• How women take to self-help in child delivery due to lack of funds, affordable healthcare services, others
…It’s worrisome, frightening, says medical doctor
From WOLE BALOGUN, Ado-Ekiti
mrs. Ajofoyinbo Iyabo, 40, lives in Ode-Aiyegunle in Ode-Ekiti, Gbonyin Local Government Area (LGA) of Ekiti State. She delivered five children right in her room at home and has graciously come out of the exercises safely. To her, there is really no need why she should go to hospital when next she would put to bed!
She, however, confessed to Daily Sun it was never a palatable experience: “The first time I delivered my baby myself at home, the pregnancy was overdue for delivery. It was over 11 months. At first, I was going to the hospital. It got to a point the doctor said my pregnancy was due for delivery but the baby didn’t come. The doctor said I would have to deliver the baby through a caesarian operation.
“Personally I was not happy with that and my father-in-law was very sad. He advised that I be brought back home. When I was brought home, my father-in-law went to fetch some herbs believed to assist in labour and ease delivery. He administered them on me, and as God would have it, I eventually gave birth to the baby, after a long-hour of painful labour, in the mid-night of same day.
“We didn’t invite any nurse. It was my mother-in-law who took over after I delivered the baby. She detached the baby from its placenta and did other cleaning. We did not entertain any fear because the baby cried immediately it dropped out of my womb. That delivery was my second time. The first time I had done it in the hospital.
“However, the second delivery at home which did not give me any problem emboldened me to repeat same feat at home during my third born’s labour. Then, we had moved far away from my husband’s parents, which meant that neighbours were the ones at hand to help. The labour had caught me right inside the market.
“Immediately I noticed it coming I rushed home and told my friend at the market to look over my wares. On getting home, I positioned myself properly on the floor of the room for the exercise. I even locked the door to prevent any of my neighbours from intruding and finding out what was happening. It is believed traditionally that if a bad person finds out before I was done with the exercise, he or she might cast a spell on the child.
“God was so good to me that day as it did not take up to an hour when my bundle of joy dropped and I heavied a heavy sign of relief. It was after the delivery that I asked my husband to call some close neighbours who invited a nurse nearby that eventually did the rest of the health work.”
What advice does she have for others who may want to toe her path? She replied: “Our body is different. And the way we can ride the pain that accompanies labour is different. For many women, once a small pain associated with labour strikes, they run to the hospital, but some of us have mastered the art of riding such pain till eventual delivery.
“Also, the way God deals with us is different, others may not find it easy to deliver their babies at home. I cannot advise just anyone to cultivate that habit. Many of us who resort to deliver baby at home have reasons for it. In most cases, the attitude of some health workers in the maternity homes and clinics is very bad.
“They talk down on pregnant women most of the time. They are not friendly and accommodating, why this baffles me is that they are also women themselves and having passed through the experience, or expecting to pass through it, should understand how it feels when one is in labour.
“Another reason is that our hospitals nowadays, especially the government hospitals, charge a lot. Many of those ante-natal services that are announced to be free-of-charge are actually not free. For instance, injections against infection during pregnancy and registration with passport photographs among similar other things are not free at the hospital. The nurses/doctors have positioned some people to collect some amount of money from N200 to N800 for such services. All these scare many who cannot afford the fees away from the hospitals and they rely on God to midwife them at home.”
Adijat Oguntuase, 36, of Usi-Ekiti, Ido-Osi LGA, had three of her babies delivered at home:
“I resolved to give birth to my babies at home and I thank God that He has been merciful. The first time it happened was really very painful before the baby dropped. I had to call a nurse friend nearby to help in post-delivery exercise. But by the second time, I had become more experienced and was able to manage the situation. In fact, I detached my baby from its placenta myself at the second and third births.
“At the third time, I almost regretted doing it when after almost 30 minutes my baby refused to cry. It took an elderly woman’s intervention who shook it violently and slapped severally before it eventually cried and got me relieved.
“Do you know that in our government hospitals today, they make you to buy baby accessories from them and reject any item you buy outside the clinics, under the guise that the one bought outside is fake? More painful is that half of all those things they recommend for you to buy from them are not released for use during and after delivery! To me, that is petty robbery!
“A neighbour who recently gave birth in our general hospital here in Usi had complained bitterly about how the health workers ripped her off. She said they collected N10,000 as charges for mid-wife services and also cornered many of the accessories she bought for the exercise. And if the parents fail to pay the amount charged on day of delivery, they would add to it the next day.
“Imagine health workers charging farmers who can hardly afford N5000 as much as N10.000, and increasing it when there is a delay in getting the money! Meanwhile, such a pregnant woman has paid the newly introduced development levy into the accounts of the state government before she is even allowed to register at the government clinic.
“This ugly development has made many pregnant women from humble background to seek help at the private birth attendants or convalescence homes being run mostly by auxiliary nurses or informally trained nurses. There are also churches or mission houses that offer mid-wifery services at very low charges. Those depend largely on prayers and spiritual help in rendering such services.
“These private nurses or health workers in churches or small private clinics don’t charge you because they understand your condition. You only give them a token you can afford after a successful delivery. It is even safer going to them to doing it at home, because they have professional mid-wives and doctors as friends or bosses who they run to for help when there are complications during the exercise.”
Fifty-year-old Mrs. Tolulope Aribigbe delivered her baby right inside a farm in Ayedun-Ekiti, in Ikole LGA: “I made a serious effort to ride the pain but it got to an almost unbearable stage and thankfully, other women at the farm noticed me and rushed to me. Some suggested that we rush to the maternity home in the community, but that idea was soon dismissed as the hospital was several miles away.
“The women rose to the occasion, removed their wrappers and formed a circle around me. They urged me to push and I did and lo and behold! The baby dropped into the arms of some of them. Its piercing cry woke me to reality for I had fainted for a while after the hard push.”
Dr. Pious Ade-Ojo, a consultant pediatrician and gynecologist at the Ekiti State University Teaching Hospital (ESUTH), Ado-Ekiti, and lecturer at the Department of Obstetrics and Gynecology at the university, discouraged women from embarking on the suicidal mission of child delivery at home and without any medical expert’s assistance. Describing the development as very worrisome and totally unacceptable, he also pointed out on the dangers associated with it:
“Home delivery is actually a dangerous and frightening development, because globally, everybody is trying to reduce the high rate of maternal mortality. We are talking of women that die during pregnancy or all within 42 days of delivery.
“It is totally unacceptable, apart from the fact that Nigeria contributes only 2 percent to the world population, this country accounts for the 10 percent maternal mortality worldwide, this is a very worrisome development to the government and everyone in this country.
“Child birth is supposed to be a good experience as these women want to fulfill God’s injunction that of giving life, being fruitful and multiply. However, these women should not just die while fulfilling such injunction. And again, people around would be joyfully expectant of the arrival of a new life when she is about to give birth. But to some people, mainly out of ignorance, this exercise that is supposed to be of joy, results to regret or damnation as such women die while attempting to deliver at home.
“As easy at it may look, because even lower animals such as goat or sheep do give birth without medical assistance in most cases, but for a woman, if she dies while employing self-help, that is monumental tragedy.
“Those deliberately attempting to deliver without medical help are reducing themselves to the lower animals. It is true that some women deliver safely at home with or without any help. In fact, some women have come to us for medical care after they have delivered safely at home, but truth is that many other women cannot do so.
“There are about five life-threatening complications that arise during child delivery. The complications are very significant and they can only be recognized when the would-be mother come to the hospital for the delivery.
“First of these causes of death at delivery is excessive bleeding. Sometimes, a woman bleeds excessively after delivery and such bleeding might get beyond control to the point of compromising the life of the woman. In such situation, it may be the placenta that is delayed or it may be that there are medication needed to administer on the woman immediately which would allow the uterus to contract properly so that the woman would not bleed to death and all that.
“Where would the woman get such help when she is delivering at home in a rural community? So, many of them bleed to death and by the time they rush her to the hospital, there might have been very little the doctor could do to save the woman’s life.
“A second one is obstructed labour. Sometimes, the baby may be to big for the passage from the uterus.
In such cases, the womb can burst or get ruptured due to obstructed labour. A third one is that in the hospital, the way we deliver the woman of the baby is usually called ‘clean and safe delivery’ because during delivery, the woman is exposed to a lot of dangers as the womb is open to a lot of germs in the environment. Micro-organisims can easily enter into her and cause serious problems if they are not prevented. So, infraction is a very serious problem.
“Meanwhile at home, many of these women use leaves, rags and other terrible things that carry these micro-organisms to clean the open womb. Some even put olive oil, anointing oil and dirty holy water into their virginia.
“Another one is women who naturally have fits during labour and child birth. It is a serious one. But it can be prevented if the pregnant woman comes for ante-natal because we often discover that some of them do have high blood pressure during pregnancy. In the ante-natal clinic we go ahead to check their urine for protein and there discover those who are likely to have fits and there is no way we can detect that if the woman stays at home. a fifth one is abortion and all these things contributes to death during child delivery.
“The main reason women choose to deliver at home is ignorance. This is because the government and health workers across the board and at all levels, local and international advocate zero tolerance to child delivery at home and maternal mortality. This is because the death of a woman at home is a total loss to the society, her husband, the families of the couple and most of all to the other existing children at home.
“In our society, there is a high level of ignorance besides economic factors responsible for some of the choosing to deliver their babies at home. Particularly for our women, there is ignorance they don’t even have value for their life. For instance, you have a situation that a woman decides to have a seventh child while the six already on ground are suffering. Such a woman may die while at home attempting to deliver the seventh baby and you wonder why a seventh one when the six already on ground are suffering.
“We have found out that women who are educated tend to live longer and don’t live as a result of maternal mortality than women who are illiterate. Ignorance is the major factor, many of them don’t even know about family planning and when they do, they even have misconceptions about it, misconceptions arising from harmful traditional beliefs and dogmatic religious beliefs that: ‘ God is the one that provides for a child’ and such like.
“Many of the rural women do not have the right health seeking approach or attitude. They blame most of the health challenges on some non-exisitng ethereal powers and rely on religion, traditional fetish practices as way out. Meanwhile, these challenges only require little and practical health steps to solve.
“About the perceived hostile attitude of health workers in the hospitals, that is not an excuse as you have a number of other hospitals you can visit if in a particular one their attitude is bad. The attitude of health workers has change significantly.
“In spite of all these, the government should continue to ensure continuous advocacy to create widespread awareness about all these things.”