Friday, March 06, 2015

Blog #4 - International Women's Day: Delivering comprehensive obstetric care for mother's in Nigeria

Teenage mothers in northern Nigeria account for sixty percent of patients at the Medecins Sans Frontieres (MSF) obstetrics unit in Jahun Hospital.  The MSF unit aims to reduce neonatal and maternal mortality among young mothers in Nigeria. The majority of patients are adolescents, ages 15 to 19, who come into the clinic seeking care for conditions such as anemia, malaria and eclampsia, which is characterized by high blood pressure and weight gain in the pregnant woman.  Miscarriage is also more prevalent in this age group, with seventy percent of miscarriage patients occurring with these women.  One of the biggest problems seen in the obstetric unit are fistulas.  This condition consists of a hole, usually in the vaginal wall, which causes incontinence, either urinary or rectal.  The constant drainage that results causes social rejection of the young mother, by her husband, family and friends.  This usually happens because young mothers suffer prolonged labor, presumably because their birth canals and pelvis are not fully developed, which in addition to a fistula, can also result in death of the newborn.  Delayed obstetric care is also a common problem, as women often don't have access to medical care, or have financial constraints that prevent them from seeking adequate medical care; this, along with giving birth at home with traditional birth attendants as a means of being seen as a strong woman in the community, increases the chances of neonatal and mother mortality which the MSF obstetrics unit is greatly trying to reduce.

The goals of the MSF obstetrics unit in Jahun Hospital I think will be very effective in time.  Obviously, this clinic can not change the customs of the Nigerian women.  Many of these women have been giving birth at home for generations as part of their tribal traditions.  The goal is not necessarily to change the minds of the Nigerian women about the safest birthing practices, instead, it is to educate them on the safest birthing practices for their babies, and provide them with the obstetric care they need beforehand, so that if they do choose to deliver at home in the company of a traditional birth attendant, then the woman's pregnancy has at least been monitored up until that point.  There's also the possibility that with additional education, women who are high risk pregnancies, may in time choose to be in the company of professional medical care when delivering their children, which would reduce neonatal and mother mortality even further.

Megan Wrench

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