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It is alarming and a cause for concern, the rate at which women continue to die at the highest level of care during labour in the country. What hope then for the women at the rural areas, where primary health care centres are virtually nonexistent and where available, they are inadequate?  WINIFRED OGBEBO examines some of the cases.

The papers were awash last month over the death of the anchor of the Nation's newspaper, Education pages, Mrs Ngozi Agbo.

She died as a result of complications during childbirth.  Though the reports did not state where, it was clear that Agbo died at a higher level of care.

Also, a lawmaker in Oredo Local Government transition committee, Efosa Osunbor, slammed a N250m suit damages against the management of the University of Benin Teaching Hospital, (UBTH) hospital at the High Court sitting in the ancient capital town for negligence that resulted in the death of his wife, Mrs. Etinosa Ruth Osunbor during labour.

He is seeking the declaration of the court that the defendants caused the death of his wife and mother of his two children between 30th and 31st May this year.

Late Mrs. Osunbor was admitted in the labour ward of the hospital with a view of delivering her   third child when she died in the process.

The plaintiff stated that the defendant without his notification or express consent, took his wife to the surgical theatre  of the defendant on the same date of admission of his late wife whereupon she was operated and the baby delivered in that process.

It was gathered that the mother and child just delivered were taken to Prof. Ajabor's ward and she was kept in bed 16 wherein she spent about 24 hours and subsequently transferred to bed 18 of the same ward.

In addition, she was taken to the theatre for a second time without the consent of the husband and was devastated to hear the news of the wife's death on 30th March 2012 through a phone call by one of the nursing staff on duty at the hospital.

The plaintiff added that an autopsy was carried out on the late wife on 3rd April 2012 in the presence of a Pathologist appointed by him to ascertain the true cause of her sudden death, pointing out that the defendant on the 10th day of April, 2012, belatedly, accepted the said request for an autopsy through a letter dated same 10th April 2012.

He stated that both the primary and secondary cause of death (intra abdominal hemorrhage and hemorrhage shock) clearly established the very serious negligence of the defendants.

The plaintiff said his wife was born in Lagos on 25th July 1984 and was 27 years old when she died suddenly, adding that she would have worked for 35 years even without promotion until she is 65 years with a salary and allowances of one hundred thousand naira monthly.

According to him, the late wife would have earned one million, two hundred thousand naira annually and would have earned forty two million naira from her employment alone for 35 years.

The plaintiff therefore prayed the court to grant the sum of two hundred and fifty million as special and general damages for the negligence that caused the said death.

Same last week, the Minister of State for Health, Dr Muhammad Ali Pate, directed an independent inquiry be conducted to unearth the underlying systematic forces that led to the death of a pregnant woman at the Federal Medical Centre, Bida, Niger State.

Though Pate in a statement issued, commended the management of the Federal Medical Centre, for the prompt action taken after the incident,  he insisted that a thorough investigation into the matter is desirable, as it would offer an opportunity to address some of the systemic issues plaguing the health sector and ensure this never happens again in future.

The investigation, he said, should be concluded in three weeks so that action can be taken.

He reiterated that the Federal Ministry of Health was taking the issue of maternal deaths very seriously and it is unacceptable for the country to continue to lose pregnant women during child birth.

Mrs. Uloma Egbuchulam Anyanechi died on the theater table of the Federal Medical Centre Umuahia, Abia State on Thursday 24th November 2011.

She had given birth to a healthy baby girl under normal delivery inside the labour room of the hospital by 10.45pm on Wednesday 23rd November, 2011.

About an hour later, bleeding erupted but the medical officers could hardly stop it even after delayed blood transfusion. They later took her to the theatre for surgery but they failed to resuscitate her. So she died.

Also last year, another pregnant woman, 26 year-old Mrs Nana Lasisi was booked at the University of Abuja Teaching Hospital, Gwagwalada on the 21st of February at a gestational age of about 15 weeks. She was seen by the managing team regularly in ante natal clinic.

She was admitted at 41 weeks, two days for induction of labour on the 21st of July 2011, the indication being post date. She had cervical ripening with misoprostol and was transferred to labour ward on the 22nd of July when she was found to be in active phase of labour.

Lasisi who was hospitalised on the 21st July, 2011 for the purpose of delivery had her delivery period elapsed for one week and two days after being placed on induction for labour, a situation that complicated her delivery process.

She was taken to the theatre at about 11 am that day. While the scrub nurse and the nurse anaesthetist were preparing their trolleys and the surgeon went to scrub, the patient fell from the operating table and had a laceration injury on the forehead.  Although a live baby was eventually delivered, she was to die four days later.

According to  the 2008 Nigeria Demographic Health Survey (NDHS), 52,900 women die every year from pregnancy-related causes.

What is most worrisome about these deaths is that they occur at the highest level of care. When a woman dies giving birth or a child is orphaned, the ripple effect on the society is enormous.

According to the Chairman, National Population Commission, Eze Festus Odimegwu, the consequences extend beyond the existence of these individuals and have implications for societal peace, prosperity and stability.

But, Pate maintained that a major policy thrust of the Federal Ministry of Health, is the focus on improving the quality of care through better clinical governance.

According to him, the objective of the initiative is to address quality in three principal ways:

'Ensuring patient safety: One of the first tenets of the health profession is 'First, does no harm!' Patients should not be made worse off from the care received. Medical errors should be eliminated.

Improving clinical outcomes: We should be focused not only on the buildings constructed, or equipment purchased, but also on how these translate to improving health outcomes for the patients.

Enhancing patient experience: Care should be provided in a way that is responsive to the needs of the patients and respectful of their privacy. All patients should also be treated with dignity,' Dr Pate said.

As Prof Oladipo Ladipo said, 'the magnitude of maternal and infant mortality is perhaps the greatest social injustice of our time….. our inability to act proactively is but a symptom of a larger social injustice of discrimination against women and denial of women's right.'