Medical Director at the General Hospital, Ikorodu, Dr. Taiwo Hassan, has warned Traditional Birth Attendants against admitting and treating pregnant women with hypertension, diabetes, or septic shock.
Dr. Hassan urged TBAs to know their limits and refer pregnant women to the hospital in order to reduce maternal and child mortality in the country.
According to him, the leading causes of maternal death are hypertension in pregnancy (high blood pressure), obstetric haemorrhage (bleeding), maternal sepsis (infection), and venous thromboembolism (clot).
Hassan, who spoke during the maiden edition of the stakeholders meeting on maternal and perinatal morbidity and mortality reduction in Lagos State, said there was the need for awareness on adequate access to care during pregnancy, childbirth, post-natal services, and perinatal care.
“We have already told them the Traditional Birth Attendants that pregnant hypertensive patients are not meant for them, they should send them to the hospital. Diabetic patients are not meant for them.
“A pregnant woman who is shocked is not meant for them, they should send them to the hospital.
“We have engaged them and of course, we have engaged private hospitals too that they should know their limitations.
“We want to reduce the number of women that die during pregnancy or women that die from pregnancy-related issues and we want to stop the babies that are born from dying because pregnancy and children are gifts from God.
“So, they need to refer these cases to the hospital and of course, the Medical Officer of Health of all the local government areas who oversees the health centres have been engaged that their doctors should know their limitations,” he said.
According to Hassan, Nigeria is one of the most high-risk places in the world to give birth, with a maternal mortality rate of 814 per 100,000 live births, “which is the second-highest in the world, contributing to 14 percent of annual maternal deaths.
“Common contributing causes in Nigeria include poverty, distance to health facilities, lack of adequate information, inadequate and poor quality services, cultural beliefs, and practices. Most of these deaths are, however, preventable.
“Pre-pregnancy and postnatal care can help to prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy.
“With regular prenatal care, women can reduce the risk of pregnancy complications.”
“When mothers receive sufficient care from preconception to delivery, it can lead to profound benefits for the health and well-being of women and children and improve subsequent pregnancies and child health outcomes.
“To avoid maternal deaths, it is also vital to prevent unwanted pregnancies. All women, including adolescents, need access to contraception,” he said.
He said maternal death is highly preventable if pregnant women have access to healthcare during, before, and after childbirth.
“We need to change the narrative in terms of maternal mortality. Nigeria is second to India in terms of mothers dying from childbirth, we are almost nearing overtaking India now because 814 women die per 100,000 births and we need to reduce that completely.
No woman should die during childbirth, every woman is expected to experience a healthy pregnancy, safe delivery, and safe baby.
“Maternal death is highly preventable. When a woman is pregnant, she should go to the hospital early to book to see a doctor who can classify them into a high-risk group or low risk.
“For the high risk, they monitor the patient closely and that will improve the patient’s outcome and tell them what and what not to do before, during, and after delivery,” the MD said.
According to the Chairman, Technical Committee of the Lagos State Maternal and Perinatal Death Surveillance and Response, Dr. Donald Imosemi evidence has shown that vaccine-preventable diseases can easily be managed if the children are vaccinated at the right time.
“The life of every woman counts and we give them the best so that we address the scourge of the huge maternal and perinatal death. Evidence has shown that when you come for ante-natal care and it is properly conducted, you have given yourself a very good chance to have a good outcome.
“Though it is not the only requirement, it is very critical for maternal and child health so that at the end of the day, the indices of maternal and child death will be reduced.
“Evidence has shown that vaccine-preventable disease can easily be managed if the children are vaccinated at the right time.
“When they come to the hospital, we provide the information and reinforce the right information in them so that this evidence-based information can be adhered to and the lives of the children will be safe,” Imosemi said.
The World Health Organisation in a report on June 2020, said Nigeria is the country where nearly 20 percent of all global maternal deaths happen.
“Between 2005 and 2015, it is estimated that over 600,000 maternal deaths and no less than 900,000 maternal near-miss cases occurred in the country.
“In 2015, Nigeria’s estimated maternal mortality ratio was over 800 maternal deaths per 100 000 live births, with approximately 58,000 maternal deaths during that year.
“By comparison, the total number of maternal deaths in 2015 in the 46 most developed countries was 1,700, resulting in a maternal mortality ratio of 12 maternal deaths per 100,000 live births. In fact, a Nigerian woman has a 1 in 22 lifetime risk of dying during pregnancy, childbirth, or postpartum/post-abortion; whereas in the most developed countries, the lifetime risk is 1 in 4,900,” WHO stated.
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