Delays In Accessing Care Makes Pregnancy, Labour Fatal | Independent Newspapers Limited
Newsletter subscribe


Delays In Accessing Care Makes Pregnancy, Labour Fatal

Posted: Aug 31, 2016 at 10:25 pm   /   by   /   comments (0)

I was brought to the facility via the sea, early in the morning, around 4 a.m., after two days of labour. I first visited some traditional birth attendants (TBAs), because there was no doctor at the PHC. When they could not handle my case, I was thereafter brought to the private hospital, where I finally delivered through CS.”

These were the words of Charity Felix, a 32-year-old mother who survived prolonged labour. Charity told this reporter that she went through a perilous sea journey at night during labour to access care at the only privately-owned Medical Centre at Igbologun.

Igbologun is one of the riverine communities in Amowo-Odofin Local Government Area, Lagos, where pregnant women and children pay through their nose to live, although maternal services are free in Lagos State.

Igbologun 1

The hard-to-reach community, also known as Snake Island, which is made up of largely childbearing women and children, has only one poorly functioning Primary Health Centre (PHC).

Charity represents the plight of women and children in the 20,000 island populace, with poor access to health service.

Similarly, Elizabeth Duke, a 20-year-old, and her baby, are among the lucky ones whose survival was made possible by Igbologun Medical Centre. That was after paying the stiff price of navigating through the hazardous sea journey to obtain health care.

Her words: “I was in excruciating pain; I didn’t know I could survive the journey. I almost died at sea. I took about 30 minutes boat drive that night from my community – Sabokoji. Finally, I arrived the Medical Centre and delivered through CS,” Elizabeth told this reporter.

However, both Charity and Elizabeth were detained in the hospital, until their husbands were able to pay the N160, 000 each for the caesarian section (CS).

Dr. Sodipo Gbolahan, Medical Director, Igbologun Medical Centre, confirming the experiences of Charity and Elizabeth, explained that he set up the only hospital in Snake Island, Apapa, Lagos, to save women’s lives.

“Elizabeth had obstructed labour. “I never knew the baby would survive. When she came here, her case was serious, I had to struggle to save her life first, but I was surprised that she and the baby survived. Although the baby had jaundice, he came out fine,” Gbolahan, a general practitioner told Independent.

Dr. Sodipo, also said: “Charity was brought to his clinic around 2 a.m. by a traditional birth attendant where she had gone to give birth.”

Though Charity and Elizabeth are alive to tell their stories, the reverse is the case for Aminat Douglas. She started bleeding one late night, five months into her pregnancy. Aminat died before she could be rushed via the risky boat journey to the Medical Centre.

“Nearly every minute, one woman dies from the complications of pregnancy and childbirth. That is more than 500,000 dying each year. 99 per cent of these deaths occur in the developing countries,” according to World Health Organisation (WHO).

The United Nations health body defines maternal death as the loss of a woman while pregnant or within 42 days of a termination of a pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental and incidental causes.

“Every minute, 380 women become pregnant, while 190 women face unplanned or unwanted pregnancy,” the WHO report of 2014 further stated. The report also said: “110 women experience a pregnancy-related complication; 40 women have an unsafe abortion, while one woman dies from a pregnancy-related complication.”

On average, 116 Nigerian women die daily from complications of pregnancy, labour or childbirth, the report added.

Some of the causes of maternal death are hemorrhage – 24.8 per cent, infection -14.9 per cent, eclampsia – 12.9 per cent, obstructed labour – 6.9 per cent, unsafe abortion – 12.9 per cent; other direct causes – 7.9 per cent and indirect causes – 19.8 per cent

Reasoning that the high incidence of maternal deaths is avoidable, a family planning (FP) expert, Fistula Care Plus, Amina Umma Bala, itemised other causes.

These include: Lack of antenatal care; lack of skilled attendant at delivery; lack of access to obstetric emergency care and lack of access to family planning.

“But, why do these women die,” Bala asked rhetorically. She stressed: “Women die due to three levels of delays from conception to labour and then delivery.

“Women die due to delay in decision to seek care; lack of understanding of complications; acceptance of maternal death; low status of women and socio-cultural barriers to seeking care.

“Women die due to delay in reaching care, following lack of access to health services, in hard-to-reach areas surrounded by mountains, islands or rivers.

“The next is delay in receiving care, supplies from personnel at the health facility, coupled with poorly-trained personnel with punitive attitude and lack of fund to pay medical bills,” the FP expert said.

According to Bala, Charity, Elizabeth and Aminat belong to the categories of women in hard-to-reach areas of the country, where pregnancy and childbirth has become a dangerous venture.

Bala said: “Obtaining care from skilled attendants at birth reduces the chance that a woman will die at delivery or develop obstetric fistula; therefore, every woman should have antenatal care and deliver with a skilled birth attendant.”

Similarly, a Clinical Associate with EngenderHealth, Dr. Suleiman Zakariya, told Independent that many women who live in rural areas have no access to good hospitals.

He said that during labour the women trek long distances before they get to a health clinic, hence the delays could lead to prolonged labour and birth complications such as obstetric fistula.

Zakariya said: “Government needs to implement some of the reproductive health policies that tackle the root causes of maternal death and obstetric fistula, such as delays in accessing emergency obstetric care as well as invest more funds in emergency obstetric services.

Noting that prolonged labour is one of the five major causes of maternal death, he added that provision of health infrastructure and improvement of services would ensure prompt access to care.