When America’s greatest athlete Serena Williams opened up about her pregnancy challenges, the world was once again called to the dismissive nature prevalent in regards to women-related issues. Williams shared how complications had risen from her history of blood clots, stating that she needed a CT scan right away. After conducting an ultrasound of her legs instead, she was later sent for the CT which revealed several small blood clots settled in her lungs—the first chapter of a six-day drama.
For its September issue, Beyoncé, in an unexpected press feature with Vogue, shared that she had suffered complications prior to giving birth to the twins. She experienced toxemia, which can cause high blood pressure and kidney damage, and was confined to bed rest for a month before having an emergency C-section.
The conversations which unfolded later on Twitter questioned the silence surrounding pregnancy related issues and revealed what most of the women folk thought: Even wealthy, especially black, women were not exempt from having their pain misdiagnosed, and pregnancy related conditions which could go either way regardless of one’s social standing.
Between notorious bedside manners of nurses, a declining health sector, and the mass exodus of its doctors to Canada, the health of women is in even greater risk in Africa’s most populous nation. Currently, Nigeria is the highest contributor to maternal mortality in Central and Western Africa with 19% to the global maternal mortality rate.
A joint report (Trends in Maternal Mortality: 1990 to 2015 by WHO, UNICEF, World Bank and United Nations Population Fund) estimates that Nigeria has approximately 58,000 maternal deaths, putting the mortality ratio for Nigeria at 814 deaths per 100,000 live births. In March, Co- Chair of the Bill and Melinda Gates Foundation, Bill Gates, said Nigeria is one of the most dangerous places in the world to give birth and 4th country with the worst maternal mortality rate ahead of Sierra Leone, Central African Republic and Chad.
It is easy to point out the infrastructural factors. Education, culture and lack of access to healthcare and skilled health workers all affect the average Nigerian woman as well as whether she lives in an urban or rural area, her socio-economic status and geo-political zone—the northern eastern part of Nigeria ranked highest with 1,549 deaths per 100,000 live births while the South-west has 165 deaths per 100,000 live births.
What is often overlooked, however, is the religious stance which is also a major contributing factor to decision making in incidents related to health. It is not uncommon to hear cases of religious houses rejecting the view of modern contraceptives, which then result in women giving birth to as many as seven children, sometimes to their own detriment. Middle-aged poor women are affected more, most suffering from anaemia, malnutrition and damage to their reproductive systems from frequent child bearing. The focus on the boy child as legitimate heir has also seen damaging practices done so as to secure the livelihood of their families. And most of the recordings do not account for unmarried women who face difficulties accessing quality services due to bias. Nigeria also ranks high in the use of unsafe methods to achieve abortions as it is still illegal in the country, and deaths which arise from complications due to these restrictions are also not fully accounted for.
Post-partum hemorrhage has been identified as a leading cause of maternal deaths, closely followed by hypertensive disorders, especially eclampsia, and preventable deaths are often laden with failure to detect complications in time or notice early signs as well as the lack of coverage, prompt access, and quality of healthcare services.
Majority of healthcare related issues inadvertently boil down to funding. Without appropriate funding, healthcare reforms cannot be implemented. And without implementation, pregnancy will continue to be a high risk threat to the lives of women—a contradiction in a society obsessed with keeping unborn children alive.
The 2018 budget for Nigeria has just 3.9 percent allocation to the health sector, a drop from the 4.16 percent and 4.23 percent allocated in 2016 and 2017 respectively. Nigeria is currently rated 187th out of 191 countries in healthcare delivery, far off from meeting Sustainable Development Goals in reducing global MMR to less than 70 per 100,000 live births by 2030. Maternal mortality alone is a key indicator of international development and investments in other critical sectors will not yield maximum benefits if half of the population, women and the girl child, do not have unfettered access to sexual and reproductive information and services.