Eunice Akhigbe is a registered midwife. With over 10 years experiences in midwifery, she educates and empowers women especially pregnant women and nursing mothers in communities, on ways towards healthy pregnancy and safe delivery .
In this interview with Daily Sun in Lagos, Akhigbe speaks on issues bothering on safe delivery, importance of breastfeeding and reasons some doctors often suggest Caesarian section in delivery.
What is the major challenge in the Nigeria health care delivery?
In my opinion, both major and minor challenges in Nigerian health care sector are interwoven. It ranges from inadequate manpower to unskilled personnel and inadequate equipment for prompt service delivery.
There are lots of health facilities, both public and private but the personnel is not enough. Some of the few ones available are going abroad in search of greener pastures, hence the decline in manpower.
Of course, but not all skilled doctors, midwives, nurses and others health personnel are recruited because some of these facilities especially, in the private hospitals do not have the capacity to pay for their services.
This is the major reason private health care facilities, most often than not, go for unskilled hands who incidentally are not skilled and knowledgeable enough in the practice. They do more harm than good.
What is the commonest ailment for pregnant women and how can it be tackled?
From my interaction with expectant mothers, malaria is the commonest health challenge for them. To tackle malaria, it has to be essentially, preventive.
It can thereafter be followed with prompt diagnosis and treatment.
Preventive measures include early registration for ante-natal sessions where adequate services will be rendered. The use of long lasting insecticides, treated mosquito nets, use of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine- pyrimethamine (SP) are all part of antenatal care services.
Others are clearing of breeding places for mosquitoes, intake of adequate diet as to help improve immunity, increase personal as well as environmental hygiene.
Why is early initiation to breastfeeding important?
Breastfeeding of a newborn within one hour of birth is referred to as “early initiation of breastfeeding”. It helps to ensure that the infant receives the colostrum or “first milk” which is rich in protective factors.
It also serves as the first immunization for the baby and helps reduce blood loss for the mother thereby preventing hemorrhage.
It equally promotes early lactation, enhances skin to skin contact for mother and child, and promotes bonding between mother and child, just to mention a few.
Why do some women decline exclusive breastfeeding?
Some are for health reasons while some others say they are not lactating enough hence they feel the baby is not getting enough from the breast. Some working mothers use their resumption to work after three months of maternity leave as excuse.
Few women hold on to cosmetic reasons. They claim that their breasts would sag, if they breast feed. Therefore, they don’t want their breast to sag. While the truth of the matter is that the breast will eventually sag whether or not, they breastfeed due to ageing.
What is the rate of success recorded with UN goals on infant and maternal mortality rate?
Maternal mortality reduction remains a priority under “Goal 3: Ensure healthy lives and promote well-being for all at all ages” in the new Sustainable Development Goals (SDGs) agenda through 2030. And it is to reduce maternal mortality rate to 70 percent per 100 000 live births by 2030.
According to the UN report on the sustainable development goal, the maternal mortality ratio has declined by 37 per cent since 2000. Over the period 2012–2017, almost 80 percent of live births worldwide occurred with the assistance of skilled health personnel, up from 62 per cent in 2000–2005.
Globally, from 2000 to 2016, the under-5 mortality rate dropped by 47 percent, and the neonatal mortality rate fell by 39 per cent. Over the same period, the total number of under-5 deaths dropped from 9.9 million to 5.6 million.
Even in the region facing the greatest health challenges, progress has been impressive. Since 2000, the maternal mortality ratio in sub-Saharan Africa has been reduced by 35 per cent, and the under-5 mortality rate has dropped by 50 per cent.
Some factors that have attributed to the decreased maternal deaths seen between this period are in part to the access that women have gained to family planning services and skilled birth attendance, meaning a midwife, doctor, or trained nurse, with back-up obstetric care for emergency situations that may occur during the process of labour.
How can you rate young nurses’ attitude towards their duty?
The skilled young nurses are energetic and purpose-driven to contribute in assisting the sick and saving lives. However, some people’s personalities interfere with the way they relate with their patients or clients.
In what area has the government fared well in improving the health care delivery?
They have fared well in providing formidable environment for service delivery, especially for maternal new-born and child health. I also observed that the government has made available some vaccines for children under the age of five of which parent used to pay for.
Now, children are being given vaccines such as pneumococcal vaccine, Rotavirus vaccines for free. They are doing well but we are not there yet and like Oliver Twist, we are still asking for more.
What’s your view on the non-uniformity in the way nurses dress now?
I want to assume you are referring to the private health facilities. Each facility has its own style of uniform. Variety, they say is the spice of life. What is most important, is the services rendered to save lives. As long as the uniform is neat, looks sharp on the health personnel and does not obstruct their effectiveness then, it should not be an issue.
Why do young doctors quickly go for Caesarian Section as a fast option these days?
I actually wonder where that notion is coming from. This is a delicate issue. True, I have heard it from some women, though, and I try to dissuade them from such and educate them on it.
For me, I think most doctors will assist a woman through the process of natural child birth and only suggest or advice caesarean section, if there is threat to the life of the mother and or the baby.
But then, let me help us understand that Caesarean section is also a form of delivery. I call it “an extreme form of delivery” when other methods have failed. I don’t think any doctor will leave the normal safe vaginal delivery and go through the rigours of sectioning without any justification especially, to the mother if not done.
It will not be carried out on a woman without the woman’s and or her husband’s consent and only recommended when there is need for it. However, some pregnant women opt for caesarean section on their own mostly because of fear of labour pain, unnecessary anxiety or for some other personal reasons.
What can a woman do to have normal delivery?
Normal delivery is also called natural birth because it is a natural process. However, there are few things that the woman can do to aid the natural birth.
Here are some few tips: plan to have your delivery in a health facility by a skilled health personnel, midwife and doctor. Go for early ante-natal care, attend childbirth/ante-natal education classes, keep to your clinic appointments, eat adequate diet, do regular ante-natal exercises and comply to medication as prescribed.
Prompt report of any abnormal feeling to your midwife/doctor for prompt diagnosis and adequate care. Ask questions where need be. Never be afraid to ask questions that is why the midwives and doctors are there.
What is your advice for women who shy away from ante-natal because of finance?
There are options like the primary health care centers where ante-natal services are rendered with little or nothing. I will suggest they explore such opportunities. Ante-natal care is very important in ensuring a safe pregnancy process, delivery and post-natal period. It should not be taken with levity.
The outcome of pregnancy and labour is not known until after the conclusive process of delivery. Proper ante-natal care will help ensure a positive outcome.