Miscarriage, Every Parent’s Greatest Fear

Miscarriage. Every parent’s greatest fear is in losing a child. It is a very great indescribable pain. When it is especially a baby either at birth or as a toddler, it can be depressing for the mother.

According to the World Health Organisation (WHO) too many babies still die in pregnancy or childbirth, about one million are estimated to die daily within 24 hours of birth.

When the statistics are reeled, the fear increases and it becomes heartbreaking because these are not just numbers but humans.

From the WHO data, 10-15 percent of women who knew they were pregnant end up with miscarriage. Generally,  a baby who dies before 28 weeks of pregnancy is referred to as a miscarriage, and babies who die at or after 28 weeks are stillbirths. Not less than 2.6m babies are stillborn every year.

A miscarriage is medically described as the the loss of a fetus during pregnancy; usually before or around the 20th week of pregnancy. The medical term for a miscarriage is spontaneous abortion.

There are different cultural attitudes to losing a baby, and women have access to different levels of quality antenatal care worldwide. Yet as varied as the experience of losing a baby may be around the world, stigma, shame and guilt emerge as common themes notes, the WHO.

According to Consultant Pediatrician, Lagos University Teaching Hospital, (LUTH), Professor Chinyere Ezeaka, babies die during pregnancy as a result of miscarriage and are also lost at birth due to suffocation . Some other related causes of deaths in newborn are neonatal tetanus, malaria, and maternal anemia.
Professor Ezeaka noted during a recent conversation on safe birth initiative in Lagos.

Ezeaka, who is also the President Nigerian Society of Neonatal Medicine and Consultant Paediatrician explained, “neonatal deaths are largely as a result of asphyxia which is a major reason why babies do not cry-when oxygen is not supplied to the brain and sometimes, those who survive after interventions may end up with brain damage and would not reach full potentials in life.

Going by available evidence in Lagos State as documented in the Maternal, Newborn and Child Health (MNCH) Scorecard January-June 2018 by Mamaye Evidence 4 Action, 89 percent of births in the State are attended by skilled birth attendant out of which 25 percent are through Cesarean section and 2 percent end up as stillbirth.

Experts however say for this every parent’s fear much can be avoided or prevented.

In the words of Chairman, Association of Advanced Family Planning, Nigeria (AAFPN) Dr, Ejike Oji, “the general principle of Obstetrics and Gynecology expects every pregnant woman to visit the hospital for at least four time in the life of her pregnancy to enable prompt medical attention in the event of any signs of distress”.

But in Lagos evidence from the MNCH Scorecard shows only 47 percent of pregnant women attended four antenatal clinics in the months of January to June 2018 hence many who experienced miscarriages are not detected early enough and could not be prevented.

From the Scorecard for example, only 44 percent ( 4 out of 10) pregnant women reported for antenatal care in the first 20 weeks of gestation period thus fueling the incidence of complications that usually occur around the time, when a pregnant woman fails to be seen by a skilled health worker early enough to avert any untoward.

In the words of Ezeaka, “mothers still die giving birth at our hospitals due to high blood pressure, hypertension, eclampsia, anaemia, malaria, infections and unsafe abortion among others which are all preventable causes.

“And when pregnant mothers fail to show up in the early weeks of pregnancy the possibility of detecting conditions that could lead to spontaneous abortion or miscarriage such as Infection, certain medical conditions in the mother, such as diabetes or thyroid disease would be missed.

Other causes of miscarriages could be Hormone problems, Immune system responses, Physical problems in the mother and sometimes too, uterine abnormalities.

In the words of Dr Folashade Oludara, Director Family Health, Lagos State Ministry of Health, “the advise to all pregnant mothers is to immediately register at nearest health facility for continuous monitoring by skilled nurses, midwives and Obstetricians and Gynecologists who are trained to identify any possible abnormalities that could endanger the life of a mother and her unborn child at every stage in pregnancy”.

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