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Opinions of Sunday, 23 November 2008

Columnist: Bannerman, Nii Lantey Okunka

When A Woman's Tender Care Ceases Toward The Child She Bear

On Saturday the 15th of November, I opened my e-mail to learn that a friend has lost a niece in Ghana. The niece in question died after giving birth to a healthy baby girl. She is reported to have bled to death after giving birth. An attempt was made to transfer her to Okomfo Anokye hospital when the attending private clinic failed to put a kibosh on the bleeding. The bottom-line is that this lady died from hemorrhaging. Not too long ago, I read a news item about the alarming death rate during childbirth in the Central region. The blame this time was squarely pinned on Traditional Birth Attendants (TBA). Who is a traditional birth attendant and what kind of training is he or she given? Compare this grim situation to what we are used to in the west and you know we are in trouble. No wonder the higher ups and royals send their wives to birth in the West. Anywhere but Ghana is their policy when it comes to birthing and medical care. If the latter is not an indictment of our situation, what is?
Helena Selby, writing for the Ghanaian chronicle, indicates that, maternal childbirth deaths are on the rise. According to Helena, “Maternal mortality, which simply means a woman dying as a result of childbirth, has of late been a silent killer and a menace in our societies.” According to the Western Catholic Reporter, Canada’s largest religious weekly, in Africa, 600,000 women die in a year due to complications arising from pregnancy and childbirth. Dr. Walley a professor of obstetrics and gynecology at Memorial University in St. John's, Nfld., said, “most women's deaths occur during or shortly after delivery due to lack of access to emergency obstetrical services. Most of these deaths are the result of bleeding and obstructed labor. Thousands of teenage mothers, whose pelvises are often too small to accommodate a healthy delivery, are particularly vulnerable to injury and hemorrhage.” There is no doubt that we are not doing as well as we can in making sure that our women are not only safe but well cared for during childbirth. Death, during or immediately after child birth in developed countries, is becoming an extremely rare event. What can we learn from them? Can we do better? Yes, we can if we put our mind to it. Indeed, Dr Seth Borquaye, an OBGYN in Georgia, USA, and chairman of Ghana Visions Foundation board of directors maintains that there is a lot we can do to minimize these risks. He laments the current situation and wished we could do more to save lives.
The case of my friend’s niece prompted me to ask so many questions for which the answers were not readily available. What kind of equipment for child birth do we require private clinics or government hospitals to carry? What kind of medical supplies are these birthing clinics required to carry? Are these centers required to stock supplies take into consideration the possibility of hemorrhaging after birth? Is it really helpful to throw a birthing mother in an ambulance and transfer her to another hospital while she is bleeding to death? In other words, should all birthing medical centers be equipped enough to deal with bleeding during or after birth? I thought the news about my friends niece was gut wrenching till I heard another story that ended well but was equally shocking. I was on the phone yapping to a good friend about this death when he offered to share his own horrific true life experience. And before I tell you his story, I encourage all with similar experience to share it. This is the only way we can bring pressure to bear on our so called leaders to take pregnancy and child birth seriously. We must stop these needless deaths now!
Can you imagine your wife bleeding profusely and precariously during child birth? This is what happened to a close friend of mine. In the midst of this searing experience, he was asked by the doctor to go and buy blood for his wife. He rushed to Tema general hospital and managed to find some blood to buy. After procuring the blood, he drove it under normal weather conditions to the clinic where his wife was birthing and literally bleeding dangerously. On his way to the clinic, he began to worry about the integrity of the blood he just bought. What if it was HIV infected, he thought to himself. Could an effort to save the life of a birthing mother lead to her death eventually? Has the integrity of the blood been comprised? At the very last moment, he decided to ask the doctor to hold off on the blood transfusion if there is any chance that his wife could make it without the purchased blood. Luckily, the doctor decided that his wife could survive without the blood after all. My friend therefore ended up returning the blood to Tema hospital where it was accepted without question. All I can say is good luck to the person who eventually received this blood in question. My friends, is this not scary? What really has gotten hold of our dear and beloved Ghana, if this is he kind of medical practices we indulge in? Can we do better? Yes we can!!
I don’t know what the conditions and requirements are at the moment. What I think will make sense is a new approach that will help. The following are recommendations I will like to make. Hopefully, some of these ideas are already being contemplated. Please enforce the rules if you already have then on the books!
1) Require all birthing centers to report any death that occur under their watch to the authorities. They must also tell all prospective clients about all deaths that have occurred under their watch and what they’ve done to prevent such deaths in the future. This way, clients can make informed decisions.
2) Government has to take steps to shut down birthing centers that are not adequately resourced. By resource I mean both human and physical or material resources. For example, all birthing centers must have a doctor on call. Also, they should have well trained medical personnel who can stop bleeding and other problems associated with child birth.
3) Require all birthing centers to carry significant malpractice insurance to cover their victims. Either through mediation or lawsuits, victims and their families should be adequately compensated. Hopefully, these bad centers who continue to kill innocent women will be priced out of business if they become too risky to be tolerated by any insurance company.
4) Government must mandate continuing education for all personnel of any birthing center. A badly trained medical personal is in fact far more dangerous than having none.
5) Government must mandate basic equipment needed to ensure that birthing centers can deal with all known medical situations during childbirth. For example, if we know that bleeding and obstructed birth are major problems during childbirth in Ghana, why don’t we prepare adequately for such emergencies?
6) Government must take steps to punish severely those who negligently cause the untimely death of birthing mothers. Revoke their license and throw them in jail if that is what it takes.
7) Prenatal care should be made a right in Ghana. Safe birth starts with taking good care of yourself during pregnancy. Not just taking good care of yourself but staying informed and making educated decisions. Information is the key!
8) Please men, get involved in the prenatal care of your loved ones! Birthing starts way before the baby comes out.
9) Government must invest in the state of the art equipment to help women give birth safely. All regions must have multiple centers conveniently located to help our women. Giving birth is a sacred duty and we must make it as pleasant as can be.
10) Mass education on this issue should be a priority for the country. Inform, inform and inform!!
This article will not be complete if I don’t recall the old hymn that beckons us to sing thus:
Can a woman’s tender care
Cease towards the child she bare?
Yes, she may forgetful be,
Yet will I remember thee.
But where will that tender care glow if we continue to kill our mothers needlessly? Modern science offers us great opportunity to significantly reduce all needless deaths during child birth. Most advance countries are doing it and there is no doubt that we can too. As always, it will take a deliberate effort to make this sacred duty a reality. We all have a responsibility and thankfully, this is not a partisan issue. So, surely no finger pointing!! Please let’s get it done. Please let’s keep this issue alive until we see significant improvements. We must take the attitude that every life is precious. I dedicate this article to my friend’s niece and all those who have died needlessly through child birth. Hopefully better days are ahead. Viva Ghana!
Nii Lantey Okunka Bannerman
(Also known as the Double Edge Sword)
I don’t give them hell, I just tell the truth and they think it is hell—Harry Truman