Intricacies Of Normal and C-Section In Nigeria
At a time Nigeria is said to account for 25% of maternal and infant deaths in sub-Saharan Africa, many women are opting for CS with joy, while to some others, it is a nightmare; Odimegwu Onwumere writes
There is a rampant debate going on in Nigeria about giving birth through the normal canal and Caesarean Section (CS). This debate is eating up the fabrics of many in different foray and it’s uncontrollable online.
Being a religious country, when a woman is delivered of her baby in Nigeria other than the normal way, a phantom Satan is fingered as the culprit for such. In some tribes, such a woman is ridiculed, as not being woman enough. Apart from the stigma attached to CS, some women say they fear to be conducted CS on, because of the fear of death.
However, many have a view that there are complications associated with giving a birth in Nigeria – either giving birth normally or through CS in Nigeria – due to shallow state of the hospitals. Others argue that there are severe pains that are associated with CS, unlike normal delivery. Some even believe that it is suicidal having three times CS, adding that any woman, who had gone through CS two times, would do everything to avoid the third time.
Their fears range from saying that Nigerian doctors are not using modern health technologies to not suturing the women operated on properly. As a result of this, a woman complains that after giving birth through CS two times, her stomach still protrudes, as if she is five months pregnant. Some opinions are however that giving birth through the birth canal gives pains, no doubt, but the joy after the baby overwhelms the pains; but the pains of CS lasts, even nearly a year. Some say that doctors purposefully conduct CS on women in labour for economic gains.
But speaking to News Agency of Nigeria (NAN) recently, some medical experts rebuffed the claim, saying that it depends on the doctors the people are talking about. However, they didn’t rule out the fact that the economic hardship Nigerians are facing in the name of recession that started about two years ago can push some doctors to go for nefarious gains. According to the source, “When we talk of economic gains to doctors, are we talking of doctors who work in public or private sector because for a doctor who works for government, the money is not going into his pocket.”
Nonetheless, some men add to the debate, saying that under normal circumstance, they will not allow their wives to go for CS, but can only bulge under medical advise. To some of the men, it is even surprising that their wives who have had CS, they never believed they would. This is given to the fact that where they had the CS, were in the same hospitals they conducted their antenatal. They were never told the state of their babies till labour. To them, this is a nightmare.
Yet, while some women frown at CS, some others prefer it. A woman whose name was given as, Vera Onyeaka-Onyilo told newsmen on April 16 2016, saying that she could not bear with pains, having experienced pains in the past. She said, "I am not someone who can endure pain. I have had previous experience and I was kind of scared. I see CS as an option that will be easier and not take me through a lot of pain. It is a matter of choice. If I have that option, I would opt for it, provided it is in a good hospital."
Conversely, some medical experts, like a surgeon at the Lagos State University Teaching Hospital, LASUTH, Dr. Olugbenga Saliu Oseni told Journalists in 2013, saying that hardly will any woman think of CS but complications cause CS. According to Oseni, “The best thing to happen to a woman is to have a normal delivery but when this is not available, the preferred option should be CS, because you can evaluate your result.”
Without a doubt, CS is on the increase in Nigeria for other reasons such as social factors and has remained a matter of worry to authorities. According to NAN, July 16, 2017, “Mothers are now also requesting caesarean section because they want to preserve the tone of the perineum and vagina. Mothers, who want their babies delivered on a particular day like their birthdays, husband’s birthday, wedding anniversary, special occasions like New Year day, Christmas or other religious occasions, are not left out of social factors.”
Albeit, Caesarean Section is not as cheap as the number of women undergoing it soars. In some hospitals, those who know better say that the cost of a C-Section goes for the ratio of N250,000 to N300,000. These amounts are said to double for multiple births. Equally, some women that have obstetric fistula are advised to go for CS during labour, whereas some normal women who opted for CS to avert pains associated with labour, have been injured, leading to obstetric fistula.
Whilst some women think they welcome CS to normal delivery, and doctors having no other option during complications in the theatre to CS, there are experts who believe that CS is associated with some risks that include "maternal death, bleeding, dangerous clot formation in blood vessels, infection and anaesthetic complications."
Even as CS is said to be the only option left to save a mother and her baby during complications in the theatre, the World Health Organisation, WHO had frowned that much of it cannot be said to be good. As according to media reports of 2013, “The Centers for Disease Control and Prevention, CDC, said there has been a gradual increase in caesarean births over the past 30 years. In November of 2005, the Centers for Disease Control and Prevention, CDC, reported the national caesarean birth rate was the highest ever at 29.1 percent in the United States, which is over a quarter of all deliveries. This means that more than one in four women are likely to experience a cesarean delivery.
“But the WHO, has stated that the caesarean rate higher than 10-15 percent is unnecessary regardless of location. In Nigeria, also a study carried out on Caesarean Section in a secondary health hospital in Awka, by the Department of Obstetrics and Gynaecology, Amaku General Hospital, Awka, Anambra State by LC Ikeako1 and colleagues in 2009 showed a gradual yearly increase in rate from 9.0 percent in 2005 to 11.4 percent in 2009. Maternal mortality rate was 480 per 100,000 deliveries, while the prenatal mortality rate was 63.8 per 1000 total births.”
Odimegwu Onwumere is an award-winning journalist based in Rivers State, Nigeria. He contributed this piece via: [email protected]