FREETOWN, Sierra Leone—Sonita Kamara is in obstructed labor, a life-threatening complication where the baby cannot pass through the birth canal despite strong contractions. She is rushed to Princess Christian Maternity Hospital in Freetown, the busiest maternity and newborn hospital in Sierra Leone. Her baby is in distress. “If we don’t operate within 30 minutes, the baby might die,” says Rosetta Cole, a senior obstetrician-gynecologist, as she prepares to perform an emergency cesarean section.