Women with too many children prone to bleeding after delivery – Gynaecologists

By Francesca Hangeior

Maternal experts have said death during pregnancy and after childbirth in Nigeria could be averted if women have fewer children.

The gynaecologists said having too many children comes with a lot of health consequences on the health of the woman, stressing that every pregnancy and birth comes with risk.

According to them, one of the most common reasons why women die after delivery is haemorrhage- excessive bleeding.

This, they added, was common among women with too many children.

The physicians who spoke in a separate interview with PUNCH Healthwise also said having pregnancies too close together doesn’t give the mother time to recover after losing nutrients such as iron and folate after pregnancy and breastfeeding.

Nigeria’s fertility rate, which is put at 5.3 births per woman, is notably one of the highest in the world even as the country’s maternal mortality ratio stands at 512 per 100,000 live births, as contained in the National Demographic and Health Survey 2018.

The gynaecologists said lack of access to skilled birth attendants negatively impacts pregnancy outcomes, lamenting that about 80 per cent of women in the country still deliver their babies at home.

A Consultant Obstetrician and Gynaecologist, Dr Joseph Akinde, told our correspondent that pregnancy and childbirth complications are among the leading causes of maternal deaths in Nigeria.

Akinde who is a former Chairman of the Society of Gynaecology and Obstetrics of Nigeria, Lagos chapter, noted, “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 also said 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.”

Akinde pointed out that pregnancy puts a lot of pressure on a woman’s body system, a development he said was further compounded if the woman has chronic diseases.

“ 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.

He urged pregnant women with chronic diseases to begin antenatal care early and register in well-equipped hospitals where there are skilled birth attendants.

The World Health Organisation says women die as a result of complications during and following pregnancy and childbirth.

“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 said.

Also speaking, a Consultant Obstetrician and Gynaecologist at the Nnamdi Azikiwe Teaching Hospital, Akwa, Anambra State, Dr. Stanley Egbogu, said pregnancy among women with co-morbidities comes with lots of complications.

Egbogu also said pregnant women with these conditions should not use Primary Healthcare Centres for their antenatal care, stating that pregnancy among them is associated with high risk, especially during delivery, and therefore cannot be managed at the PHCs to avoid the death of the baby, the mother or both.

He said, “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 says Nigeria is nowhere near achieving the Sustainable Development Goal target.

“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 said.

The UN Sustainable Development Goals target is 70 maternal deaths per 100,000 live births by 2030