Saving mother and child, demystifying Caesarean Sections

Oyinkansola Ayoola

The process of bringing a human being into the world is one that is fraught with dangers of different phases. The first phase of danger is ensuring that the child is carried to term, with the pregnancy posing no risk to the wellbeing of the mother. The second phase is the process of birthing a child, which in itself is very intense and requires an amount of expertise, as situations can switch within the twinkling of an eye. The third phase is preventing post-birth death of the mother and/or child. All three phases require close monitoring and knowledgeable handling by healthcare personnel to avoid any casualties.

As highlighted, these different phases all have the challenges that are peculiar to the third world. For instance, some pregnant women prefer the services of traditional birth attendants to the hospitals. This in itself is not a bad idea if the attendants are properly trained, but most of these same women would rather use herbs and root mixtures, which is presently not measurable and requires more research, rather than seek the services of professionals that have information and experience at their disposal.

Cloaked in religiosity, some women in developing countries, especially rural areas, would avoid the ultrasound scan at all costs, claiming that they did not want to ‘tu ise Olorun wo’ meaning unravel the handwork of God. In reality, the scan is meant to monitor the health of the baby, and watch out for any abnormalities that might require prompt medical attention. Without the scan, also, it might be impossible to determine the number of foetus being carried.

These points have been advocated and shared in enlightenment programmes regularly, yet some women would rather go into labor without all the information they can acquire regarding the process.

In the process of giving birth itself, if all the tests and monitoring are not properly followed, it will be difficult to plan for contingencies, and therein lies the crux of the matter. It is not uncommon to hear prayers against caesarian sections, such as ‘won o ni fi abe gbe omo jade ninu e’ which roughly translates to ‘they will not operate on you to bring out your child’.

This is one of the major causes of fear and stigma surrounding issues of childbirth – the belief that women who go through caesarean sections were somehow less than those who gave birth naturally.

In truth, situations that can lead to caesarean sections include failure of labour to progress, the foetus going into distress, multiple births, small pelvis/pathway for the baby in some women with very small statures, preeclampsia, fibroids, placental abruption, placental previa, cord prolapse, position of foetus and many more.

With these wide range of possible caesarean causes, women that have already been prejudiced against caesarean section might be setting up themselves for trouble. Records show that the most common cause of infant mortality is lack of oxygen during child birth for the baby, while the most common cause of maternal mortality is after-birth bleeding, all of which can be avoided or might require performing a CS. This is however, also subject to the timely access to medical facilities.

While the traditional and religious rulers have a lot of work on their hands regarding the sensitization of women (and men) about the dangers of mystifying CS, governments such as that of Ogun State have been putting efforts in place to ensure that women, whether in rural or urban areas, can access basic healthcare at their time of need and beyond.

Apart from ensuring that the primary healthcare facilities across the state are well staffed and equipped, the government continues to demonstrate its commitment to the reduction of maternal and infant death through initiatives such as the introduction of tricycle ambulances to operate across the wards of the state, towards providing fast transportation to healthcare at any time, especially for women who require CS in a bid to reduce the instances of avoidable loss of lives.

This initiative is already common in over 20 countries including Australia, Germany, Ghana, Hong Kong, India, Japan, Malawi, etc. Research shows that if it takes a normal-sized ambulance 15 minute to reach an emergency situation, the tricycle ambulance will take 7 minutes because of its light weight. It is also less likely to be stuck in traffic and can be pushed if need be.

Many people in rural areas cannot afford the use of private transportation, so the tricycle ambulances would be a lifesaver once it’s on standby with a rider and a telephone for communication purposes at each ward.

The tricycle ambulance can make more trips faster than a regular sized ambulance which will increase neonatal survival rate especially for women who decide to deliver at home with the help of traditional birth attendants.

Pregnant women who live in villages or away from places with good road access can obtain easy and fast transport to the hospital and this would substantially add to the functionality of the health system in the State.

In summary, the survival of the mother and child should be paramount in the minds of all involved, rather than giving in to unfounded fears, mythical beliefs and unnecessary paranoia that surrounds the caesarean section in a typical Nigerian setting.

Oyinkansola Ayoola from Ibara housing Abeokuta writes through glamorousme23@ yahoo.com