More pregnant women shun clinics for herbal homes

• Stakeholders urge govt to review cost, retrain herbal practitioners

By Kehinde Aderemi

Hajia Rasheedat Mustapha has never seen the inside of a labour ward, yet she is a proud mother of more than three children. And they are all doing well in their respective endeavours.

Her reason for choosing traditional birth attendants is not money or ignorance, but belief, trust and spirituality that has held her family for over two decades.

According to her, it is a family belief she shares with her husband. What keeps her with herbal medical practitioners is their spiritual understanding of how they handle birth delivery without stress.

“All my life, I have never visited a general or private hospital for delivery. By the grace of Almighty Allah, I have more than three children and I gave birth to all of them with the assistance of local birth attendants.

“These have spiritual knowledge about the different stages of the baby in the womb. They prepare herbs for every stage and tell you the spiritual journey of the unborn baby. I am happy my experiences with them have been very good,” she said.

She explained also that both public and private hospitals are mostly concerned about their bills and not about the health of their pregnant patients.

“No matter the condition of the pregnant woman, if she doesn’t pay a deposit of the bills charged, they won’t attend to her even at the peak of birth,” she said.

For Mrs Folashade Jimoh, a mother in Alimosho, Lagos, her choice of traditional birth attendants is about care and attention.

According to her, the traditional birth attendants have all the time to take care of their pregnant patients and they give them adequate attention.

Some of the traditional birth attendants, she said, have been going for medical trainings and they are now using natural herbs and drugs to cater to the needs of their patients.

She stated also that religious institutions like churches and mosques also run medical facilities for their members. The religious institutions, she noted, employ professionals and provide both spiritual and medical services at very low cost to help their members.

In her words, the public and private hospitals are doing their best, but the challenges still remain that they are too expensive for some people to bear.

“Cost of delivery in either public or private hospital now is very high and there are cases of negligence and delay to be contend with in general hospitals.

“This is because they attend to many patients at the same time. But the traditional birth attendants usually take good care of their patients because they are like fathers and mothers who understand the pain of childbirth,” she said.

These two represent thousands of Nigerian women who, despite medical warnings and government campaigns for hospital delivery, still find comfort, joy, affordability and humane care in the hands of birth attendants away from the nurses and doctors.

Beyond spirituality and care, also at stake is the state of the economy.

Cost of bringing a new life into the world has become unbearable for many.

Saturday Sun gathered that delivery that was affordable a few years ago is now a financial burden. In Lagos, public health centres still offer subsidised delivery charge under state programmes.

But in private hospitals, normal delivery now costs N150,000 to N200,000 in average facilities, and as high as N500,000 to N1million in highbrow hospitals in Lekki, Ikoyi and Victoria Island. Caesarean Section (CS) can be up to N350,000 to N1.5 million.

Lagos-based medical practitioner, Dr. Salam Ismaila, said Nigerians must accept one hard truth: good healthcare is no longer cheap.

According to him, there is nothing cheap when you want good service, especially in health. Even in public hospitals, he noted, good service is not cheap. He identified Nigeria’s unstable economy as the main reason for the hike in the cost of birth delivery.

“In private hospitals, doctors buy almost all the materials such as gloves, delivery kits, diesel to power generators, and also payment of the staff salaries and other services.

“Honestly, we cannot say it is cheap. We are not in the era of N20,000 or N30,000 delivery again. That is why we encourage family planning for those with more than two children. When you cut your coat according to your cloth, you have less problem,” he said.

Salam explained also that safe delivery requirements are same in both the public and private hospitals.

“The pregnant woman must first register early. She must attend regular antenatal care. As soon as pregnancy is confirmed, she must see her doctor. If positive, do a scan in the first three months to confirm the baby is alive and inside the uterus. Sometimes pregnancy is outside the uterus. This is one reason it is not cheap anymore.”

He highlighted the three stages of pregnancy, noting that the first, second and last trimesters are the procedures to be followed before delivery.

“If a patient follows medical advice strictly, complications can be largely avoided. Planned pregnancy is best. If you notice any strange situation, go straight to the doctors.”

Dr. Salam frowned at traditional birth attendants. He said delivery is not home service and such adventure is risky.

In his words, there are two reasons women still visit herbal homes – ignorance and poverty.

“We must note also that there is a big difference between doctors and traditional birth attendants. They have roles, but they handle things beyond their capability,” he stated.

Salam, however, warned that women with previous CS history, more than three children, hypertension, diabetes or heart disease should never patronise traditional birth attendants s.

“Things are costly in private hospitals. Doctors will say buy this, do this, and they run to where it is cheaper. However, there is no amount of money spent on good health services that is too costly. But good health service is no more cheap. That’s the honest truth,” he said.

Mr Sunday Usulor, a Lagos-based businessman, has different experiences from public and private hospitals. His wife had three Caesarean Sections (CS) in six years for their three children.

“My wife started antenatal early enough at a health centre in Ikorodu for our first child. But when it was time for delivery, the centre couldn’t handle it because of the size of the baby.

“She was in hard labour for two days. We almost lost the baby. By the time we transferred her to a private hospital, it was almost too late, but God intervened.

“The doctor did the operation in under 10 minutes, even without asking for a deposit, and saved my wife and the newly born baby girl,” he said.

His second experience was tougher. On delivery day, they could not get to the hospital because of the traditional Oro festival held in Ikorodu at the period.

“We rushed her to another hospital and she went through another CS for the second time in two years.

“But despite the initial difficulties in having the baby boy, God still intervened because he had a fracture in one of his legs resulting from the negligence of the doctors that did the CS. But he was healed miraculously at the point when we got to Igbobi Orthopaedic Hospital where we were directed to treat the fractured leg,” he said.

However, he said his first encounter at Ikorodu General Hospital where they intended to register and had their regular antenatal was too bad.

“I later left the hospital in anger when they wasted my time and that of my wife for two days without any true justification.

“I was asked to donate a pint of blood as their normal procedure, but I was disappointed that there is no coordination and care for the pregnant women at their wards.

“The delay for two days was not enough compared to their complete negligence and complacency. That was when I vowed never to return to the hospital for my wife’s pregnancy procedures. In the end, I paid the huge bills, but it all went well to the glory of God and I blessed God that I still have my wife and my babies doing well,” he said.

Despite several medical warnings for pregnant women not to visit the traditional birth attendants, they still offer delivery services across the country.

Mrs Karimat Asabi, a certified traditional birth attendant at House of Herbs Solution Trado-Medical Centre, Lagos, said the practice has improved and that pregnant patient’s patronage is not only about the low cost of birth delivery.

She explained also that there are different reasons pregnant women still patronise them.

Some of the reasons, she stated, included the history and belief in traditional birth attendants centres, urgency of labour, and negligence and unnecessary bureaucracy in the activities of many of the staff of the general hospitals and how they handle patients.

She pointed out also that many traditional birth attendants are now registered and monitored by the Lagos State Government.

“Many of us have undergone medical trainings that have made us more professional. Our role is now complementary. We refer patients to bigger facilities when needed and we charge reasonably,” she said.

A graduate of English Education, Asabi said passion led her into the practice. She added that whenever she is doing her job, she takes full cognisance of the health history and ensures patients do necessary tests.

“I am trained at the Lagos State Traditional Medicine Board and did a six-week course at the University of Lagos. I am certified by the state government.

“I get their health history and make sure they do all tests — hormonal tests, blood samples and everything. Birth delivery is not like the olden days practice.

“The state government monitors us strictly. Whoever commits error through negligence will be sanctioned, jailed and lose certificate. So I do my job holistically,” she said.

“It is the state government that gave us referral letters. Officials come every three months to inspect our facilities. We have lab technicians who help with blood samples and donation,” she stated.

According to her, the general hospitals are usually congested and the staff are usually overwhelmed with the numbers of patients they handle at the same time.

“General hospitals are bureaucratic and overwhelmed. But we pay adequate attention to our patients,” she stated.

She noted also that traditional birth attendants give personal attention to the patient. In her words, there are some pregnant women that attend both hospitals and traditional birth attendants centres to get adequate services from both sides.

Asabi explained further that each of the trimester stages offers different opportunities for proper and adequate examination of the pregnancy.

“The first trimester is for HIV, blood group and counselling; the second trimester is for scans and foetal weight; and the third trimester is for the final preparation for safe delivery,” she stated.

Mrs Modupeoluwa Aderibigbe, a nurse at a Lagos health centre, said the state government has reduced delivery cost across health centres.

She pointed out also that cost of delivery in general hospitals still remains high, but added also that location and facilities always determine the hospital charges.

“Health centres handle basic delivery cases, the cost is as low as N10,000. Registration is also less than N3,000, and patients usually pay a token for drugs during antenatal.

“Delivery in Lekki or Ajah will always be higher than in Ikorodu. It is also not the same in Abuja or Port Harcourt, and anywhere in Nigeria.

“The practice in all general hospitals is that the husbands must donate one or two pints of blood as routine. This is to ensure blood is available during childbirth.

“General hospitals also test both the husband and wife. The husband has commitment to ensure safe delivery and must be available at every request,” she explained.

Aderibigbe also explained that cost of delivery varies by facilities and services, but no delivery service is cheap anymore.

As cost continues to soar in public and private facilities, Nigerians are appealing to the government to expand free maternal health policy nationwide, subsidise delivery kits and essential drugs, and make health insurance mandatory for pregnant women.

They also call for retraining of traditional birth attendants to serve as referral agents, not delivery agents, and intensified public awareness on family planning.

The post More pregnant women shun clinics for herbal homes appeared first on The Sun Nigeria.