Mothers on zig-zagging way to maternity hospitals

Halima Adamu chose the hospital where she would give birth even before she became pregnant.

She registered for antenatal at Customs Clinic, a small hospital staffed by Customs officials. She could have used the Nyanya District Hospital, but didn’t.

“I know Nyanya would have more experienced hands, but Customs is smaller-and they take better care of you,” Adamu explains.

She gave birth by lantern, was monitored for 48 hours, then discharged. She returned to keep immunisation appointments for her child, but she is now considering changing to a private hospital after an incident this week.

“My child was taken ill on Sunday. On Monday, which was Democracy Day, I took him to hospital. The entire [sic] admin didn’t want to do anything because it was a holiday. They said my child’s case was not an emergency.”

Public hospital staff are disrespectful to women, she complained.

A study this year backs her up. Researchers documented evidence of “physical abuse including slapping, physical restraint to a delivery bed, and detainment in the hospital and verbal abuse, such as shouting and threatening women with physical abuse” in two Abuja hospitals.

Many working mothers and affluent women would prefer to use private hospitals. For a fee, their comfort is guaranteed, they don’t need to deal with crowds waiting to get consultations and access to care is only presumed.

What public-or general-hospitals have over private is more experienced personnel, despite the congestion and stress that characterise them.

Celestina Ihenacho, mother of two and living in Jos, had both her children at a private hospital. It is popular and frequented by many working women but has just one gynaecologist, who is absent most times.

But the hospital scores well among women for its care of newborns.

“No matter how safe your delivery was or how healthy your baby looks, you will not be discharged until the paediatrician monitors the baby for 24 hours,” Iheanacho says.

“That was how my child was detected with jaundice and we had to stay in the hospital for additional seven days.”

The mother of two said she was diagnosed with uterine prolapse because she was in labour for too long and no surgeon was available to operate on her.

“In my hospital, it is nurses who take delivery and because there was only one gynaecologist and she was unavailable despite calls put to her, I developed uterine prolapse.”

By contrast, Margaret Idowu, 46, who gave birth to her third child last month at the Jos University Teaching hospital (JUTH), opted for a teaching hospital, citing concerns about pregnancy complications.

“The gap between my second child and the third is 13 years and so I visited a teaching hospital where there are a number of experts who assess my situation and take the necessary precaution,” Idowu said.

Health talks, blood pressure and weight checks were routine, as was a scan on every visit.

“Teaching hospitals are still good, the only challenge is that you may have to spend hours in the hospital because of the large number of patients,” said Idowu.

The National Demographic Health Survey documents health indices once every five years. By its latest finding, one woman dies every 10 minutes giving birth. The maternal mortality ratio has been compared to three jumbo jets crashing every day.

Complications during pregnancy and childbirth are the leading causes of death and disability among women of reproductive age. When a woman dies, it is not just a loss to the newborn, but to the family as well as the nation at large.

Women themselves blame medical negligence, staff nonchalance and unprofessional conduct of health workers.

“I was about four months pregnant and was having stomach upset, so I went to the hospital (private) in Kaduna town where I normally attend to complain and after some checks, I was told the baby was not breathing well and that I will be evacuated,” narrates Chioma Samuel, living in Kaduna.

“I was evacuated and discharged. After some weeks, I felt a sharp pain in my stomach. When I stood up I noticed I was bleeding, so my husband rushed me to a nearby private hospital where it was discovered that I was still pregnant.

“It was in the hospital it was discovered that I was pregnant with a set of twins and only one of them was evacuated in the first hospital I went to. So, I was operated upon and my womb cleansed because I also had some blood clotting. If not for God, I would have died and I am still believing God for another pregnancy.”

Another resident of Kaduna, Halima Aliyu, is concerned about close monitoring in both private and public hospitals, especially by night when patients may be abandoned.

“I understand that the medical practitioners are also human beings and they must also answer the call of nature but they should also always bear in mind the nature of their profession that they are trained to save lives and that they are suppose to do at all cost,” she said.

She speaks from experience. Her sister went into labour at night but was left to herself, as the nurses kept telling her it wasn’t time to deliver.

“She was left to labour for two days in pain and at the end, the baby died inside of her and she had to undergo caesarean section to bring out the baby because she had no strength to push the dead baby out.”

Kayode Ajayi came close after rushing his wife in labour to a private hospital the family used.

“After a while, I was told my wife will have to be operated on and that I should make an advance payment of N50,000. While I was still thinking of what to do, a nurse in the hospital called me aside and told me to take my wife to the primary health care centre in Kakuri and I immediately obliged.

“After a short while, a nurse rushed out to tell me that my wife has delivered the baby and I was asked to pay N1,050. I was very happy and rolling on the floor, full of joy and I didn’t know when I willingly gave them all the money in my pocket just to show my appreciation,” Ajayi said.

Concern about cost of care scares many from going to hospital. Hospital workers say Kaduna’s free maternal and child health “for now is not very effective as the drugs are not available.”

“So, the out-of-pocket cost is a challenge to many because when you write the drugs for them to go and buy in the pharmacy, they will not buy,” says the nurse, unwilling to be named.

Lagos has more private hospitals, but its public hospitals are weighing in heavily.

Perception of care varies. In some patients’ view, the care and services rendered are perfect but to others, the government needs to do more.

Madinah Folami, currently pregnant, uses General Hospital, Isolo, and has become used to its protocols.

“I do not know the number of women or children treated by the nurses. I know there are protocols before a patient can see the doctor,” Folami said.

“For antenatal, two nurses are on ground attending to the over 100 pregnant mothers. They do a routine check of the blood pressure, urine and weight. They also give medical advice on the wellbeing of the mother and child and thereafter share our folders out to the doctors on duties for one-to-one assessment.”

Aminah Arije also attends antenatal clinic at the hospital, which she also uses for her child.

“People have different opinions. To some, their services are not okay and this is largely connected with the large number of patients at the hospital during the clinics. But in my view, I am contented with their services, they are okay. The nurses care about us and the doctors do a thorough examination on us during the clinics. There is truly stress attached to the general hospital but it is basically during the time of registration. It’s quite hectic. After that, nothing more.”

Aisha Adamu gave girth in April at General Hospital, Ifako, and is happy with her choice.

“To me, the services rendered at my general hospital are okay and the health workers showed a high level of professionalism. The only thing is that, in general hospital, one must exhibit lots of patience due to the number of patients at the hospital during the clinics. If care is not taken, one can easily get fed up. But, with patience, whatever reason that took one there, maybe as a pregnant woman or mother, will surely be addressed.

“When I gave birth there, they fed us well and we were attended to appropriately. Unlike some other general hospitals who quickly discharge a patient on the pretext of inadequate bed space, in our own case, a new mother is not discharged until the second day, if birth is vaginal, or on the fifth day if it’s by caesarean section. Before they discharge a patient, they would have ascertained that nothing is wrong with both mother and child. The other condition is that, you must pay their fees. If you owe them, you will stay longer.”