Cases of post natal mortality, despite advancement in medicine
in this part of the world, is not on the decline. SADE OGUNTOLA reports
that socio-economic and socio-cultural factors in Nigeria are major
causes and the situation may not change too soon.
JUDAH Adekola lost his wife in 2007, three days after their son was born. It was the easiest birth out of the three his wife had had. According to Judah, his wife was deemed to have fully recovered by the doctor which prompted her being discharged from hospital the second day after giving birth.
However, at dinner after she arrived home, Judah recalled that Hannah (his wife) began to feel some pressure in her diaphragm and chest area. Within one hour, the pain had become so bad that she asked to be taken to hospital. But she lost consciousness on the way to the hospital and died later that evening reportedly due to severe internal bleeding.
Sadly, the case of Hannah Adekola is all too familiar in Nigeria, where, in spite of advances in medical care, maternal mortality arising from pregnancy or birth is still very common. Though, maternal mortality worldwide has decreased by nearly half in the last decade and a half, Nigeria still faces a heavy burden of being the world leader in the total number of maternal deaths per year.
According to the United Nations Population Fund (UNPFA), Nigeria is responsible for 10 per cent of the global burden of maternal mortality. It is estimated that 111 Nigerian women die during childbirth daily.
The cause of death varies from woman to woman. Some result from infection, some hypertension, some excessive blood loss, and some “psychosocial distress”. Psychosocial distress is a broad term that covers depression, stress and dissatisfaction with life.
The period following birth in Africa is often marked by cultural practices. Many communities throughout Africa observe practices that keep mothers and babies indoors for the first month after birth – a period of seclusion.
If mothers or babies become ill during the period of seclusion, seeking formal health care is often delayed. Yet, delay in seeking appropriate medicare may result in death or disability, as well as missed opportunities to promote healthy behaviours affecting women, newborns, and children.
According to medical experts, half of all postnatal maternal deaths occur during the first week after the baby is born, and the majority of these occur during the first 24 hours after childbirth.
“Quite a number of things that cause these deaths are related to events during pregnancy and childbirth. For instance, a woman that has hypertension in pregnancy, known medically as preeclampsia, stands a higher risk of death if this is not managed adequately,” said Professor Adetunji Adeniji, a consultant obstetric and gynaecologist, at Ladoke Akintola University of Technology Teaching Hospital Ogbomoso, Oyo State. Professor Adeniji explained further that severe bleeding after childbirth is a major killer of women in the first week after the baby is born but “many a times, patients come in and there is no blood to use. If the bleeding lingers, the woman may die.”
Apart from this, infection, according to Adeniji, causes another 10 per cent of maternal deaths, mostly during the postnatal period. “The conditions under which many women deliver are not optimal in many hospitals. Some (hospitals) do vaginal examination for women in labour using unsterilsed gloves, thus heightening the risk of infection,” he added.
Dr Dattigo
Unfortunately, when signs of these complications are not picked or discovered early the patients, who should be promptly referred for specialist care, for example, at a teaching hospital, they end up with severe ill health that could end up in stroke; some may not even be able to get pregnant years after.
Despite increasing awareness among pregnant women in Nigeria concerning their health status, Professor Adeniji believes that money is another major constraint most Nigerian families face. As most women “are financially constrained,” he explained, “they resort to alternatives such as, birth attendants (TBA), a group trained to give some basic care in terms of childbirth. Unfortunately, some TBAs because of monetary or economic gains tend not to refer these women (to hospitals) until complications stare them in the face, by which time it may even be too late for an expert to intervene.”
Certainly, the frequency of deaths in women days after child birth varies from one community to another. In Northern Nigeria, where six to seven of every 10 women still deliver their babies at home and only come to the hospital if there is a problem, many deaths are recorded, says Dr Lamaran Dattigo, a consultant obstetric and gynaecologist, at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State.
Giving a new mother a hot bath and intake of pap that contains potash, a cultural practice that is common among the uneducated rural dwellers, Dr Dattigo said, had also accounted for some women developing heart failure which might result in death later.
While noting that “pregnancies that are too often, too close and too many, increase the chances of a woman dying from pregnancy-related problems,” Dattigo stated that “excessive bleeding after delivery, a major cause of death pregnant women and childbirth is common among women that have delivered many babies.
“Once a woman has five, six children, she has a higher risk of developing complications during childbirth and after, compared to another woman who has maybe one or two kids and who are properly spaced.
JUDAH Adekola lost his wife in 2007, three days after their son was born. It was the easiest birth out of the three his wife had had. According to Judah, his wife was deemed to have fully recovered by the doctor which prompted her being discharged from hospital the second day after giving birth.
However, at dinner after she arrived home, Judah recalled that Hannah (his wife) began to feel some pressure in her diaphragm and chest area. Within one hour, the pain had become so bad that she asked to be taken to hospital. But she lost consciousness on the way to the hospital and died later that evening reportedly due to severe internal bleeding.
Sadly, the case of Hannah Adekola is all too familiar in Nigeria, where, in spite of advances in medical care, maternal mortality arising from pregnancy or birth is still very common. Though, maternal mortality worldwide has decreased by nearly half in the last decade and a half, Nigeria still faces a heavy burden of being the world leader in the total number of maternal deaths per year.
According to the United Nations Population Fund (UNPFA), Nigeria is responsible for 10 per cent of the global burden of maternal mortality. It is estimated that 111 Nigerian women die during childbirth daily.
The cause of death varies from woman to woman. Some result from infection, some hypertension, some excessive blood loss, and some “psychosocial distress”. Psychosocial distress is a broad term that covers depression, stress and dissatisfaction with life.
The period following birth in Africa is often marked by cultural practices. Many communities throughout Africa observe practices that keep mothers and babies indoors for the first month after birth – a period of seclusion.
If mothers or babies become ill during the period of seclusion, seeking formal health care is often delayed. Yet, delay in seeking appropriate medicare may result in death or disability, as well as missed opportunities to promote healthy behaviours affecting women, newborns, and children.
According to medical experts, half of all postnatal maternal deaths occur during the first week after the baby is born, and the majority of these occur during the first 24 hours after childbirth.
“Quite a number of things that cause these deaths are related to events during pregnancy and childbirth. For instance, a woman that has hypertension in pregnancy, known medically as preeclampsia, stands a higher risk of death if this is not managed adequately,” said Professor Adetunji Adeniji, a consultant obstetric and gynaecologist, at Ladoke Akintola University of Technology Teaching Hospital Ogbomoso, Oyo State. Professor Adeniji explained further that severe bleeding after childbirth is a major killer of women in the first week after the baby is born but “many a times, patients come in and there is no blood to use. If the bleeding lingers, the woman may die.”
Apart from this, infection, according to Adeniji, causes another 10 per cent of maternal deaths, mostly during the postnatal period. “The conditions under which many women deliver are not optimal in many hospitals. Some (hospitals) do vaginal examination for women in labour using unsterilsed gloves, thus heightening the risk of infection,” he added.
Dr Dattigo
Unfortunately, when signs of these complications are not picked or discovered early the patients, who should be promptly referred for specialist care, for example, at a teaching hospital, they end up with severe ill health that could end up in stroke; some may not even be able to get pregnant years after.
Despite increasing awareness among pregnant women in Nigeria concerning their health status, Professor Adeniji believes that money is another major constraint most Nigerian families face. As most women “are financially constrained,” he explained, “they resort to alternatives such as, birth attendants (TBA), a group trained to give some basic care in terms of childbirth. Unfortunately, some TBAs because of monetary or economic gains tend not to refer these women (to hospitals) until complications stare them in the face, by which time it may even be too late for an expert to intervene.”
Certainly, the frequency of deaths in women days after child birth varies from one community to another. In Northern Nigeria, where six to seven of every 10 women still deliver their babies at home and only come to the hospital if there is a problem, many deaths are recorded, says Dr Lamaran Dattigo, a consultant obstetric and gynaecologist, at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State.
Giving a new mother a hot bath and intake of pap that contains potash, a cultural practice that is common among the uneducated rural dwellers, Dr Dattigo said, had also accounted for some women developing heart failure which might result in death later.
While noting that “pregnancies that are too often, too close and too many, increase the chances of a woman dying from pregnancy-related problems,” Dattigo stated that “excessive bleeding after delivery, a major cause of death pregnant women and childbirth is common among women that have delivered many babies.
“Once a woman has five, six children, she has a higher risk of developing complications during childbirth and after, compared to another woman who has maybe one or two kids and who are properly spaced.