A 9-month journey ends with a bizarre surprise: The baby stuns all

It is not uncommon for traditional birth attendants, midwives, and medical personnel at various levels of the healthcare system—whether managing normal or complicated deliveries to encounter newborns, alive or stillborn, with physical abnormalities. Historically, such cases were often attributed to witchcraft or supernatural forces by medicine men, priests, and herbalists, a belief that still persists […]

It is not uncommon for traditional birth attendants, midwives, and medical personnel at various levels of the healthcare system—whether managing normal or complicated deliveries to encounter newborns, alive or stillborn, with physical abnormalities. Historically, such cases were often attributed to witchcraft or supernatural forces by medicine men, priests, and herbalists, a belief that still persists in some communities today. However, many of these birth defects can be traced to preventable factors involving the mother, healthcare providers, and broader community practices.

Safe motherhood is a key component of global best practices aimed at promoting the health of both mothers and their newborns. It emphasises the need to prepare all prospective mothers—especially adolescent girls—for healthy pregnancies through proper pre-conception care. This includes guidance on maintaining a nutritious diet, which plays a vital role in supporting a healthy pregnancy and delivering a healthy baby. For instance, medical evidence shows that a deficiency in folic acid—commonly obtained from daily food intake—can lead to spina bifida, a congenital condition associated with significant medical and psychosocial challenges. This highlights the importance of adequate nutrition for all women planning to conceive. In addition, adopting a healthy lifestyle, such as avoiding alcohol and refraining from cigarette smoking, is crucial for ensuring a healthy pregnancy and baby.

Risky sexual behaviours among prospective mothers are linked to sexually transmitted infections, with syphilis being a major concern. Syphilis, often contracted through unsafe sexual practices, is recognised as a leading cause of birth defects. To address this, routine syphilis screening during pregnancy is a key preventive measure to identify and manage infections early. Additionally, medical research shows that women aged 40 and above face a higher risk of giving birth to babies with Down Syndrome—a condition associated with various health issues, including intellectual disability and congenital heart defects.

Furthermore, the use of over-the-counter medications or so-called “safe” drugs without a prescription from a qualified healthcare provider poses significant risks. Some medications can interfere with the development of the fetus, leading to birth defects by disrupting organ formation. These risks highlight the importance of early antenatal care, ideally within the first trimester, and the need for pregnant women to seek professional medical advice for any health concerns or treatments.

For healthcare workers, screening for pregnancy before prescription of medications known to affect early pregnancy should be strengthened, and early referral, especially lower level of healthcare for higher level of care should be ensured for all pregnancies that require an advance level of care. Similarly, health promotional and social mobilization activities for healthy preconception life should be an important area for emphasis.

At the community level, environmental pollution plays a significant role in contributing to birth defects. The environment—which includes the air we breathe, the food we consume, the water we drink, and even the animals we raise and eat—can become contaminated with harmful chemicals. When pregnant women are exposed to such pollutants, it can adversely affect fetal development and lead to congenital abnormalities. This highlights the importance of protecting our environment and ensuring that environmental regulations are strictly enforced by the relevant authorities. More importantly, there is a need for all Nigerians to recognise the value of environmental protection and understand that these laws exist for our collective safety. Supporting and complying with these measures is essential for a healthier society.

It is important for Nigerians to note that one of the most common causes of birth defects is infection with the rubella virus, also known as German measles. This virus is transmitted in a manner similar to the measles virus—through respiratory droplets—and although it generally causes milder symptoms than measles, it can lead to severe consequences during pregnancy. The most serious of these is Congenital Rubella Syndrome, which can result in deafness, heart defects, cataracts, and intellectual disabilities in newborns. Sadly, Nigeria contributes significantly to the global burden of rubella and its complications.

The encouraging news is that there is a safe and highly effective vaccine available, which will soon be introduced nationwide and integrated into the routine immunisation programme. Research shows that individuals who receive this vaccine develop lifelong immunity, meaning their immune system will always be ready to fight off the virus if exposed. By getting vaccinated, individuals protect themselves not only against measles and its complications but also against rubella and the severe outcomes it can cause—especially in unborn children.

The National Primary Health Care Development Agency (NPHCDA) and the Federal Ministry of Health should be commended for their remarkable efforts in reducing the burden of rubella-related birth defects. This significant achievement adds to the many ongoing health initiatives across the country. For instance, in 2023, Nigeria integrated the Human Papillomavirus vaccine into its routine immunization program to tackle the high burden of cervical cancer linked to HPV infection.

Similarly, key partners such as the World Health Organization, UNICEF, and most importantly, the Nigerian public, who continue to support and engage with health interventions aimed at building a healthier nation deserve commendation. As we prepare for the rollout of the measles-rubella vaccine, it is crucial that all eligible individuals receive it to help prevent the devastating impact of Congenital Rubella Syndrome. Let us remember—a child born with birth defects will never have the same start in life as a healthy child. Together, we can change that through timely vaccination and collective responsibility.

Ibrahim is a Consultant Public Health Physician, Department of Community, Rasheed Shekoni Federal University Teaching Hospital Dutse  [email protected]