By Francesca Hangeior

Gynaecologists have expressed concern that the recent hike in fuel prices could significantly reduce antenatal attendance among pregnant women across the country.

The maternal health experts have warned that low antenatal attendance could lead to poor pregnancy outcomes due to a lack of supervision and specialist care.

The physicians further expressed worry that the hike in fuel prices could exacerbate Nigeria’s already troubling maternal health indices, highlighting that effective antenatal, intrapartum, and postpartum care were crucial in averting maternal mortality.

The hardship, which started after the removal of fuel subsidy and devaluation of the naira, was exacerbated on Wednesday when the pump price of fuel jumped from around N800 to N1,150 per litre.

This has led to increased transport fares nationwide and worsening the hardships faced by Nigerians.

The gynaecologists disclosed that the new fuel pump price would certainly impact antenatal attendance, stating that pregnant women with low income would not be regular with their appointments due to high transport fares.

The World Health Organisation’s new guidelines recommend at least eight antenatal visits during pregnancy, emphasising that care should begin within the first trimester.

According to the 2018 National Demographic and Health Survey, Nigeria has a worrisome maternal mortality ratio of 512 deaths per 100,000 live births.

Speaking exclusively with PUNCH Healthwise in different interviews, the gynaecologists expressed concern that reduced antenatal attendance would prevent many expectant mothers from receiving necessary interventions.

Dr Chukwuneme Okpala
A Consultant Obstetrician and Gynaecologist at Nnamdi Azikiwe University Teaching Hospital in Nnewi, Anambra State, Dr Chukwuneme Okpala, warned that the recent fuel price hike would lead to decreased antenatal attendance.

He explained that the initial increase in fuel prices had already raised transportation costs, and the latest hike had further worsened the situation, making it difficult for many pregnant women to keep to their appointments.

Okpala stated, “Hospitals will see a decline in antenatal care attendance in Nigeria due to the rising fuel cost. High transportation costs will have a ripple effect on people’s living standards, reducing the purchasing power of pregnant women.

“Many will struggle to afford basic needs, which will inevitably affect their ability to attend appointments. When finances are tight, families will have to prioritise essentials like food over healthcare, leading to fewer women attending routine antenatal services.

“Many women will not visit the hospital regularly for antenatal care due to financial constraints, regardless of their proximity to healthcare facilities.”

Okpala stressed that irregular attendance at antenatal clinics could lead to poor quality care, significantly impacting pregnancy outcomes.

“Without regular visits, those who need interventions may not receive them. Attending antenatal clinics frequently increases the chances of detecting and managing potential complications.

“Only through hospital visits can healthcare providers assess and identify any issues, whether maternal or foetal. When women do not present or arrive late, it often results in more severe problems that could have been addressed earlier”, he said.

Okpala lamented that decreased antenatal attendance will exacerbate Nigeria’s maternal health indices.

“If the current hardships persist, our maternal health statistics will suffer. In 2023, the WHO reported that Nigeria has the second highest rates of maternal, stillbirth, and neonatal deaths in the world, following India,” he said.

The expert explained that maternal mortality serves as an indirect measure of a country’s Gross Domestic Product, adding, “If our GDP declines, healthcare will be adversely affected. Preventing maternal mortality relies on proper antenatal, intrapartum, and postpartum care.

“If women begin to seek alternative care due to high transportation costs, our maternal mortality rates will undoubtedly rise. While the effects may not be immediately visible, they will become apparent if the current trend continues without intervention.”

Offering recommendations, Okpala stated that the government was aware of the necessary actions to take, as many professionals have provided potential solutions.

He said, “The government has two options: either reinstate the fuel subsidy and tackle corruption or refine our fuel and sell it reasonably. Alternatively, they could establish an affordable public transport system for antenatal mothers, enabling them to attend their appointments.”

He emphasised that such measures could lead to positive pregnancy outcomes, asserting, “The responsibility lies with the government, not individuals. If they implement these changes, it would help, but I remain sceptical about their willingness to do so.

“Our government travels abroad and observes how things work there. If we can enhance purchasing power, we will access quality care; if purchasing power decreases, the outcomes will suffer.”

He said, “If a person earns N100,000 and that amount remains unchanged over time, their quality of care, as well as the quality of food they can afford, will decline.

“Consequently, the amount they can allocate for healthcare will also decrease. The government knows what needs to be done, but corruption often hinders these efforts.”

Corroborating Okpala’s statement, a Consultant Obstetrician and Gynaecologist at the Niger Delta University Teaching Hospital in Bayelsa State, Dr Judiet Ugbechie, emphasised that reduced antenatal attendance increases the risk of pregnancy complications.

She noted that higher numbers of antenatal visits are crucial for decreasing the likelihood of stillbirths and improving pregnancy outcomes.

Ugbechie said, “Having eight or more contacts for antenatal care can significantly reduce perinatal deaths compared to having only four visits or none at all.

“A woman’s visit to her antenatal care provider should encompass more than just a routine check-up; it should involve comprehensive care and support throughout the pregnancy.”

She highlighted that more frequent and higher-quality visits between women and their healthcare providers facilitate the uptake of preventive measures, timely detection of risks, and address health inequalities.

“Antenatal care is particularly vital for first-time mothers, as it sets the foundation for how they will engage with antenatal care in future pregnancies,” she said.

She recommended that pregnant women schedule their first antenatal visit within the first 12 weeks of gestation, followed by subsequent visits at 20, 26, 30, 34, 36, 38, and 40 weeks.

By Francesca Hangeior

Leading health experts have said doctors should ensure they account for the placenta of women after childbirth to avoid getting into trouble with their family members.

The physicians revealed that many doctors had been harassed by family members of women who delivered in their hospitals for not being able to account for the placenta.

According to the senior health practitioners although there was no scientific basis for placenta collection, some Nigerians insisted on collecting it after childbirth due to cultural beliefs.

Recall that in March 2024, the police in Kwara State arrested a doctor and three nurses following the disappearance of the umbilical cord and placenta of a newborn baby at Government Cottage Hospital, Iloffa in the Oke-Ero Local Government Area of the state.

The mother, identified as Mrs C. Williams, a class teacher at Orota Secondary School, Odo-Owa, was reported to have had the child on Sunday night but was not given the umbilical cord and the placenta by the hospital’s workers.

It was gathered that the health workers were detained by the general Investigation unit of the State Criminal Investigation Department of the command in Ilorin.

A Consultant Obstetrician and Gynaecologist, Dr. Joseph Akinde, told our correspondent that some family members were so crazy about the placenta to the point that they could sue the doctor if he failed to provide it after delivery.

Akinde, who is a former chairman, Society of Gynaecology and Obstetrics of Nigeria, Lagos State chapter, said the placenta, in some cultures in Nigeria, especially in the eastern part, is highly valued.

He explained, “We have people that are superstitious. If a doctor cannot account for the placenta, he can be fought to any length, especially in the eastern part of the country.

“Some people bury the placenta in designated places. Their belief is that no matter where the child grows, he will always trace his path to where the placenta is buried.

“Some people believe that the placenta could be used for ritual purposes, hence their insistence on taking possession of it.

“So, that is why some families are so crazy about it that if a doctor cannot account for it, they might even want to take him to court.”

Akinde pointed out that some people believe that the destiny of the child is linked to whatever is done with the placenta.

“But there is no medical basis for all these and there is no scientific basis for such belief,” he warned.

“So, many doctors have been harassed because they could not account for the placenta. I remember some time ago, a family made a hell of noise because a doctor in one of the government hospitals where the woman delivered could not account for the placenta.

“They went to the press and they were making noise that the doctor had sold the placenta of their baby, accusing the doctor of selling the destiny of the baby.”

The gynaecologist urged doctors to always make sure that they account for the placenta in order to save themselves from accusations.

He suggested that doctors should always ask family members of the woman if they want to collect the placenta or not before discarding it.

A past Chairman, Nigerian Medical Association, Cross River State chapter, Dr. Innocent Abang, also corroborated Akande’s statement, saying many people are steeped in traditional beliefs and practices about the placenta, though such practice has no scientific basis.

Abang said, “They believe that if somebody picks a baby’s placenta and buries it somewhere, that is where the child’s destiny is buried.

“So, there are a lot of connotations attached to it. Most times, family members take it themselves and go and bury it under a tree. Sometimes, they plant coconut atop the placenta.

“They believe that as the coconut is growing, that is the child growing. As it blossoms, they believe that the life of the child will blossom. So, there are a lot of spiritual, traditional and cultural connotations attached to the placenta. It is really funny.”

The physician noted that medically, immediately after a child is born, the child has no business with the placenta, stressing also that the collection of the placenta by family members has no link with medicine.

“But some family members can sue a doctor or burn down his hospital if he fails to produce the placenta.

“Many families do not joke with it. If the doctor mistakenly throws it away, that doctor is in trouble. They will read many meanings to it.

“Many doctors have suffered at the hands of family members of women after delivery because of the placenta. I have seen where a family member made serious trouble in a hospital over placenta. But those who have no attachment to the placenta are not bothered,” he said.

He, however, said, “In medical practice, anything that you bring out of a patient must be shown to the patient.”

By Francesca Hangeior

A musical artiste, Owodunni Ibrahim, popularly known as Primeboy, has dragged the Nigeria Police Force to court for alleged abuse of his fundamental human rights.

Reports have it that the Lagos State Police Command, on Wednesday, October 4, 2023, declared Primeboy wanted following his failure to honour a police invitation successfully sent to him since the commencement of the investigation into the circumstances leading to the death of the singer, Ilerioluwa Aloba, popularly known as Mohbad.

In a statement made available on Thursday, Primeboy’s lawyer, Akinpelu Ogunbona, said the suit was filed before the Federal High Court, in the Ikoyi area of the state.

Ogunbona said the singer was demanding the removal of his name from the wanted list, amongst other prayers.

“Primeboy has sued the police via an originating motion filed before the Federal High Court, Ikoyi, Lagos on October 11.

He prayed to the court for a couple of reliefs, some of which included a declaration that the special police gazette bulletin issued by the office of the IGP declaring Primeboy wanted was a contravention of Primeboy’s right to respect for the dignity of his human person.

Primeboy also prayed the court to delist his name from the wanted list amongst other prayers,” the statement read.

Primeboy has since the death of Mohbad been at the centre of the controversies trailing the death of his late ally.

He also surrendered himself to the police barely 24 hours after he was declared wanted.

Mohbad died on September 12 at the age of 27, with circumstances surrounding his death sparking controversies on social media.

Being a former record label signee of Marlian Music, owned by Naira Marley, Mohbad left the label in February 2022.

The state police command had, on September 18, 2023, inaugurated a 13-man special investigation team to probe the death.

His death also led to the arrest of Naira Marley and controversial Lagos socialite Balogun Eletu, aka Sam Larry, amongst others.

The body of Mohbad was, on September 21, 2023, exhumed for autopsy to unravel the cause of his death.