The most dangerous day in a woman’s life

By Dr. Femi Ogunyemi
Many across Nigeria will be celebrating a baby’s delivery
today. Labour has ended with smiles, cheers and
thanksgiving.
They say birthdays, funerals, weddings and naming
ceremonies are the commonest social pastimes in Nigeria.
Cue music……..
What with the dancing, the food, the drink, the rituals…
kolanut, salt, honey, the Pastor, the Imam, the Priest…
Pregnancy and labour have been vanquished.
Baby is well….mother is –
Stop the music …..
Today, in Africa, the most dangerous day in a woman’s life
is the birth day!
Almost one third of all maternal deaths globally are
concentrated in two countries: India and Nigeria!
Globally, an estimated 289 000 women died during
pregnancy and childbirth in 2013, a decline of 45 percent
from levels in 1990.
Most of them died because they had no access to skilled
routine and emergency care. Since 1990, some countries in
Asia and Northern Africa have more than halved maternal
mortality.
There has also been progress in sub-Saharan Africa. But
here, unlike in the developed world where a woman’s life
time risk of dying during pregnancy and childbirth is 1 in
3700, the risk of maternal death is very high at 1 in 38.
Increasing numbers of women are now seeking care during
childbirth in health facilities and therefore it is important to
ensure that quality of care provided is optimal.
Globally, over 10 percent of all women do not have access
to or are not using an effective method of contraception. It
is estimated that satisfying the unmet need for family
planning alone could cut the number of maternal deaths by
almost a third.
Most maternal deaths are preventable.  By far the
commonest cause is bleeding; bleeding during pregnancy,
while in labour or soon after delivery of the baby.
Infection, disorders related to high blood pressure, AIDS and
prolonged obstructed labour make up a significant amount.
Abortion, anaemia, embolism and rarely ectopic pregnancy
make up the rest.
The Millennium Development Goal #5 set in 1990 aspires
(a) to reduce maternal deaths by 75 percent from 1990 to
2015; and (b) achieve universal access to reproductive
healthcare services by 2015.
As of 2011 Sub-Saharan Africa (including Nigeria) had the
highest number of births to women between 15-19 years of
age in the world: 117/1000 women, relatively unchanged
from 123 in 1990.
Early childbearing poses great risk to mother and child.
Another problem is family planning. In Nigeria, large
differences in contraceptive use persist between urban/rural
populations, rich/poor people, and the educated/
uneducated. Healthcare during pregnancy is important and
must be provided by “skilled and equipped health
personnel”…i.e. a doctor, nurse or midwife.
MDGs Report
An important document titled “Nigeria 2013 MDGs Report”
has been released on the NPHCDA.org website.
It states:  “…the maternal mortality rate is 350/100,000
against the target of 250. The proportion of births attended
by skilled health personnel is currently 53.60% against the
target of 100 per cent and antenatal care coverage (at least
one visit)” * the WHO recommends at least 4 visits!* “is
currently 67.7 per cent.”
The Federal Government has established a MDGs
Acceleration Framework (MAF) for MDG 5 that they believe”
will enable all the targets of MDG 5 to be achieved by
2015.”
We are less than 500 days to the deadline.
Nigerian women, daughters, sisters and mothers are
waiting.