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Curbing maternal mortality with family planning



Curbing maternal mortality with family planning

Out of every 13 women giving birth in Nigeria, at least one dies due to pregnancy-related issues. But taking advantage of family planning interventions to stem the tide remains a huge challenge, reports APPOLONI A ADEYEMI



The new baby of Mrs Ekaete Udom was barely three months when she conceived again. Her new state was not only shocking, it was embarrassing. As a graduate with BSC Nursing, she is aware of the importance and benefit of child spacing. Similarly, the advantage of using contraceptives to prevent unwanted pregnancies is not new to her. However, Udom didn’t take advantage of both.

The present burden is what does she do with another pregnancy considering the age of the baby at hand. In no time, an idea flashed through her mind – she left her husband’s home in Isheri-Oke area of Lagos and went to live temporarily with her mother who resides in Lekki. Being out of sight, it was easy to evade prying eyes and rumours about women who get pregnant too close to a previous delivery.

The good news is that nine months after, her husband, Mr. Nelson Udom came to announce safe delivery of the new baby in Isheri Oke. “How,” a resident of Isheri Oke that was first to hear the news asked.

“Was she pregnant?” She asked again. Although, some doubted, the arrival of Mrs. Udom and her new baby at Isheri-Oke for the traditional naming ceremony of the baby convinced all that it was a true story.

Mrs. Udom was lucky because the baby was delivered safely. Another housewife, Mrs. Adun Cooker, who was a resident of Ido-Ekiti in Ekiti State who went through a similar experience, did not live to tell her story.

As soon as it became clear that she had conceived four months after the previous delivery, she believed that the way out was to terminate the pregnancy. Sadly, Mrs Cooker procured abortion from a quack nurse and died in the process.

She is not alone. Many housewives have died in the course of terminating unwanted pregnancies in Nigeria in the hands of unskilled personnel. So are numerous adolescents. In Nigeria, abortion is illegal but allowed only to save a woman’s life and in some cases of health challenge.

Investigations however revealed that while some couples and singles face the ordeal of unwanted pregnancies, free family planning interventions are available in states and local government areas.

Contraception, or birth control, is the use of different devices, sexual practices, techniques, chemicals, drugs, and/or surgical procedures to purposely try to prevent getting pregnant while having sex.

There are several types of birth control methods that have been officially labeled as contraception—they have been shown to be reliable in preventing conception from taking place. In addition to contraception, birth control is also referred to as family planning, contraceptives, pregnancy prevention, and fertility control.

During investigations of ‘Uptake of Family Planning Commodities by Rural Commodities in Lagos’ recently, it was found that though family planning commodities were available in Eti Osa Local Government in Lagos, their uptake by women in the community was seriously hindered by myths, religious and cultural practices.

For instance, rather than accept these commodities that were provided free and use same, three women who spoke with the New Telegraph HEALTH claimed it was better to keep off the products because of the associated side effects including weight gain especially around stomach areas, irregular bleeding, failure to achieve conception even when the use of the family planning commodities had been discontinued, among others.

The experience of women from Gbagada area of Lagos was not different. Only a few clients go for these family planning interventions which medical experts call life-saving measures. It is estimated that only 10 per cent of Nigeria’s population use family planning.

Yet, every day, Nigeria loses 145 women to pregnancy related causes. Also, during the investigations in Ikorodu, Ijaye and Lagos Island, it was found that the uptake of family planning commodities was low, resulting in many unplanned pregnancies and abortions both of which contribute significantly to maternal deaths. According to a new report,‘Maternal Health in Nigeria: A Situation Report’, although, an estimated 9.22 million pregnancies occur annually in Nigeria, a quarter of these pregnancies were unintended and 56 per cent of the unintended pregnancies were aborted.

“In 1996, an estimated 600,000 abortions occurred in the country and the number of abortions rose to 760,000 in 2006, and to 1.25 million in 2012.” While receiving this report which was presented in Abuja early in October, by Chima O.Izugbara, Senior Research Scientist, the Minister of Health, Prof. Isaac Adewole admitted that the unacceptable maternal mortality in the country could not be addressed without tackling the issue of family planning.

The minister said the promotion of family planning and child spacing are key ingredients to reducing morbidity and maternal mortality in Nigeria. Earlier, while giving the background of the Report, Izugbara stressed that the majority of the abortions performed in the country were clandestine and unsafe; they are terminated either by persons lacking the necessary skills or in an environment lacking the minimal medical standard or both.

As a result, the senior research scientist affirmed that unsafe abortion is a leading cause of maternal mortality and morbidity in Nigeria. He however reasoned that ma-ternal health remains an area for urgent policy and programmatic attention in Nigeria, adding that nearly one in every four women in Sub-Saharan Africa is a Nigerian.

Izugbara stressed that the plight of women in Nigeria would vastly impinge on the achievement of the Sustainable Development Goals, SDGs, in the region, adding that investing purposely in safeguarding maternal health in the country was a sure strategy for improving on the current levels of progress and guaranteeing the future potential for growth and advancement in Africa as a whole.

The senior research scientist attributed top medical causes of maternal mortality in Nigeria to obstetric haemorrhage, infection following childbirth, unsafe abortion, eclampsia and obstructed labour, all of which medical experts agreed were largely treatable and preventable.

Similarly, a Professor of Obstetrics & Gynaecology, Emmanuel Dipo Otolorin identified family planning as one of the major factors that can reduce the maternal and new born mortality rate in the country by as much as 44 per cent. “It saves lives of women, children and teenage girls” Otolorin added.

According to him, 95 per cent of the causes of maternal death can be prevented. He said: “If you use family planning, you prevent unplanned pregnancy, and you prevent unwanted pregnancy. You use it to space your pregnancy as well as delay your first pregnancy.

You use it to limit the number of children you want. “If you don’t get pregnant, you cannot die from pregnancy. We need pregnancy to fulfill our physiological needs, but we can plan it and do it when it is least dangerous.”

Dr. Jennifer Anyanti, Chief Strategic Technical Officer at the Society for Family Health, SFH, called on all Nigerians to take the message of family planning very seriously and embrace the use of contraceptives to help save the lives of the Nigerian women and children. She said a situation where only 10 per cent of Nigeria’s population is in tune with the use family planning is unacceptable.

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