#IDM2018: Midwives highlight factors affecting service delivery

Some midwives have identified quackery, ignorance, poor attitude of patients, late presentation of complicated cases and inadequate equipment as major challenges encountered in the profession in the country.

The midwives, who spoke on Saturday in Lagos, said that the challenges contributed to the high rate of the country’s maternal and child mortality.

They spoke as they joined their counterparts across the globe to mark the 2018 International Day of the Midwife (IDM) with theme “ Midwives Leading the Way With Quality Care’’.

The day is aimed at focusing on the important role of midwives and midwifery. This year’s theme highlights the vital role that midwives play in ensuring that women and their newborns are safe during delivery.

It also highlights the way these women receive respectful and well resourced maternity care that creates a lifetime of good health and wellbeing beyond the childbirth continuum.

Mrs Bolatito Olawale, Chief Matron, Amuwo Odofin Maternal and Child Centre (AOMCC) , told NAN that quacks and untrained Traditional Birth Attendants (TBAs) hinder smooth operation in the profession.

“Most of them don’t have the facilities and equipment to deal with complications, if any arose; unfortunately, many women still patronise them.

“Ignorance on the part of patients also hinders the efforts being made by midwives. A lot of women do not get proper healthcare due to ignorance.

“Ignorance because they are not well informed; many of them take advice from uninformed friends and relatives rather than the counsel of health workers; even the seemingly educated ones’’.

Olawale said that myths, misconceptions, as well as religious and socio-cultural beliefs also affect the operations of midwives and relationship with patients.

“Often times, instead of facing the realities of the situation at hand, our people believe a lot in `miracles’, `it is not my portion’ and `my case is different’.

“For example, a woman, of whom it has been established has narrow pelvis, breach presentation or prolonged labour will still want to go through vaginal delivery rather than have caesarean section.

“This leads to further complications that can result to bleeding and even death,” she said.

According to her, sometimes, secrecy also affect effective delivery of their services because patients lie about their history or health situations.

“There was a woman already in her ninth month of pregnancy who just came to register for antenatal and wasn’t forthcoming with her duration; but of course, being experienced, we were able to estimate the gestation age before we sent her for a scan.

“For such a patient, if she had immediately gone into labour, there could have been confusion because we do not know about her history.

“What if she had been HIV positive, a hypertensive person or has gestational diabetes? What if she had also been taking some concoctions that may have affected her baby or even herself?’’ she said.

She urged pregnant women to register for antenatal in any government hospital or approved private hospital as soon as they notice that they are pregnant .

According to Olawale, this is where they are sure to get deserved care and monitoring from certified, registered or experienced midwives.

She urged midwives to continue to work relentlessly and selflessly; she also advised them to continuously sensitise their antenatal and post natal patients on best practice before, during and after delivery.

Also, Mrs Olubunmi Betiku, Senior Matron in the same facility, affirmed that many patients were ignorant of what to do.

“Most of them get advice from people who are not well informed.

“Some also say that they must give birth at TBA places, religious houses and herbalists places, where they are given concoctions, including a mixture of herbs locally called `agbo’.

“There are dangers to this, especially when complications arise; so pregnant women are advised against this practice,’’ she said.

Betiku advised pregnant women to access the Primary Healthcare Centres (PHCs), as they also assist in reducing the number of patients that come in with complications, thereby averting incidences of maternal mortality.

Also, Mrs Oluyemisi Adelaja, Chairman, National Association of Nigeria Nurses and Midwives (NANNM), Lagos University Teaching Hospital (LUTH) chapter, told NAN that there was acute shortage of midwives in Nigeria.

According to her, midwives are the first point of contact to gynecological patients, either during pregnancy or at the point of delivery.

“IDM is recognised worldwide and celebrated every year to show the relevance of midwives in the healthcare of women in the reduction of mortality rate.

“However, there is acute shortage of midwives in Nigeria due to brain drain, cost of training and enough number of people not going into the profession.

“This shortage is a reason why people patronise TBAs whom they say complement the work of midwives.

“This cannot be compared with the duties of midwives in delivering quality healthcare to Nigerian women.

“But, the midwives are trained to take care of women throughout the period of pregnancy, the delivery and also immediate care after the baby is delivered,” she said.

The chairman urged government to employ more trained midwives to help reduce mortality rate and also improve the health indices of Nigerian women.

According to her, there should also be training and refresher courses for the ones on ground, to reduce brain drain as well as for improved patient care, service delivery and health indices.

Adelaja encouraged midwives to put in their best in their duties to improve maternal healthcare in Nigeria.

“Celebrating them every year will motivate them and encourage them to sacrifice more in order to achieve better health indices for Nigeria and to bring hope and happiness to mothers and the family at large,” she said. (NAN)