Safe Motherhood #5: A disturbing trend.

A couple already has 5 male children and they arrived at this number because of the desire to have a female child. Nothing wrong with wanting to have both genders but many times things do not work out the way we plan. This woman gets pregnant again and the family is excited and hoped that they will eventually have their much-desired girl child. By the way, it is nice to see a turnaround in the cultural belief that only male children are important in a family.

Back to my story, it turns out that this couple had a double blessing for their long wait. A set of twin baby girls arrived into their lives. They were ecstatic but soon the mother began to bleed after the delivery of the children. Some of her placentae remained in her which caused bleeding. She was eventually referred on emergency to a tertiary hospital for special care. It took a lot to stop the bleeding and save this woman’s life.

Seriously why do we keep endangering our lives as women?  And there are men who insist on having more children when their wives have health challenges or difficult birth experiences… I ask …

Do you want a living wife or a dead one who will leave you to struggle to care for the many children you so desired at the expense of her life and wellbeing?

If God gives you only girls be contended. If it is boys be satisfied too. Have you thought about couples who would give anything to have just one child? I have family friends who insist that they want a certain number of children and it doesn’t matter which sex they are blessed with their decision remains.

Now the couple in my story have seven children…hen! All in the name of having a particular gender as a child. Please be grateful and contented and take care of your children no matter which gender they are.

Hemorrhage or bleeding is one of the leading causes of maternal death. It can occur before, during and after delivery. One cause of bleeding is when the uterus does not contract quickly enough after birth. Having multiple births in quick succession enlarges the uterus. This reproductive female organ is described to be like a balloon and many births cause the uterus to keep expanding and may just “burst” figuratively speaking. This means that the mouth of the womb/cervix may not close up as it should which causes bleeding that can lead to death when next such a woman is having another baby.

It is important for mothers to rest well in between births and equally avoid undergoing too many births than their health can withstand. So encourage and advice your friend, family and those who work for you doing menial jobs to take things easy and plan their babies and also be satisfied with whatever gender they have.

If you are wondering how to prevent unplanned pregnancy visit any family planning clinic or hospital nearest to you to discuss your options. I know that primary health centers also provide these services for a token.

Family Planning reduces maternal mortality by 40%

Adebisi Adetunji ©

SPITFIRE Advocacy Skills Training for Media in Oyo State

When I first heard of the catch phrase “Spitfire”, I thought in Pidgin language…”Wetin this one mean now”? Analysing it further I came to the conclusion that it possibly means reinforcement and persistently talking about an important social issue or whatever issue. In this case spacing births in order to save lives, improve on the quality of lives of citizens and of course making governance easier for government.

I have been part of the Spitfire Advocacy training on how to effectively share family planning stories organized by DEVCOMS and NURHI holding in Ibadan, Oyo State.

As the training began it became clear what Spitfire Advocacy means. It is a tool for helping non-profit organizations develop high impact and effective persuasive communication. It is a Smart Chart for communications and the latest version is known as Chart 3.0

In advocacy efforts the Spitfire tool can be used at different levels of creating awareness and making impact about an issue. Some of these stages include:
1) Just starting a communication process: This is the planning stage where you determine your message; goals and objectives and what you intend to achieve.
2) Building on a campaign that is already on-going
3) Reviewing and wanting to scale up on an already executed project.

Spitfire is also a more effective strategic communication advocacy tool. It helps organizations and individuals who are change agents to make decisions that will produce high result. Read more about The Spitfire Strategies Smart Chart 3.0, a highly effective communication tool.

Why  the media is important here: Because it has the capacity to educate the public. The media is a potent force that can cause change positively or negatively.

Spitfire strategies helps you make:
Specific
Measurable
Actionable/Attainable
Realistic
Time Bound

Set SMART goals, decisions in achieving a change.

I learned that nothing is impossible if you set your mind to it. Team work and coalitions makes pursuing and achieving success at an idea more effective. As you can see in this photo

A group of participants in a tight interlocked hand holding exercise. Lots of laughter 😂😂😂 as they tried to untangle while still holding each others hands to form a circle. It looked unachievable at first but we ended up unraveling the mystery 😀😀😂

Facilitators at the training:
Mrs Stella Akinso – State Team Lead, Oyo (NURHI)
Mallam Kabir. M. Abdullahi – State Team Leader, Kaduna(NURHI)
Mr Samuel Rapheal – Senior Program officer, Advocacy & Demand generation (NURHI)

Adebisi Adetunji (C)

Safe Motherhood #4 – My Personal Eventful Birth Experience Prt 2

Catch up on  my previous post, Safe Motherhood #3 – My Eventful Birth Story part 1

I woke up in the early hours of the day I would eventually deliver my baby to go to the toilet. I discovered that I was already wet, wet with a lot of blood. It was kind of scary but I thought it was the blood show that sometimes occurs as a prelude to labor pains in some pregnant women. How naïve I was if only I had known what that meant but not knowing kept me from panicking. I had to change my sanitary towel like twice before day break. When we saw how heavy the blood flow was, my husband and I knelt down beside our bed and prayed not knowing what lay ahead. We simply had faith that God will take control beyond our understanding of what was happening. I didn’t get much sleep so I had my bath and as soon as it was 6 am off we went to the home of a family friend who was a doctor and lived in our neighborhood.

When we shared what had been happening with him he simply said he would immediately take me to the hospital in a very unsuspecting doctor’s way of treating an emergency in a not alarming way. We had no idea that it was a serious thing. It was only after a series of scan tests and then my consultant was called to attend to me on a Sunday that I realize something serious was up. He came in right from attending church service.

I was still puzzled by all the back and forth going from the hospital ward to the scan room severally. Finally, my consultant said, “Madam we are going to do a caesarean section in order to save the life of you and your baby”. I took a heavy breath and became really afraid of going to the theater to deliver my baby that in the given circumstance I had no choice.

I was wheeled into the theater and I woke up two weeks after delivery of my baby. I do remember trying to wake up from the anesthesia effect but that was all I can remember. Much of what happened afterward was narrated to me by my husband.

The surgery was successful and my baby was alive only he was underweight. And because I couldn’t breastfeed him since I was really sick myself, he was admitted to the special baby care unit.
Why did I need a caesarean section? What was the cause of the bleeding? I was told that I had Placenta Previa (When the placenta detaches from the uterine wall and bleeding occurs).

mumjunction.com

After delivery of my baby, I had eclampsia (Pregnancy induced high blood pressure that leads to seizure). Usually, a woman can experience preeclampsia during pregnancy which later leads to eclampsia. This characterized by swollen feet, high blood pressure. However, these signs did not present itself in the last trimester of my pregnancy. Unfortunately, my B.P went up after the CS that resulted in a seizure. All these I didn’t know and do not have a memory of. My husband prayed hard that I would survive and my doctors did their best to stabilize me.

After coming around two weeks after delivery, I still was very weak and needed some time to recuperate. Mostly my body had been starved of proper nutrition through pregnancy and I didn’t have enough stamina to even breastfeed. I was not to be discharged for another week and a half. My baby’s naming ceremony held one month after delivery!!

The two major birth complications that occurred (Placenta Previa & Pre-eclampsia) during the delivery of my baby are factors that have been the cause of many maternal deaths. I do not take lightly the blessing and mercy of been alive to tell my story and possibly help as many women from being endangered in such a way.

What Saved Me:

Registering for antenatal and delivering at an equipped hospital with trained health personnel went a long way in prompt attendance to my emergency. Imagine if I had gone to give birth at a mission house or with a local mid – wife where they are ill equipped to manage my kind of emergency. It would have been a different story.

Lessons
• My body was severely malnourished and starved of the required nutrient needed to carry a baby. Therefore the after effect of my falling ill after delivery. Even after being discharged from the hospital I needed to really feed and rest well before I regained my strength and weight again (Though I am naturally a slim person).

Ignorance is no excuse to dare consequences of not knowing what you should know. Please get registered for antenatal quickly as soon as you discover you are pregnant.

Read books on what expectant mothers should do in order to have a healthy baby and be healthy themselves.
Measures that helped me relax in between births

Managing after effects of my  birth complication and Resting Well

I was advised to go for family planning in order to prevent me from getting pregnant too soon. My body was not ready for another pressure of carrying a baby.
It also afforded me the time needed to heal properly.

Three years down the line I became pregnant and this time I was ready. I even began to take folic acid and B-complex to boost my multivitamin level. I had learned my lessons and today I can sing this song:

I’m Alive today because God kept me…

Thanks to all my doctors and nurses who took care of me at that very trying period in my life and that of my family.

Photo Credit: mumjunction.com

Adebisi Adetunji (C)

Safe Motherhood #3: My Personal Eventful Birth Story Prt 1 – Before You Get pregnant

Lending my voice to creating awareness about Safe motherhood I will be doing a few posts on my personal eventful birth story and also share how women can have a safe journey through pregnancy and delivery by preparing ahead even while a single.

The beginning of my own story:

Whenever a couple decides to tie the knot or make a lifetime commitment in Marriage their families say prayers of fruitfulness for them. In Nigeria, you will hear parents and even their pastor offer prayers of twins and triplets if possible.

Often people prepare you for other aspects of marriage but no one talks to the couple about what to do when they are expecting a baby. No one would tell them how to manage the period of pregnancy. As a lady, my eating habits left much to be desired. Often I will only eat a little meal and then of course loads of junk food was the order of the day. I had no idea what this would later mean to my health.

When I got married to my beloved husband or Boo as is the trend now I was excited and happy. We were contented even though we both earned a meager salary. Our mothers will often call and ask how we were doing. By that, they meant, “are you pregnant yet?” My husband and I will laugh and tell them to keep praying and hopefully, soon they would be grandmas.

One day I started to feel dizzy and my stomach won’t just settle and the first thing I wanted to do was confirm if I was pregnant. We were advised thankfully not to take any drugs until we confirm with our doctor. You know newlyweds don’t know sometimes that when the woman is not feeling too good she might be pregnant. And so such a woman will assume it is a case of malaria or other mild illness and begin to take drugs that will end up harming her baby and herself.

The funny thing was that I went for a scan and didn’t go for the usual urine or blood test. There I saw my active baby swimming all around. I became excited and then the doctor conducting the scan said madam there is a little problem.

My heart sank. My doctor said my baby was growing with multiple fibroids around my uterus. I was scared but she allayed my fears that since it didn’t prevent me from getting pregnant my baby can still grow normally and be delivered safely.

And so the journey through pregnancy began. My first three months was unexpectedly not turbulent as I went about my normal business going to work and doing every other thing. Still, I wasn’t eating well neither did I register for antenatal care where I could have gotten the necessary information about kinds of rich foods for an expectant mother. Instead, I was eating things like cereal, cornflakes and no serious meals.

When my pregnancy clocked four months the battle began. I became very ill and couldn’t retain any food. You would expect that we would immediately go to the hospital but we were managing the whole situation at home. Our excuse was that we did not have money to go to a private hospital and the general government hospital was on strike.

I was barely eating for three months so it was not until 7 months into the pregnancy that I was able to feel well but my baby had not received the needed nutrition for his development in the womb. Finally, I was able to register for antenatal but rather late.

Wait until you hear about my traumatic delivery experience that almost cost the life of my baby and me in the next post about safe motherhood.

Lessons from My Story

  • Develop a good healthy eating habit now.
  • If you experience distress or fall ill during pregnancy do not stay at home, get to the hospital to see a doctor. A simple drip to help return body fluid I had lost while vomiting continuously could have helped to stabilize me. Also, my doctor would have prescribed something to stop the vomit.
  • Get medical help at a Primary Health center if you cannot afford the secondary or Tertiary government hospital. They are cheaper and almost free.

 

Before You Get Pregnant:

Now is the time to eat right as a single lady or as a couple who plans to have a baby. Your body needs to have all the necessary nutrients because in pregnancy you and your baby will need a double dose to be healthy.

Junk foods and sweets look juicy and feel tasty but they provide nothing useful to your body. Avoid them as they can increase your blood sugar level.

What to eat now that you are not pregnant:

  • Lots of fruits and vegetable – Carrots, Apple, Pineapple, Pawpaw, Water Melon, Ugwu leaf, Green(Efo tete) (Vegetables)
  • Dairy products such as milk, yogurt are rich in calcium
  • Foods rich in protein such as beans, fish, meat, egg. For Nigerians, if you do not really like beans, make akara and moimoi. These will still provide you with the much-needed protein.

Eat healthy to have a healthy baby. And seriously you need to be healthy yourself as a mother.

Know your health status before getting pregnant so that your health care provider can know how to properly manage you.

Adebisi Adetunji (C)

 

12 Factors that makes a Woman Susceptible to Obstetric Fistula, Prevention & Care (Safe Motherhood #2)

Mama sat at the bedside of her daughter looking dejected at the hospital. She prays hard that God will save her daughter from this affliction that left them all in open disgrace and embarrassment. Her daughter had just put to bed but her vagina was leaking with urine. The young lady had sustained an injury during a mismanaged childbirth and was later brought to the hospital. Mama is burdened with caring for her daughter and newborn as the girl’s husband had abandoned them. He couldn’t cope with the mess as he referred to it. Mama believed that somebody had bewitched her daughter but at the hospital, she finds out that there is hope for her daughter. She prays hard that the surgery to the injury will work but also worry about raising enough money to pay for it.
This young lady has what is known as Obstetrics Fistula which occurred during childbirth with unskilled birth attendants: A sad story but hopeful.

The international Fistula awareness day comes up every 23rd May and this year’s theme is tagged: Hope, Healing & Dignity to us All.

Obstetrics Fistula is an abnormal hole in the bladder or rectum as a result of a traumatic birth experience. Urine drains uncontrollably through that hole to the vagina. It can also be termed to mean injury sustained in difficult childbirth or a birth not properly attended to.
Fistula occurs mostly in younger people (under 18 years) not old enough to give birth.

Factors that makes someone susceptible to Obstetrics Fistula:
1. Children below age 18 getting pregnant are a risk as their birth canal is not big enough for a baby. The injury is usually sustained during childbirth.
2.  Labor that is not managed properly especially when there is an obstruction. This is a situation a baby is too big to pass through the birth canal.
3. When a woman presents a breech baby she can sustain an injury during delivery or in the process of trying to assist her.
4.  During the operation of a woman to remove her womb probably because of fibroid mistakes can occur and she sustains an injury.
5.  Unskilled birth attendants in the rural or urban area can put a pregnant woman at risk of Fistula injury.
6. Quacks carrying out a caesarean section can injure the bladder or vagina of a woman.
7. Cancer of the neck of the womb can also erode into the bladder leading to Fistula.
8.  Female Genital Mutilation (Female Circumcision) could cause injury to the bladder. Also, infections may occur in patients not given any antibiotic after FGM. This infection can erode into the bladder and vagina.
9. Women who in an attempt to treat Fibroid or abort through herbal means take caustic materials are at risk of sustaining an injury in their vagina and bladder leading to Fistula.
10.  In some cultural or family practices where women are not allowed to go to the hospital to give birth but instead are required to give birth at home with spiritual chants, when there is an obstruction such women are at risk of Fistula injury.
11.  Lack of funds/poverty prevents people from going to safe hospitals to give birth. Stillbirth may occur and in an attempt to deliver the mother of the baby an injury can occur.
12. In remote villages/places distance to the hospital denies women access to proper care and therefore are exposed to quacks to monitor their labor. This is dangerous.

Prevention of Fistula:
Integration of family planning to reduce the number of abortion by quacks helps to reduce fistula cases.
Training and updating midwives to be able to detect when there is going to be a problem with a pregnant woman’s delivery. Such women are referred on time to a hospital equipped to care for them.
Provision of Maternity Health centers in remote areas will enable women to have access to proper maternal care.
Preventing underage marriage
Sex and health education of teenage girls to keep them from engaging the services of quacks to do abortion.
Health education on the importance of pregnant women registering with hospitals for proper care.
Government making maternal care cheaper or even free.

Why Fistula should be eradicated
A leak of urine or faeces through the vagina leaves the woman psychological traumatized and physically incapacitated. She cannot go to work or go about her business for fear of the smell and stigmatization. Therefore she is economically handicapped. This will also affect the income of her family and her wellbeing.
Some women have been abandoned by their husbands because he could not cope with the trouble of his wife wetting the bed and smell. This further affects her well-being and that of the family.

The Good news is that Fistula is repairable. Many do not know that this is possible. Share with a woman with a Fistula today that her case is treatable.
Right now the University Teaching College Hospital and Adeoyo in Ibadan are offering free Fistula treatment. It is from 22nd May – 26th May 2017.

Fistula is Preventable; It is treatable

Apart from the opening story and conclusion, this article was drawn from points on an interview with a team from the Engendered Health (NGO) and members from Ministry of Health in Oyo state on the radio station Premier F.M 93.5 in Ibadan on the 23rd May 2017.


The team includes:
Prof. Oladosu Ojengbede – Chief Surgeon Obstetrics & gynecologist UCH.
Dr. Doyin Bello (Gynaecologist)
Mrs. Olajumoke Adekogba (Rep. Engendered Health – Fistula Care Plus (USAID)
Mrs. Oluwakemi Olawoyin( Rep. Commissioner for Health)

Adebisi Adetunji (C)

SafeMotherhood#1 – Times when having a baby might be a Risk for a Woman

A few hours ago I heard the unpalatable news. I was actually outside my house trying to clear up some debris into the dustbin. My neighbor arrived and she had this gloomy face. I had to ask her what was wrong and out came the words that made me jump and exclaim. A friend of hers who was pregnant had just died leaving a baby behind. The cause of death was attributed to bleeding after birth which ended up as a complication. Doctors tried so hard to save her but she didn’t make it. It is so painful to hear what happened to this woman.

While talking with someone else about this case with all of us still beating our chest in empathy and concern out came another case. This time a woman had four boys already and she wanted a baby girl. She ended up becoming pregnant but gave birth to another baby boy. That would have convinced her to give up on the quest for a female child but she didn’t get the chance to make that decision. She would never live to raise her boys. It’s now a case of if only she had just put a full stop.

No woman should die giving birth to another life!!!

When you read about statistics of women who died during or after giving birth what comes to your mind? For example:

According to National Demographic and Health Survey(NDHS) 2013, the maternal mortality ratio is 576 per 100, 000 live births.

Does it seem like just a figure? Remember that number 1 represent one human- a woman- a soul. It’s happening all around us these needless deaths of women at the birth tables.

So here is what you need to know to protect any pregnant woman including yourself.

According to NDHS 64% of births in Nigeria are classified as high risk. The categories of women at risk of things going wrong trying to bring a child into this world fall under this time lines:
1) First timers: Couples preparing to have their first baby must get registered for antenatal early and be monitored through pregnancy. The first story I shared in this post was a first-time pregnancy. And there have been many of such cases due to lack of proper information about how the woman should have managed the pregnancy.

2) Too Early: Pregnancy that occurs in children from 10 – 13years. We call them baby mothers. Imagine your 11-year-old pregnant…? God forbid you will say. So we must protect our girls and stop giving out babies in marriage.

2) Too Young: This is the period before 18years.
Many cases of VesicoVaginal Fistula (VVF) happen with underage girls having babies. This is rather sad and is preventable. As close as of March 2017, Dr. Aliyu Mohammed El – ladan the National Director of Fistular Centre in Kastina said there are about 12, 000 new VVF cases every year in Nigeria. Something to be really concerned about

3) Too close/soon: Getting pregnant when still breastfeeding one baby is stressful and can become a health risk for both mother and baby.

4) Too Many: Frequent births of many children wear a woman out. She becomes prone to a number of health challenges sooner or later in life. That is if she survives it.

5) Too Late: A story is told of a woman who got pregnant when her oldest child was getting ready to graduate from the university. You can imagine how old she was. Sadly she didn’t survive that birth because of complications. This shouldn’t be!!!

Retirement babies are risky: You shouldn’t be nursing a baby when you should be enjoying grandma –hood.

Ways to prevent maternal deaths:

  • Know your medical history so you can share with your doctors right early in pregnancy.
  • Register for antenatal on time.
  • Do all the required tests and routine ones too.
  • Eat right and healthy.
  • When you are not feeling too good or have concerns speak to your doctors on time. Don’t just take every untested advice from others whose pregnancy experience may not be the same as yours.
  • After delivery of your baby don’t forget to keep your postnatal appointment at the hospital.
  • Take time to rest in between births by going for family planning.

My submission:

Plan your babies… Let’s protect our girls; let’s protect our mothers, sisters, friends and neighbors by sharing this information with them.

The life of one mother is precious. Go for family planning today.

Photo Credits: 123Freevectors, Center for Communications Program Nigeria

Reference: NURHI/DEVCOM

Adebisi Adetunji (C)

In the News : 37 year Old Woman Gives birth to 38 Children!!😱

A Ugandan Woman named Mariam Nabatanzi Babirye has the photo of herself, husband and some of her 38 Children splashed all over the pages of newspapers and social media.

As I stared at the photo of this “massive” family my jaws dropped open for a long while😱. Being a mother myself I can’t even begin to imagine having to go through birth pains 5 times not to talk of 38 times!! It is simply writing a suicide letter in my opinion. Expert says that having too many children increases a woman’s health risk

Mariam’s story is that she was given off in marriage at age 12 to a 40 year old man. A child abuse case, I mean I don’t understand the excuse that it Is because parents are ignorant that makes it easy to give away a child in marriage. This has to stop!

I believe it is only by sheer Providence that Mariam survived these births which were mostly probably delivered by a local midwife before she finally arrived at a hospital. Now the world knows her story. Haaaaa it is simply not a funny matter to me!!

By age 40 possibly the ware and tear of her body may soon start manifesting in form of one ailment or the other.

Medically the reason she has had multiple births is because she is hyper-ovulating. Meaning that she her ovaries releases multiple eggs monthly.
They say ignorance is costly and it is not an excuse. I can’t help but think about the what ifs of Maria’s case.
If only she and her husband had known better ; if only a family member or friend or neighbor had pointed her in the way of a permanent modern family planning method solution. Seriously somebody should have told her that her ovaries and even the uterus could be removed.

Anatomy – medicine. com

Somebody said the children didn’t look hungry or under nourished in the photo. Maybe because their father is a farmer? How big is his farm to be able to feed a family of 40 including making extra money to cloth and send them to school?

My what ifs returns… Seriously having too many children puts the mother, children and even the father at risk. High blood pressure from not having enough to care for them will set in.

Another angle to this is that government needs to better equip and strengthen primary health centers in villages and communities. It is my business; it is your business to save a mother and child.

Maternal deaths can be prevented through adequate health education and family planning.

Adebisi Adetunji (C)