HOME BIRTH DELIVERY WOES…

HOW COUPLES GROIN OVER STILLBIRTHS, DEATHS OF MOTHERS

By Ima Nkanta and Joy Hanso

If statistics were available, the numbers would scare a hell out of anyone who loves life, particularly new-borns and their mothers. From our investigations, the prevalence of stillbirths in communities is alarming, begging for urgent attention by government and nongovernmental organizations.

Abigail, her real name withheld, has been thrown into near coma. She has since remained inconsolable after suffering stillbirth two months ago. Her case really calls for concern. Married almost ten years ago, all efforts to conceive became futile.

At 38, she began to nurse fears of going childless; though medical reports showed she was still within her reproduction age. Since she lives with her husband and his siblings, including the mother-in-law in a family apartment, her anxieties can be well understood, as she made regular visits to churches for prayers. And her prayers were answered!

Her protruding tummy couldn’t hide the cheery news her family members and friends were expecting. But her joy was turned to mourning. She suffered prolonged labour due to complications that resulted in stillbirth.

Information available indicated that though she had registered with St. Luke Hospital, Anua, Uyo and was attending routine prenatal care, she and her family member had a different idea on where and how the baby would be delivered. Her elder sister said to be a nurse with a private clinic in Uyo had assured her she would undertake the delivery at home without any assistance – she claimed of her endowment with gift in midwifery. So, both agreed that once labour begins, Abigail would turn into her residence – a single room apartment in a downtown suburb of Uyo.

The poor woman struggled on the mat throughout the night into early hours of the next day, battling between life and death. Neighbours familiar with the incident said the baby head was bigger than her birth canal and needed better medical assistance. The child died because prolonged labour.

You could call that an act of wickedness but this is what thousands of young expecting mothers go through in the hands of quack midwives and home birth attendants. 

Two months after, the woman is yet to be consoled. The husband who narrated how he lost the baby blamed spiritual attacks. He said the baby came covered by thin nylon on the face which didn’t let him breathe. But medical personnel this writer spoke to disagreed with his belief. A midwife at the University of Uyo argued that the unborn baby died of exhaustion due to prolonged labour. 

Etieneobong, 16, has a similar sad experience. She went to live with the parent of a boy responsible for the pregnancy in a community in the outskirt of Eket. She attended the cottage hospital for prenatal care. A month to her due date she started feeling pain in her lower abdomen and was immediately placed on prayers, and later moved into the pastor’s apartment when labour started. In her case, the pastor’s wife was said to have insisted taking delivery of the baby, as her case required prayers to wade off ‘evil spirits’ so she deliver without difficulties.

Her baby was also stillborn as a consequent of prolonged labour. The teenager almost bled to death as the placenta hung for hours. Sensing trouble, the guardian of the poor girl rushed her to a private clinic, which rejected admitting her but referred to Immanuel Hospital, Eket, where she was immediately infused with blood to resuscitate her. She was lucky help came in time. Others don’t live to tell the stories of what they suffered in the hands of quack midwives.

But why should pregnant mothers endure for nine months and instead of approaching the hospital for delivery of their children, put their lives in danger in the hands of quack midwives?

Our discoveries are quite instructive. It is pertinent to know that even in the urban areas where we have medical facilities, many still prefer risking their lives with the patronage of traditional home birth attendants. Even educated people still patronize traditional birth attendants (TBAs) for delivery over qualified medical personnel.

In interviews conducted with some patrons of traditional birth attendants (TBAs), it was noticed that most of them are exposed to modern medical facilities, but prefer to deliver at TBAs centres. It is the beliefs of some pregnant women that community midwives use some herbs that can aid easy delivery. They also have the notion that there are some spiritual forces that could make delivery difficult and that the traditional birth attendants have herbs that can expel such forces. 

But not all traditional birth attendants agreed on this. Mrs. Eno James in Uyo who is a TBA, argued that not all cases of birth experience complications. She has been in the business of home birth delivery for many years now. Her interest in the trade is money. She trained as a TBA and she is practicing it as a business.

Like her colleagues, she prefers pregnant women to deliver with them than go to the hospital and urges expectant mothers to visit her for check-ups, so that in cases where the baby is not positioned properly, she can adjust the child in the womb. She also gives herbal treatment to women with swollen feet and other symptoms to help them pass the excess water away through urine.

Ma James boasted that delivering at home is best because prayers are made to drive away evil forces. The expectant mother is to stay at her centre right from seventh month pregnancy till delivery. During this period, she’s not allowed to visit any clinic for proper check up. However, she accepted the fact that complicated delivery should be immediately taken to the hospital.

Apart from the fear of evil forces, the high hospital bill too contributes to increase in patronizing local birth attendants. Diana Inyang, a midwife in a cottage hospital, said: ”Pregnant women go to the traditional birth attendant because it’s affordable.” Inyang also pointed out that although there were many pregnant women who could afford hospital facilities; their fear often is that most hospitals don’t have capable hands like the TBAs.  

Nurse Diana made it known that hospitals are now collaborating with TBAs to train them properly on delivery. However, the TBAs are trained to refer complicated cases to the hospital. According to her, there are two kinds of referrals. First, if there is complication the first place to run to is the primary health centre. Secondly, if the case is more than what they can handle, it should be referred to the general hospital.

The midwife advised that when a woman is pregnant she should register in a hospital, attend antenatal regularly for follow up, run all the necessary tests and when it is time for delivery, she should come straight to the hospital so as to ensure the safety of the mother and child. She stressed the necessity of antenatal examination and frowned at women who wait until emergency before rushing into the hospital for delivery. 

According to the midwife there could be side effect because the case has not been followed up in the hospital to know the patient’s health challenge. Some women do come in with high blood pressure while others with complicated illnesses.

Notwithstanding, Nurse Diana noted that the main cause of maternal and infant mortality is ignorance of health status and failure to follow medical advice. She hopes public health officials will embark on more sensitization and advocacies on pregnancy and child birth, while also discouraging women from risking their lives with home or traditional birth attendants.