Small pelvis & CS delivery. Image source: Del Mar Birth Centre
Angela Onwuzoo
Maternal health experts have warned pregnant women with small pelvises to stop refusing caesarean section delivery because of cultural and religious beliefs.
The experts warned that trying to give birth vaginally through a narrow pelvis is associated with lots of complications that could lead to the death of the mother and her baby.
A caesarean section is often necessary when a normal delivery would put the life of the baby or mother at risk, and the factors that might necessitate the procedure include obstructed labour, twin pregnancy, and high blood pressure.
Others are breech birth or problems with the placenta or umbilical cord.
A caesarean delivery may be performed based on the shape of the mother’s pelvis or the history of a previous c-section.
According to the experts, if a pregnant woman has a small pelvis, the chances of vaginal delivery are limited, and therefore, has to be offered a CS.
A Professor of Obstetrics and Gynaecology at Ahmadu Bello University, Zaria, Solomon Avidime, told PUNCH HealthWise during an interview that pregnant women with small pelvises are typically those that are naturally not too tall.
He, however, said women with small pelvises could still give birth vaginally depending on the size of their babies.
The gynaecologist said, “When the pelvis is small and the baby is small, the woman can still have a vaginal delivery. So, the size of the baby is very important here. If a woman has a small pelvis and the baby is big, it will not be wise to allow the baby to pass through that small pelvis.
“Occasionally, we encounter women who will refuse CS if it is offered to them as a way to aid their delivery.
“But they refuse such an offer because of their cultural and religious beliefs.
“Some of them have ended up regrettably losing their babies because, by the time they agree, the situation would have been worse. They usually have an unwanted outcome.
“Now, if a woman that is to deliver through CS refuses, obviously, she cannot deliver on her own or even if she eventually delivers, she will have complications and the baby may die. Also, the mother can have injuries, bleeding, and may die.”
Avidime pointed out that some babies forced out of a small birth canal could have deformities later in life.
“You have seen some babies who have injuries in their hands or legs just because of the way they were delivered. Short mothers will have small pelvises and the baby will not be able to pass”, he said.
Experts say CS is a surgical procedure used when women experience complications during pregnancy and childbirth to save the lives of mothers and babies.
According to them, improving the access and availability of cesarean sections in the country is therefore pivotal to reducing the number of maternal deaths and achieving the Sustainable Development Goal on maternal health of reducing maternal deaths to less than 70 per 100 000 live births by 2030.
The World Health Organisation says that in countries where at least 10 per cent of women have caesarean sections, the number of maternal and newborn deaths decreases.
WHO
Nigeria’s latest maternal mortality ratio is 512 per 100,000 live births, as contained in the National Demographic and Health Survey 2018, which shows that the country has a long way to go in meeting the global health target by 2030.
Avidime further said, “In some cultural settings, women still want to deliver babies by themselves despite the high risk of complications.
“But education will go a long way to help people understand the fact that having cesarean delivery does not mean that the woman is weak because there are several reasons why caesarean sections are done.
“Sometimes, the babies are big and they may not be able to pass through the birth canal or they are too weak in the process of labour or they are not lying properly to be able to pass through the birth canal.
“So, in such circumstances, CS is offered to save the life of the woman and her baby.
The gynaecologist stated that apart from bleeding and high blood pressure, obstructed labour is another major factor contributing to high maternal and infant deaths in Nigeria.
He noted that CS should be made available and accessible to women requiring the procedure, revealing that many pregnant women and their husbands often refuse CS because of cost.
This, he said had led to many avoidable deaths of women and their babies, especially in the rural areas.
He, therefore, called on the government to establish a comprehensive healthcare centre in each political ward across the federation where CS and blood transfusion services are readily available to women.
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