By CHIOMA GABRIEL

The birth of a child is almost always a cause for celebration.

Although the good book says that the faithful would deliver like ‘Hebrew women’, what many don’t know is that childbirth is sometimes dangerous for women. Nigeria records one of the world’s highest rates of maternal death.

One in 13 Nigerian women dies at childbirth. Although, many of these deaths are preventable, the coverage and quality of health care services in Nigeria continue to fail women and children. At present, less than 20 per cent of health facilities offer emergency obstetric care and only 35 per cent of deliveries are attended by skilled birth attendants. Mothers, during childbirth, die as a result of exhaustion, dehydration, infection, hemorrhage, or convulsions.

The United Nations Fund for Population Activities UNPF, recently said that 110 Nigerian women die from pregnancy and childbirth related complications on a daily basis.

It revealed that out of 2,443,000 pregnant women deaths recorded worldwide between 2003 and 2009, 90 per cent of the cases occurred in developing countries, including Nigeria. But because women are poor and disadvantaged, their deaths are often ignored. UNPF revealed, “Every two minutes, a woman dies from pregnancy or childbirth-related complications somewhere in the world. Between 2003 and 2009, this resulted in deaths of 2,443,000 women. This is equivalent to one full Boeing–747 jet crashing every day.

About 90 per cent of these deaths occur in developing countries, including Nigeria. One out of every eight of the women dying live in Nigeria. This translates to about 110 Nigerian women dying every day.

“But poor, disadvantaged women with little or no education are dying and their deaths are oftentimes ignored. Excessive bleeding and convulsion during pregnancy were the two leading causes of the deaths.”

Have you ever bothered to ask a woman that put to bed her experience in the labour room besides asking whether it’s a male or female child that she’s got?

Saturday Vanguard did and got some revelations.

Our near-death experiences

Vivian Omenka became pregnant the first time at the age of 26 shortly after her marriage. She duly registered and attended ante-natal and was given her expected date of delivery, EDD. But one week after the EDD, Vivian realised she was not having signs of labour and carrying on with the pregnancy became an issue for her. Besides the fact that she was having challenges in her marriage, anxiety began to creep in.

Her consistent fights with her husband under her condition and the threats from him became too much that Vivian decided to do something.

She had the feeling that her life and the life of her unborn baby were under some kind of threat and so, she paid a visit to her doctor. She specifically requested from the doctor to bring out the baby which the doctor considered strange. He tried to encourage her after conducting medical checks on her but Vivian was determined. So, the doctor accepted to bring out her baby.

She shares her labour room encounter with Saturday Vanguard.

“It seemed the right thing for me to do. I was under a kind of pressure over what I didn’t know about. My husband was having issues with his finance and he was transferring the aggression to me. I was tensed up most of the time and very anxious about my situation. We didn’t have money and my pregnancy was due but I was not in labour or feeling any kind of pains.

Life is strange. So, I went to meet the doctor and shared my problems with him and he brought out the Bible and began to preach to me. I was impressed but I insisted on his bringing out the baby by Caesarean section. We didn’t even have money for the C/S but I was vehement. I went to visit my cousin and explained my predicament and he took me to a friend who gave me part of the money for the C/S. Strangely, the guy that gave me money was one of the people that died in the Dana air crash in Lagos sometime ago. The one that died with his wife and all his children. Very tragic for such a good man.

“ I had a near-death experience inside the labour room. I remember being wheeled into the theatre and hearing praise-worship by the surgeons and the nurses. That was the last thing I remembered before losing consciousness. I guess the Anastasia was working .

“But at the same time, I saw myself walking up and down 22 Road in Festac Town. I was restless, crossing the road to the other side, sitting down to talk to the people without anybody seeing me, hearing me or talking back. I would get up and continue to walk aimlessly until I found myself trapped in a place. I began to hit the door and the walls of the place asking that they open it. Then, I became conscious and realised I was still in the theatre and had just had a Caesarean section in the Labour room of a hospital. I was back to life! It must have been my spirit walking up and down the road. I believe that I could have died from there if I was not trapped somewhere.”

Favour Michaels shared a different experience she had in the Labour room. She told Saturday Vanguard that she had been married for several years without a child until her first pregnancy came nine years after.

“I carried the pregnancy without stress until delivery period. But the Labour experience was something else. I was in labour for several days and the baby was not coming. I was getting weak and it was like I was going to die. I didn’t want a caesarean section because my faith is against it. The church was praying but as my suffering got worse, I had no choice than to accept C/S. But Even then, I almost died. “I was conscious of being wheeled into the theatre and the rest was like a dream. I saw myself leave my body and I was leaving the theatre when a man accosted me. He asked where I was going and I told him I needed to rest. The man asked me to look back and I did. I saw myself still lying on the bed where surgery was being performed on me.

I saw my baby being brought out and the man asked, ‘if you go, what happens to the baby?’ I told him the baby would be taken care of because my husband is rich. The man said, he would prefer I look after the baby myself but I said the baby would be okay, that I needed rest. I saw myself pass through the wall of the labour room and I came to a ‘still river’. I immediately recalled the verse, He leads me through the still waters. Again, I saw the man I met earlier who asked me to stay and take care of my baby.

This time, he told me that if I cross the still waters, I would not come back. I told him it’s okay, that I needed to rest. Then he said he would want to show me something. He wiped my face and I saw my pastor and my husband praying. They were sweating profusely and looking so agonised but I told the man that my husband and the pastor would be okay. But he said no, that because of them, I should go back. He pushed me and that was when I regained consciousness. The first thing I heard on coming around was the doctor saying, ‘we almost lost her’. That was how I came back to life. I was admitted in the hospital for over two weeks because of my weak condition.”

Also sharing her experience, Grace who was one of the people who survived the Lagos armoury explosions in January 2002 told Saturday Vanguard her story. She was preparing for her wedding when on that fateful Sunday, she went to visit some people around Oshodi and was returning to her base at Ikotun. That was when calamity struck and she found herself inside the canal that claimed the lives of hundreds. But Grace was saved from the canal and her wedding took place. But the death experience she escaped at the canal surfaced again at the labour room when she was pregnant with her first child.

“It was a great thing to experience such a miracle . I would have died before my wedding but God saved me. The wedding went through and I became pregnant shortly after. I lost the first pregnancy after I went for a massage in a traditional midwife’s home. I was having excruciating pains and somebody requested I went for a traditional massage and I did. When I got home after the massage, I slept but the pains got worse at midnight. I woke to find out I had lost my pregnancy. But God was faithful. I became pregnant again and carried it through. But close to the delivery, I went for a scan and learned that the umbilical chord was around the baby’s neck. I was also told I could not have a normal delivery. So, I opted for a C/S which nearly claimed my life.

“ Although my body was lying in the theatre and surgery was going on, I was somewhere else picking flowers and decorating myself. My hands were full of flowers and my hair was well decorated but I realised I was alone in an all-white environment with flower plants everywhere. I began to shout, asking where were the rest of the people there and that was when I came back to life. I learned there were complications during the surgery and I would undergo another surgery later to correct it and I thank God, I was able to have two other children after. If I had died then, I would have made heaven because I used the period of the pregnancy to correct everything about my life. I put my house in order and reconciled with everybody I had issues with and thank God, I’m alive to tell this story.”

Bisiriyu Mogaji told Saturday Vanguard how he went into the labour room with his wife and how he ran out when things became too hot. “My wife was sickly throughout pregnancy and I became so scared. The doctors were saying all kinds of things. She was in labour for a long time. I watched her writhing in pains and gnashing her teeth for days.

They later told us that the baby was not properly positioned and suggested a C/S but I could not have it. For one thing, we had no money. My wife suffered for days and eventually the baby came. It came with legs first and that was a very painful experience for my wife. As she screamed in the labour room and I caught a glimpse of the legs first, I shouted and ran out of the place. Her life was in danger as well as the baby’s own. We named the baby Ige but he died shortly. My wife was hospitalised for weeks and was even on the danger list at a point. But she survived. Ige was our second baby but after my wife’s experience, she became pregnant again and that was the last. The doctors asked us to stop because of her health.”

The problem of maternal death

Maternal death is a common tragedy. It’s generally related to complications during delivery. Experts say obesity and giving birth in late 30s and 40s, increases the risk of maternal deaths. Death from childbirth remains fairly rare in the United States now and the rate of the maternal death in childbirth has plummeted in the 20th century worldwide.

Experts also say there is a distinction between a direct maternal death that is the result of a complication of the pregnancy, delivery, or management of the two, and an indirect maternal death that is a pregnancy-related death in a woman with a pre-existing or newly developed health problem unrelated to pregnancy. Fatalities during but unrelated to a pregnancy are termed accidental, incidental, or non-obstetrical maternal deaths.

The traditional factor

The quest to have a male child in traditional institutions have been observed to cause maternal deaths as the woman keeps trying to have the highly prized male child and in the process, ends up having more than she bargained for. Biola Dada, had her first child at age 17 and by age 30, she was pregnant for the seventh time in a quest to deliver a prized male child, but following 36 hours of labour she bled to death. None of her seven children was delivered in the presence of a medical professional.

Biola’s experience is common in Nigeria, where just 35 percent of births are attended by a skilled health professional, and one in 18 women dies in pregnancy or childbirth, according to World Health Organization (WHO) and UN Children’s Fund (UNICEF) statistics.

“Nigeria’s maternal mortality rate is still comparable to those countries at war,” according to Iyabo Obasanjo-Bello, when she was the chair person of the senate health committee.

Half of Nigeria’s maternal deaths are due to postpartum haemorrhaging, which unskilled health workers lack the know-how or equipment to stop.

West Africa, according to UNICEF has the world’s highest mortality rates, which puts women at greater risk of dying in birth.

“If a woman has more than four children, the fifth pregnancy can be more dangerous than the other pregnancies put together. Starting young also increases mortality, ” said Ejike Oji, a gynecologist with the reproductive health NGO IPAS. In the conservative north,many women give birth in their teenage years. In Kano state, many men do not allow their wives to have a male doctor present during childbirth.

“I don’t think it is proper for a male doctor to attend to my wife, not to talk of assisting her during delivery,” said Hassan, 48, a farmer . “In our tradition, culture and religion, we do not encourage close contact between men and women who are not related; especially for unmarried women. I would rather have a female traditional birth attendant attend to her. Even my wife is not comfortable with having a male doctor around her when she is delivering a baby,” he added.

A mother of three who also shared her experience said many women in Nigeria die from childbirth simply because they don’t know how dangerous it is to have babies without medical supervision.

“We hear it all the time. We see the advertisements on TV. Even if you don’t have a television at home to watch, you see people walking around telling people that having babies at home is not good.”

United Nations Children’s Fund health specialist Esther Obinya said her organization in conjunction with Nigerian government and several other non-governmental organizations is trying to tell as many Nigerians as possible that lives can be saved when babies are born in hospitals.

She observed that poverty, isolation, traditions and lack of access to health care are among the other causes for the high death rate of women during childbirth.

“If a woman from a poor village starts to bleed excessively during childbirth, she has only hours to live without emergency medical treatment. In many remote villages, modern transportation is not always available and even if it is, many women can’t afford to pay the fare. Even getting from her home to the primary health care maybe a big problem. Even those who make it to the hospital on time might not be able to get emergency treatment.

“Mothers also die because child marriage and pressure to have many babies are common in some parts of Nigeria. Young girls often are too fragile to have a healthy birth and women who have children in quick succession become run down.”

Stars who died during childbirth

Ijeoma Okorie, a Nollywood star died February this year during childbirth. The Rivers State chapter of the AGN announced her death and issued a statement that read, “The Actors Guild of Nigeria, Rivers State Chapter regrets to announce the painful loss of our member, Mrs. Ijeoma Okori of Eleme Satellite, who died during child delivery. It pains more to know that our Comrade died alongside her twin baby.”

Also a Yoruba actress,

Bisi Komolafe died after childbirth on December 31st last year at the University College Hospital (UCH) in Ibadan. The actress is remembered for major roles she played in Igboro Ti Daru and Eja Tutu.

It’s indeed so sad that women lose their lives these days at childbirth even with so much focus on wiping out maternal mortality rate as part of Nigeria’s Millennium Development Goals (MDG)

Last month, Kemi Omotoyinbo a choreographer, who danced for several popular musicians including Pasuma, KWAM 1 and Shina Peters, died during childbirth in a private hospital in Lagos ,exactly twenty days after her wedding to husband, Godwin Eloanyi, Her husband, Godwin Eloanyi took her to the private hospital where she was in and out of labour for several days. It was reported that when it was certain that it wasn’t possible for her to have a natural childbirth, the doctors informed her that she would undergo a Caesarean Section. According to her younger sister, Seun Omotoyinbo, “On Saturday, September 13, 2014, my sister got married at White House, Toyin Street Ikeja, Lagos.

Then on Monday, September 22, she went to the hospital for check-up where the doctor told her she needed bed rest and was immediately admitted in the hospital till the day of delivery. Before her wedding, the doctor had already informed her that she would undergo surgery and she already paid N170,000 meant to cover the hospital bills. On Wednesday, October 1, 2014, my sister called me and said she wanted to give me a surprise without knowing I was getting two surprise packages from her.

At about 8-9pm, our elder sister called to inform me of her safe delivery. I requested to speak to her but was told she was still in the theatre. I decided to go to the hospital the next morning because I stay at Akoka and the General Hospital Oreke where she was, is located at Boundary, Ajegunle, Lagos. At 1am, I received a call from my elder sister saying, “Kemi just passed away”, I became mad that moment. I did not believe my sister was gone until I got to the hospital and saw her body.

“My sister never knew she had fibroid until she was almost due for delivery when the doctors detected it, that was why the doctor decided she would have a caesarian session because she would not have the strength for natural birth. I think she started bleeding after the surgery and did not survive. Kemi still spoke to her husband after the operation saying, “Honey, I made it” but did not have the opportunity to carry her son because she was still weak. The fibroid she had led to internal bleeding and unfortunately, she did not survive it”.

Why do so many women still die in pregnancy or childbirth?

Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy. Other complications may exist before pregnancy but are worsened during pregnancy. The major complications that account for nearly 75% of all maternal deaths are: severe bleeding (mostly bleeding after childbirth) infections (usually after childbirth) high blood pressure during pregnancy (pre-eclampsia and eclampsia)complications from delivery unsafe abortion.

In 2013, 289, 000 women reportedly died from complications related to pregnancy or childbirth worldwide. For every woman who dies in childbirth, around 20 more suffer injury, infection or disease – approximately 10 million women each year. While these are the main causes of maternal death, unavailable, inaccessible, unaffordable, or poor healthcare is also fundamentally responsible.

Women need not die in childbirth. Young women need information and support to control their reproductive health, help them through a pregnancy, and care for them and their newborn. Majority of maternal deaths could be prevented if women had access to quality family planning services, skilled care during pregnancy, childbirth and after delivery, or post-abortion care services and where permissible, safe abortion services. 15% of pregnancies and childbirths need emergency obstetric care because of risks that are difficult to predict.

Going by WHO’s commitment to achieving the Millennium Development Goal of reducing maternal deaths by three-quarters by 2015, maternal deaths should become history by 2015.

WHO has it that :

Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. 99% of all maternal deaths occur in developing countries. Maternal mortality is higher in women living in rural areas and among poorer communities. Young adolescents face a higher risk of complications and death as a result of pregnancy than older women. Skilled care before, during and after childbirth can save the lives of women and newborn babies.

Maternal mortality is unacceptably high. About 800 women die from pregnancy- or childbirth-related complications around the world every day. In 2013, 289, 000 women died during and following pregnancy and childbirth complications. Almost all of these deaths occurred in low-resource settings, and most could have been prevented.

Maternal deaths are detrimental to social development and well being, as some 1 million children are left motherless each year. These children are more likely to die within 1-2 years of their mothers’ death.

What gynecologists say

Women can suffer excessive bleeding after childbirth in some cases that can result in death if not checked fast, according to obstetricians and gynaecologists.

Affected women can lose as much as 500 ml of blood or more within 24 hours during childbirth which is one of the causes of maternal deaths globally. According to them, affected women feel unwell, faint and dizzy, among other indications, while some of them may become unconscious. “In some instances, they know about the possibility of bleeding after childbirth and prepare for the challenge.”

Experts opine that women who are aware of postpartum haemorrhage (PPH) –bleeding after childbirth are often frightened about the amount of blood they will lose and become apprehensive. Failure of the womb to contract properly after the baby is born, problems with the placenta and prolonged labour have been identified as major causes of bleeding after childbirth.

A gynaecologist with the National Hospital Abuja said that excessive bleeding during delivery had remained the commonest cause of more than 25 per cent of maternal death, especially in developing countries such as Nigeria. “Once the excessive blood loss is beyond 24 hours, it is called secondary hemorrhage and if it is properly managed, it will not result in death. Poor ante-natal care was another predisposing factor to excessive bleeding after childbirth .Being in labour for some days before childbirth means you have been contracting the womb for long, so after giving birth, the uterus (womb) will be weak. By the time such a person gets to the hospital, it might be too late for her survival because she must have lost much blood,” she noted.

“Besides, many women had also cultivated the habits of seeking spiritual solution in prayer houses when they were directed to undergo caesarian operation. With this habit, sometimes, such women become anemic and by the time they are brought to hospital, it may be difficult to save their lives. We are in a country whereby most of our women are not educated, their ante-natal care is poor, and they can labour for days at home. Women with multiple gestation (conceptions) and those who had had five or more previous pregnancies, were inclined to experience PPH.

“Most of our women are dying because of inadequate ante-natal care, during ante-natal clinics, these women are supposed to be identified.” Another gynecologist, also advised that women who were at risk of excessive bleeding after childbirth should be identified for the purpose of planning for their delivery dates. “Giving birth in registered healthcare centres would enable the doctors to give necessary medical attention to prevent excess bleeding. When it comes to somebody who has the tendency to bleed, steps are taken to ensure that it is prevented and for those who still bleed, we look for the cause and control it fast.”