I am still in shock! The tragic death of the spouse of my friend last week Wednesday has left me in a state of mourning. It is one death that should never have happened. It is one of those needless deaths that expose the deplorable state of our health care system.
I tell you, it is unfortunate and unacceptable that many of the labour rooms in our health institutions have become death chambers where expectant mother go to die! Visiting a hospital has become a necessary risk.
For the ordinary citizens who cannot afford to travel abroad for medical reasons, being left to die in the hands of quacks and disgruntled incompetent health workers in our broken health institutions is a hard choice they have to make.
While our political elite can seek quality health care services in the best hospitals abroad, while their spouse can afford to give birth in choice American and British hospitals, Nigeria’s bottom poor are left to die in our rundown public hospitals under perpetually irritated medical workers who vent their frustrations on their patients.
In recent times, I have heard and witnessed enough maternal deaths that have left me wondering why life means nothing to us as a people! Experiencing those tragedies have left me with scared and scarred. I tell you, this latest one was painful because I witnessed the couple’s wedding two years ago!
As if it were yesterday, I remember the joy of the bride and groom. The bride was the happiest on her wedding but now she lies in a morgue, a victim of Nigeria’s decayed health system. With her death, she has become another victim in the endless statistics of maternal death that stalks Nigerian women. The story was pathetic as it is shocking.
On Tuesday night when my friend’s wife began to experience the signs of labour pain, they headed for the hospital where she registered where she was wheeled into the labour room. But she did not return home alive. In the labour room, events took a different turn.
After several hours of trying to deliver her baby, the woman died in the process. What went wrong? How did a woman who walked to the hospital on her feet end up being wheeled to the morgue with an unborn baby?
The husband told me that after several hours of trying to be delivered of the baby, his wife became too weak that she could push no more. But the nurses kept admonishing her to push until she became weakened from the long hours of prodding.
He lamented that in spite of the pleas by family members that his wife be allowed to deliver the baby through Caesarean section, the nurses reprimanded them for attempting to teach them their job. And in any case, there was no gynaecologist in sight! After several hours, the labour room went quiet as her cries stopped. The nurses emerged wearing long faces and avoided breaking the news of his wife’s demise. He stormed into the labour room and only to meet the lifeless of his wife – with the baby also dead. He passed out momentarily and was only revived later. He is still devastated.
In recent years, more Nigerian women are dying from childbirth. The worst cases are those that also affect the babies. Unfortunately, no one seems to be paying attention.
I tell you, hapless and helpless Nigerian women are dying every day in various hospitals and maternity homes across the country! While only a few cases are reported, many maternal deaths never make headlines. Many women die with unborn babies. Yes, people die, some deaths are inevitable, but statistics of maternal mortality points to negligence, unprofessional conduct and in some cases ignorance by the victims.
Our public hospitals are also some of the worst places for pregnant women today. Expectant mothers often have to endure the negligence of abusive and aggressive nurses and other health workers.
I have been in a public hospital where agonising heavily pregnant women were left unattended to for hours. Once, I heard a nurse yell at a heavily pregnant woman, “Madam, stop shouting here, shey na me give you belle?”
Maternal death is also caused by other factors. According to experts, severe bleeding and infections (usually after childbirth), High Blood Pressure during pregnancy known medically as pre-eclampsia and eclampsia, complications from delivery, unsafe, HIV and malaria pose great risks to expectant mothers. But these conditions are preventable if well-managed.
According to a study by Boniface Oye-Okediran, et al published in the Annals of Tropical Medicine and Tropical Health, risks such as obstructed and prolonged labour, which killed my friend’s wife, also account for over a third of the deaths that occur during childbirth.
Oye-Okediran posts in his study that skilled practitioners can recognise and deal with slow progress before labour becomes obstructed and if necessary, ensure that Caesarean section is performed on time to save the mother and the baby. But for women to benefit from those cost-effective interventions, they must have antenatal care in pregnancy, and in childbirth they must be attended to by skilled health providers. But a majority of women could hardly afford quality antenatal care and these conditions degenerate or are not detected during childbirth.
In many public hospitals, the Obstetrics and Gynaecology section is chaotic with a few gynecologists on hand to attend to pregnant mothers. The attitudes of hostile nurses in public hospitals who abuse and harass mostly poor expectant mothers also drive them into the hands of charlatan.
The Maternal Mobility Rate report 2015 updated in 2016 by the World Health Organisation rated Nigeria among five countries in sub-Saharan Africa with the highest number of maternal deaths in the world.
According to WHO, there were an estimated 289,000 global maternal deaths in 2015 with sub-Saharan Africa accounting alone for 62 per cent (179,000) of the deaths. Africa is considered the riskiest region in the world for dying of complications in pregnancy and childbirth.
The MMR was calculated by taking into consideration the deaths of women while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggregated by the pregnancy or its management. India and Nigeria are reported to account for one thirds of global maternal deaths in 2015.
About 40,000 pregnant women died in Nigeria in 2016. It is worse in Northern Nigeria. Maternal deaths occur particularly in areas where women have many babies in short time spans under malnutrition, poor hygiene conditions and lacking access to medical treatment.
The last National Demographic Healthy Survey placed the National Maternal Mortality in Nigeria rate at 545 per 100,000 live births. UNICEF’s estimation of the incidence of maternal mortality in Nigeria is from 800 per 100,000 to 1,000 per 100,000 live births.
Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known. Nigerian women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. Maternal health and newborn health are closely linked.
It was estimated that approximately 2.7 million newborn babies died in 2015, and an additional 2.6 million are stillborn. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby.
Few years ago, the Federal Government launched the national Midwives’ Service Scheme (MSS) to mobilise midwives to selected primary healthcare facilities in rural communities to increase the availability of skilled birth attendants and boost safe delivery services in the country.
Government must ensure that the MSS is working! And if it is not working, it should be reinvigorated. Nigeria cannot continue to be regarded as one of the worst places to be a mother. That Nigeria ranks second in maternal mortality rate in the world is bad enough! Government must act fast to remove Nigeria from this ignominious ranking.
Apart from ensuring that there are adequate healthcare facilities, doctors and midwives to attend to the pregnant women, government should embark on public enlightenment campaigns on the need for ante-natal clinic attendance by pregnant women to see the doctors and midwives on a regular basis. Ante-natal and post-natal hospital attendance is vital to the health of the mother and the baby as well.
Pregnant women should stop patronizing traditional birth attendants, religious and miracle centres for the delivery of their babies. I say this because these centres do not have the expertise to manage complications that may arise from obstructed labour.
But where skilled birth attendants are in short supply, government should train the local birth attendants on basic child delivery skills. And where there are complications, they should refer such cases to the nearest health facility for prompt medical attention.
Since the cost of child delivery in some hospitals has gone up, government should subsidize it so that more pregnant women can access them.
Government should make child bearing a pleasurable experience for women by reducing the cost of ante-natal clinic and child delivery.
Child spacing enhances safe delivery. Hence, women should be encouraged to embrace such practice. Women should be enjoined to embrace some family planning strategies to enable them space their children.
The report on high incidence of maternal mortality in the country is a serious cause for concern. This is a wake-up call on the government to do something urgently to ensure safe delivery in the country.
The Federal, State, Local Governments and concerned Nigerians should take pragmatic intervention measures to tackle this problem headlong…
Hmmmmmmmmmmm, words fail me! I’m weak!