenting maternal health in sub-Saharan Africa, including Ethiopia, Malawi, Uganda and Democratic Republic of Congo, where 200,000 mothers die from complications of pregnancy and childbirth each year.

Patruno takes us inside maternity wards, health centers and clinics. Gaining access to these intimate situations is really a long process and as a male photographer covering one of the most private moments in a woman’s life can be challenging work. In every encounter has has with a new subject, he is sure to pay great individual attention, respect their dignity and make personal connections. To capture this intimate footage, he’s spent hours to days in maternity wards, talking with pregnant women, mothers, midwives and nurses.

The project, which started out as a completely personal undertaking, soon drew the attention of international NGO’s like Save The Children. Patruno is currently planning new trips to Africa as he feels maternal health is too complex a topic and there are many more stories to be told.

All images © Paolo Patruno