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Saving lives of mothers and children through child spacing

When Deborah had her first child, a boy, she was 25 years old and a youth corps member. She was shocked to discover she was pregnant three months after giving birth.

Though educated, she thought she had protection from pregnancy through breastfeeding her child, and felt there was no need for her to utilize any family planning method.

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“I thought that I had total protection against pregnancy since I was breastfeeding and fresh from delivery.” She said “I have never had such a challenging time in my whole life. I had to take care of the baby, and also take care of my pregnancy. We were always sick. To worsen it all , my husband who is a contractor had become jobless during my pregnancy because the administration that came in abandoned and canceled the projects he was doing.  We found it difficult to feed properly and go to the hospital when sick.”

Deborah, now 30 years old said taking care of the family became increasingly difficult after the birth of her second child, a girl , as she had to buy baby food for both of them, and the family from her meager resources.

She said she felt she robbed her first child of her childhood as the baby cried for attention all the time, and always wanted to be carried like her little brother.

Neighbours, relatives and friends alike added to the young mothers woes as they taunted her for getting pregnant too quick between.

 “I narrowly escaped death, as I bleed profusely after birth. I learnt my lesson and planned a three year gap between the second and third child. I was much healthier and had time to  do things to earn income to support my husband. I also didn’t feel that guilt of injustice between my second and third child because I bonded with them both. The second child didn’t feel neglected , no rivalry and we were not frequenting the hospital like the previous birth,” she added.

Aanu got married at age 40 and felt that she needed to get pregnant and have her children in quick succession inorder to beat menopause. However, she was not prepared for all that came her way  when she got pregnant six months after she had her second child.

 The child was always sick with persistent stooling and vomiting and Aanu herself was not in the best of health. She decided to abort the pregnancy but was refused at the private hospital she went to.

She later met the owner of  a patent medicine store   who willing aborted the child for her. She decided to settle down to nurse her little son but he died three months after. All efforts for her to conceive since then had proved abortive, and now that she has attained menopause, she only has her first child instead of the many she looked forword to.

Hajiya Maryam on her part has five children most of whom were delivered one year apart. She had suffered from complications since her third pregnancy . While she believed in family planning, her husband does not. She added that he agreed that they should space their children after the complications she developed during her  third child but the fact that he does not believe in the use of contraceptives  to space children has frustrated that effort.

The mother of five said she followed the advise of a friend and sneaked to a  patent medicine store near her house, one day when her husband was not at home; told other family members she was going for a malaria drug, and received ‘family planning injection.’

She said with that she was able to give a two year gap between her fifth and sixth child.

Asked why she did not go to the hospital instead, she said she wouldn’t be able to afford the cost at a hospital and may not get the permission from her husband to do so. She said she has been healthy and rested from the rigors of pregnancy and child birth for a while.

According to a report by Health Communication Capacity Collaborative (HC3) there are risks associated with pregnancy in women age 35 or older (Advanced Maternal Age AMA)or who had had five or more births.(High parity or HP)

Child spacing simply means giving enough time for the woman to recuperate from delivery before getting pregnant again.

Medical experts say the risk of maternal mortality rate of mothers increases with the number of children, which could also be prevented by well-spaced pregnancy and family

Dr. Uchenna Onwufor, a Consultant Gynecologist and Executive Director of Gynae Care Research and Cancer Foundation said family planning deals with child spacing, and planning the numbers of children you want to have and can take care of.

He said it was important for a woman to initiate the process of child spacing while she is pregnant, by discussing with her doctor, “he  will discourse with her the various methods, , it could be injection, it could be copper that they put inside the womb. The woman can start six weeks after birth”

While saying there are few women who don’t get pregnant during breastfeeding , he said breastfeeding doesn’t   protect a lot of women, and that is why they are advised to use contraceptive method even if its condom.

“Whichever option the person feels is easy to look out for, and you then look out for the challenge to which she can manage best .”

He added that the major challenge facing women was ignorance, and that some people who have had problems from one form of family planning or the other blow it out of proportion and people take it hook line and sinker without even wanting to try it out.

Dr Onwufor said  some of the problems a woman may encounter if she gets closely pregnant after the other one include anemia, complications , especially if she had surgery during he previous birth.

He said the ideal period of child spacing is two years so the older baby would have taken enough breastmilk, the mother would have regained her health back, the family would have readjusted financially too before they start welcoming another baby.

 He added that child spacing is also tied to limiting of the numbers of children,” there must be a limit, those two must go together and that’s what comprise of family planning,” he said.

Onoriode Ezire, Country Director of Health Policy Plus (HP+) Project  said family planning was one way to reduce maternal death by 30 percent. “Space child birth, instead of having a child every year , women should have once in three years, if that happens , women are going to have fewer number of children and that helps in managing the population, which will in turn leads to development.”

Amina Omoti  National President of Federation of Muslim women’s associations in  Nigeria  (FOMWAN) said the religious books recognize child spacing , “like in the holy Quran it speaks of breast feeding for two years. If a woman breast feed properly for two years, is that not child spacing?,”

She said there was need for enlightenment for women,  husbands, ward heads, and community leaders to allow women access to maternal health facilities and that government  should released the appropriate funds. She said doing so will ensure high quality of motherhood , quality children , good quality family life and quality society.

Alhaji  Sani Umar Jabbi District head of Gagi,  Sarkin Yarkin Gagi, District head  Sokoto  and State president  Nigerian Aid Group of Islam Jama’atu Nasril Islam , Sokoto said every child has the right as guaranteed by Islam to have at least two years exclusive breast feeding by his mother.

He added that there was need address the gaps that tends to limit the acceptance and adoption of family commodities, and also budgets and utilization of resources for child spacing commodity nationwide saying it was key in saving the lives of mothers and children.

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