Cases of women dying during childbirth, are still very high and experts suggest way through which the figures can be reduced.
Seyi Oluwole, a teacher in one of the private secondary schools in Lagos, lost his wife at a private hospital due to prolonged labour. He attributed his wife’s death to lack of qualified personnel to assist pregnant women during labour.
Oluwole’s wife’ death was just one of the many cases of women dying during childbirth every year. In some teaching hospitals, reports show that death among women during childbirth has continued to rise thereby giving a lot of concern to medical practitioners.
Available statistics from the Federal Ministry of Health showed that about 1,500 women out of 100,000 live birth die annually. This figure excludes those women who cannot afford to have their babies in the hospitals but die during childbirth.
Years back at the Federal Medical Centre, Lokoja, Kogi State, a survey covering a 20-month period of deliveries showed a maternal mortality rate of 1,310 per 100,000 deliveries. Patients with no antenatal antecedent to medical health centres amount to 75 of mortality rate.
Alexander Okoyomo, a consultant obstetrician and gynaecologist at the centre said there were direct and indirect causes of maternal death in Nigeria. He explained that direct causes were then, those related to obstetric complications of pregnancy, labour and delivery, and the post-partum periods, while indirect causes were those relating to pre-existing medical conditions that may be aggravated by the physiologic demands of pregnancy.
He said the risk of child bearing is compounded by poverty, ignorance and lack of health facilities. Also, traditional desire for large number of children along with unregulated fertility contribute to the problem. While some can’t recognize early warning signs of abnormalities they continue traditional treatment even when clear evidence of danger exists.
According to him, haemorrhage problem accounts for 25 percent maternal death and it is the single most serious risk to maternal health. Severe bleeding during pregnancy, labour or post-partum can rapidly lead to death with medical intervention. Unsafe abortion accounts for approximately 13 percent of maternal death. Since abortion is illegal in the country, some of the abortions are done by untrained personnel and in dirty environments.
Obstructed labour accounts for eight percent maternal death. It often occurs as a result of malnutrition and where girls marrying at a young age are expected to prove their fertility. It is also caused by cephlopelvic disproportion between the size of the fetal head and the maternal pelvic.
He stated that: “Pregnancy is a period of test of a woman’s physical and physiological state. Certain conditions aggravated by pregnancy include poor nutrition, anaemia and malaria. Poor nutrition in childhood, for instance, may lead to an immature pelvic and consequently obstructed labour during childbirth.
The women that are anaemic before pregnancy or labour are less capable of withstanding the extra demand of pregnancy or the blood loss during delivery. Such cases are more prone to death than women who are not anaemic.
The prevailing difficult socio-economic factors seem to contribute largely to this worrisome incidence, as most women and families tend to patronize health facilities around them such as spiritual healers and patent medicine dealers.
The medical practitioner said further that most maternal deaths are preventable. Provisions of skilled care and timely management of complications can lower maternal mortality in our set up. “To reduce complications during pregnancy and labour, it is essential to strengthen primary healthcare infrastructural provisions of antenatal and health care in the community by trained health personnel.”
He said access to low cost and good quality contraceptive to prevent unwanted pregnancies. To reduce incidents of prolonged labour, the first pregnancy should occur when the woman is physically and psychologically mature.
Okoyomo said that every effort aimed at improving the welfare of women, and reducing maternal mortalities should be welcomed, adding that the justification for these efforts to improve maternal health is not only humanitarian but also economic for the society and the world at large, as women constitute a large number of the work force, especially in developing countries.
Omo Omorogieva, then a gynaecologist at Olaiya Maternity Hospital, Ojuelegba, Lagos, said a mother who is well educated would be able to work towards her own development and the development of the children. In other words, an educated woman is more likely to be convinced of the benefits of healthcare during pregnancy and also more easily discouraged from unbeneficial cultural beliefs.
The gynaecologist also argued that women have been very much discriminated against in terms of access to health. “Access to health service implies not only the presence of facilities but also information to women about its availability. It also includes means of reaching the service facilities and ability to afford and make use of the facilities.
He added that proper medical attention and hygienic conditions during delivery could reduce the risk of complications and infection. Given that 15 percent of pregnant women experience life threatening complications and that 40 percent pregnancies require special care, it is necessary to increase medical facilities with trained attendees.
Statistics from World Health Organisation, WHO, showed that 500,000 women die annually in the world from pregnancy related cases. Every minute at least, one woman dies from complications of pregnancy and childbirth. Maternal mortality represents one of the widest health gaps between developed and developing nations.
About 99 percent of all maternal deaths worldwide occurring in developing countries and less than one percent of maternal deaths occurring in developed countries. What this suggest is that maternal deaths can be avoided if proper health resources and services are available to women in developing nations. In developed countries, there are approximately 27 maternal deaths per 100,000 live births each year. In developing countries, the average rate of maternal death is times higher, about 480 deaths per 100,000.
One in four maternal deaths could be prevented by family planning. Access to family care has a great impact on maternal mortality. According to the report 28 to 36 percent of deliveries in Africa are attended by trained health personnel. An estimated 150 million women in developing countries want to delay or stop childbearing but are ignorant of family planning. Therefore a reduction in fertility rate would be expected to be accompanies by a fall in maternal mortality rates.
