Why many pregnant women prefer home delivery in Kaduna

The trend of home delivery is not only applicable to women in the rural areas but also those in the urban centres, though they have diverse reasons why they prefer to deliver at home but the fact remains that no woman is suppose to die in the course of bringing another to live.To some, especially […]

The trend of home delivery is not only applicable to women in the rural areas but also those in the urban centres, though they have diverse reasons why they prefer to deliver at home but the fact remains that no woman is suppose to die in the course of bringing another to live.
To some, especially those in the rural areas, it is far cheaper and convenient for them to deliver at home while to others the attitude of some health workers discourages them from delivering in the hospital.
According to a mother of three in Kaduna who does not want her name mentioned when she was in labour at one of the government hospitals, instead of pampering and encouraging her to be patient and optimistic as a first timer, some of the nurses rained all sort of abuses on her and one of them slapped her and this discouraged her from going to the hospital for delivery.
Another woman who gave her name as Mairo Usman said she doesn’t attend ante-natal nor go for delivery in hospitals because of prolonged waiting; saying that hospitals keep patients or pregnant women for too long before attending to them. “Initially, I used to go for antenatal but I later discovered that anytime I go, I spend the whole day waiting to be attended to, which is not good for me and my family because I depend on daily sale of food to keep my family moving as my husband is yet to get a job,” she said.
Mrs Clara Ogbonna who resides in Chikun Local Government area of Kaduna narrated her own ordeal, saying, “When I had my first child in the hospital, I had episiotomy (a surgical cut made at the opening of the vagina during childbirth, to aid a difficult delivery and prevent rupture of tissues). During the episiotomy, I was not given any injection to kill that area before stitching, it was more painful than the labour itself and at the end, it was not correctly stitched. I was taken back to the hospital after three days where the stitch was loosed and re-stitched again. The severe pain made me forget I had a new baby to care for as I could not sit nor walk well,”
She said because of this experience she developed phobia for hospital delivery and decided to try the traditional birth attendants that operate in church, “I had my second baby there and I was dazed at what I saw, the delivery came so easily as the women carefully and prayerfully took my delivery. Since then, I stopped going to the hospital, except for ante-natal,” she explained.
Our reporter also gathered during an investigative tour embarked upon by Maternal Child Health and Civil Society (MCH-CS) Partnership in collaboration with Development Communications Network (DEVCOMS) to some facilities in the state that majority of women who attend ante natal care at health facilities deliver at home.
At Doka General   Hospital in Kachia Local Government Area, our reporter saw Maryam Lawal, 34years from Gidan Busa who has so far given birth to ten children and all of them delivered at home.
“I don’t go to the hospital for delivery because I don’t feel labour. Once I am due, I will just feel like going to the toilet and the baby will come out and this mostly happens in the night, a time when it is difficult to get to the hospital.”
Maryam pitiably announced that only four out of her ten children are alive.
Another woman, Naomi David said her labour usually comes at odd hours when she cannot find anybody to assist her to the hospital. “My husband doesn’t support me and doesn’t bother to take me to the hospital even when I am in labour, so I deliver at home not because I want it but because I cannot help the situation. I am usually helped by my in-laws to deliver at home,” she added.
On her own part too, only two out of her five children are presently alive; saying “they die either while crawling or walking.” The sixth pregnancy as usual she said will be delivered at home.
One of the pregnant women at the hospital who pleaded anonymity said that attitude of nurses sometimes scare women away from coming to deliver at the hospital.
At Primary Health Care Centre, Yakassai in Soba Local Government Area of the state, the pregnant women seen presented similar stories as many of them also deliver at home.
With the introduction of SURE-P Maternal and Child Health Care (MCH) in the facility, some traditional birth attendants were engaged to move from house to house to encourage pregnant women to attend ante-natal and also give birth at the hospital.
One of the traditional birth attendants, Hulaira Idris said they don’t take delivery at home again since they have been engaged by SURE-P, saying they only encourage women in their communities to come to the hospital. “We also urge women who deliver at home to still come to the hospital so that they can be properly checked. Initially, men don’t support what we were doing but now, some of them call us to assist their wives go to the hospital especially when they have complications,” she added.
Unlike other women, Hadiza Basiru who is carrying her sixth pregnancy said she had her five children in the hospital, saying it is safer and healthier to deliver in the hospital. “Immediately I feel labour, I walk down to the hospital myself because I prefer to be helped by professionals who have the health knowledge. A lot of women die of bleeding at home because their delivery is supervised by ignorant people,” she said while she advise every woman to endeavour to go to the hospital for ANC and delivery for the safety of both mother and child.
Similar, a senior nurse interviewed told our reporter that some husbands and in-laws don’t support their wives who want to go to the hospital, “they will rather compare their wives with other women who deliver at home; saying, this one delivered safely at home, why do you want to go to the hospital and waste money?”
“Another reason is transportation. Some patients come from rural areas that are not easily accessible. You will need to use canoe to cross big river in some communities before gaining access to health facility, so women from such area will rather give birth at home instead of going through such rigour while in labour. So the means of transportation stops some women from delivering in health facilities because the poor may not be mobile to move at odd hours,” she said.
Mallam Bello Idris Dallaji, said that giving birth at home has become a tradition in rural areas, saying “women who go for ante-natal in rural area where I live are those who have complications, if not, our people prefer to give birth at home. Even when they have complications during birth, they are given local medicine instead of western drugs. My only daughter was born at home and my wife didn’t go for ante-natal throughout her pregnancy period. I didn’t bother to force her  because that has been the tradition in my village,” he said.
He therefore advised the state government to set up a committee that will comprise of women that will be  visiting housewives in their homes to enlighten them on the importance of ante-natal and giving birth in the hospital.
The director of Primary Health Care in Chikun Local Government Area of Kaduna State, Abdulkadir Isa blamed the attitude of women who deliver at home on lack of awareness adding that there is need for awareness for women and husbands too.
He also advised nurses and all other health workers to be humble and accommodating in working with patients, remembering that they deal with human lives, urging them to abide by the ethics of their profession.
According to the chairman of Nigeria Medical Association (NMA) in Kaduna state, Dr. Mohammed Ibrahim; home delivery is common in Nigeria while he stated clearly that If a woman delivers at home, there is tendency that she could develop complication that will not be noted on time; adding that home delivery in its own self can be the reason why she developed complication because she is not having experts attending to her.
“Some of the major problems with women delivering at home, because they are not experts is that there is delay in knowing that there is complication. There is what we call ‘4 Ds’ (that is Four Delays), which commonly lead to maternal mortality and they are more likely to affect women who deliver at home,” he said,
Dr. Ibrahim therefore stressed the need for the state government to continue to raise awareness on the dangers associated with home delivery and the benefits of delivering at hospitals; adding that government needs to back policies and programmes with action and ensure proper monitoring and evaluation process to ensure that they are working.
He also advised husbands and in-laws to give the necessary support to women when they are pregnant and while in labour, they should be taken to the hospital in good time to avoid unnecessary delay which may lead to death.