birthrights - nigeria case study
From: Birthrights

Hadiza: ‘I would like to be trained’

Hadiza, a traditional birth attendant in Nigeria, has never had any training for her role.

Hadiza says she would like to have training so that she can help women in the best way possible [Save the Children]

“I am a traditional birth attendant in Jibia. I’ve been practising for 25 years. I started by just watching deliveries, and then when I started delivering the babies I would cut the cord for all my children. I remember the first delivery I assisted with – it was twins. I visited a pregnant woman and when she left to go to the toilet the babies came out. I rushed into the toilets to help her. She delivered normally without complications. I’ve been a birth attendant ever since.

The last time I delivered a baby was about 22 days ago and there was no problem. I help almost all the women around here to give birth.

Although most of the deliveries I’ve assisted with were normal and without problems, I’ve also experienced cases where the baby didn’t come out in the right position. Sometimes I managed to put the baby in the right position, but sometimes, despite my efforts, the baby died.

One case that’s still fresh in my mind happened a few months ago. The woman in labour bled intensely. I knew the case was complicated and beyond my ability. I told her husband to find a cab to take her to the hospital. By the time we reached the hospital, the baby was born – but it died. In the end, the mother was saved though.

I don’t have special tools for my deliveries, just a razor blade to cut the [umbilical] cord. But my role goes beyond just helping mothers during delivery. Afterwards, I give the baby and the mother local herbs to drink to give them strength.

I’m aware of my limits because I haven’t had any training. I’d like to be trained so I could help women in the appropriate way.

The fact is that women in our area don’t go to hospital or clinics for delivery or even for antenatal check-ups because their husbands don’t want them to be checked by male practitioners. Another common belief is that only sick women and complicated cases should go to hospital. So when a pregnant woman feels okay, she prefers to give birth at home.

Because I’ve been involved in the polio immunisation campaign as a community awareness-raiser, I know about the sicknesses that kill young children. I try to tell parents about these illnesses and convince them to go to health facilities for ante-natal and post-natal check-ups.

Most of the time when I tell them about child mortality they respond that it’s in God’s hands – God is the one who decides about life and death. Despite the deep emotion mothers who lose their babies feel, they accept the fact as a normal thing. As a woman and mother, I can imagine how tough it could be to lose a baby. I thank God that all my children are alive, but when they were sick I felt very bad and anxious. So I can imagine what it’s like for those who see their baby dying. A woman who’s lost a baby before can be anxious and scared of giving birth again. So, when she’s pregnant, she can have high blood pressure because of that anxiety and have complications during delivery.

I think that people should be educated, especially men, because they’re the ones who make decisions about whether their wives should go to health facilities or not.”

In Nigeria, more than one million children die each year before they reach the age of five. The country has one of the worst child mortality rates in the world and more than 24 per cent of those that die are newborn babies.

But the overall rates do not show the disparity between the rich and the poor. Children in the poorest Nigerian families have more than twice the risk of dying as those born in richer Nigerian families.

The biggest killers of newborn babies (0-28 days old) in Nigeria are: asphyxia, preterm pregnancy complications, infections, neonatal tetanus, congenital conditions and diarrhoea. These account for all but eight per cent of deaths. The biggest killers of 0-5 year olds are pneumonia, measles, diarrhoea, malaria, neonatal conditions and HIV and AIDS.

Click here for more information on Save the Children’s work in Nigeria.