Experts specializing in maternal care have emphasized that reducing the number of children women have could prevent deaths during pregnancy and childbirth in Nigeria. They highlighted the health risks associated with having multiple pregnancies, pointing out that every childbirth carries inherent dangers.

One common cause of postpartum mortality identified by these experts is excessive bleeding, which is particularly prevalent in women who have had numerous pregnancies.

Furthermore, they noted that spacing pregnancies too closely together hinders the mother’s recovery as she may not have adequate time to replenish essential nutrients lost during pregnancy and breastfeeding.

Notably, Nigeria boasts one of the highest fertility rates globally, with an average of 5.3 births per woman, while also grappling with a maternal mortality ratio of 512 deaths per 100,000 live births as per the National Demographic and Health Survey 2018.

The specialists emphasized that the lack of access to skilled birth attendants significantly impacts pregnancy outcomes, with around 80% of women in the country delivering at home.

Dr. Joseph Akinde, a Consultant Obstetrician and Gynaecologist and former Chairman of the Society of Gynaecology and Obstetrics of Nigeria, highlighted that pregnancy and childbirth complications rank among the primary causes of maternal fatalities in Nigeria.

Lagos chapter, pinpoint, “We have the psychological demand and of course, the health needs are there.

“ And then, when you have too many children, there is also the danger of the woman losing her life in the process from excess bleeding. If pregnancy continues to strain and put a burden on the body system repeatedly, the woman could have burnout syndrome

“But the truth of the matter is that each time the woman gets pregnant, the womb expands to accommodate the baby and when the baby is expected, it must contract. That ability to contract is progressively weakened and the woman may have bleeding after delivery.”

The gynaecologist however ,stated there is a danger of having abnormal children when you continue to have children at a very late age.

“One of the most common reasons why women die after delivery is haemorrhage- excessive bleeding. When a woman has too many children, she is prone to excessive bleeding after delivery. So, she might end up losing her life”

Dr. Akinde noted that pregnancy significantly strains a woman’s body, and this stress is exacerbated if she has pre-existing chronic health conditions.

“ Women with chronic diseases like hypertension, diabetes, cancer, stroke, and heart disease should not have many children because pregnancy puts a lot of pressure on the woman’s body system.

“When you have hypertension, the hypertension might even get worse in pregnancy. When you have diabetes too,
the diabetes will get worse in pregnancy.

“If you have diabetes or hypertension for example and you now get pregnant, it’s like pouring petrol on a burning house.
So, if you put further pressure or further strain on the woman’s body system, you might more or less be aiding and abetting her death or demise following the pregnancy.

“The pregnancy may send her to her grave. So, women with such chronic diseases should have two children, a maximum of three. They shouldn’t have many children”, he explained.

Dr. Akinde advised pregnant women with chronic conditions to seek antenatal care early and deliver in well-equipped hospitals with skilled healthcare providers, as complications during pregnancy and childbirth can be fatal, according to the World Health Organization.

“Most of these complications develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care.

“ The major complications that account for nearly 75 percent of all maternal deaths are severe bleeding (mostly bleeding after childbirth); infections (usually after childbirth); high blood pressure during pregnancy (pre-eclampsia and eclampsia); complications from delivery; and unsafe abortion”, the WHO mentioned.

Dr. Stanley Egbogu, a Consultant Obstetrician and Gynaecologist at Nnamdi Azikiwe Teaching Hospital, emphasized that pregnancy in women with pre-existing medical conditions is complex and high-risk.

He advised against using Primary Healthcare Centres for antenatal care, as they are not equipped to manage high-risk pregnancies, which can lead to fatal consequences for both the mother and baby during delivery.

He stated, “Women that have diseases like sickle cell, asthma, hypertension, diabetes, and heart diseases before pregnancy must not use PHCs for their antenatal. They must register in a teaching or specialist hospital for their antenatal because they need specialized care from experienced obstetricians and gynaecologists.

“If such women should visit PHCs for antenatal care, they should be referred to a teaching hospital immediately because they are prone to so many complications during the pregnancy.”

The Society of Gynaecology and Obstetrics of Nigeria states that Nigeria is far from achieving the Sustainable Development Goal target, with a high maternal mortality rate of 512 deaths per 100,000 live births, due to various challenges including limited access to healthcare and deep-rooted cultural beliefs.

“Nigeria’s maternal mortality rate is still among the highest in the world, with an estimated 512 deaths per 100,000 live births, which is nowhere near the SDGs target of 70 per 100,000 live births”, the body pointed out.

The United Nations aims to reduce maternal mortality to 70 deaths or less per 100,000 live births by the year 2030, as part of its Sustainable Development Goals.