Dr. Chinyere Adaeze Okafor Obstetrician – Gynecologist | University of Ibadan, Nigeria I will never forget that night shift. A young woman, only 22 years old, was rushed into the emergency room with critically high blood pressure, severe swelling all over her body, and intermittent loss of consciousness. She was 36 weeks pregnant with her first child. Her family told us she had never attended a single antenatal check-up because she “felt fine” and could not afford it. Neither she nor her baby survived. We live in a society where pregnancy and childbirth – the most sacred experiences in a woman’s life – are laden with unnecessary risks, simply because of a lack of knowledge, a lack of support, and a lack of trust in modern healthcare systems. A Grim Reality: Antenatal and Postnatal Care in Nigeria According to UNFPA’s 2023 report, only about 67% of pregnant women in Nigeria receive at least four antenatal visits – far below the World Health Organization’s recommended minimum of eight visits per pregnancy. In rural areas, the figure drops to around 40%. Nigeria also remains the country with the third-highest maternal mortality rate in the world, at approximately 1,047 maternal deaths per 100,000 live births (WHO 2022 report). A significant proportion of these deaths are caused by pregnancy complications that go undetected or untreated in time, such as: Preeclampsia and eclampsiaPostpartum hemorrhagePostnatal infectionsCardiovascular complications during pregnancyWhen Lack of Awareness Becomes a Silent Killer One of the issues that troubles me most is that pregnant women in Nigeria are not adequately equipped with the knowledge to care for themselves – from proper nutrition and recognition of warning signs to understanding mental health after childbirth. I once treated a woman delivering her second child who experienced abnormal heavy bleeding at home but delayed seeking medical help, thinking it was “normal postpartum discharge.” By the time she arrived at the hospital, she had lost more than 1.5 liters of blood and required emergency transfusion. We saved her life, but she went on to suffer prolonged postpartum depression. Another mother, aged 35, with a history of heart disease, did not attend any antenatal appointments because she “still felt fine.” The pregnancy placed immense strain on her heart, leading to acute heart failure at seven months. This was a situation that could have been avoided with regular monitoring. Cardiovascular Disease in Pregnancy – The Silent Threat Few realize that cardiovascular disease is the leading indirect cause of maternal death. Pregnancy is a “stress test” for the heart – blood volume increases, and the heart must work harder, especially in women with pre-existing hypertension, valvular disease, or arrhythmias. Symptoms such as shortness of breath, extreme fatigue, leg swelling, or rapid heartbeat should never be ignored – they may indicate pregnancy-related heart failure. Early diagnosis through echocardiography, continuous blood pressure monitoring, and ECG is critical to safeguarding both mother and child. Why Care from Qualified Facilities and Professionals Is Essential In many Nigerian communities, people still rely on traditional practices, unlicensed birth attendants, or word-of-mouth home birth advice. But the truth is this: not everyone can detect early signs of preeclampsia, heart failure, or fetal growth restriction. Only properly equipped medical facilities – with Doppler ultrasound, digital blood pressure monitors, and CTG fetal heart rate tracking – can intervene in time. Likewise, a certified obstetrician-gynecologist, with formal training, clinical experience, and continuous medical education, can make accurate medical decisions – something no amount of “instinct” or “folk wisdom” can replace. What Can Make Pregnancy Safer for Nigerian Women? Strengthen antenatal education at the community level – from young women and students to parents – so everyone understands the basics of pregnancy and postnatal care.Organize free online consultations for women in remote areas, giving them the chance to ask questions, understand risks, and take timely action.Expand access to remote pregnancy monitoring using telemedicine platforms that connect patients and doctors effectively.Provide postpartum psychological support, as postpartum depression remains a serious but often overlooked issue in many African communities.Closing Thoughts I write this not only as a doctor but as a woman, a mother, and someone who has witnessed far too many unnecessary tears – all because of a lack of awareness or limited access to proper healthcare. Pregnancy and childbirth should never be a game of chance. Let modern medicine work hand in hand with the warmth of tradition, so Nigerian women can embrace motherhood in safety, knowledge, and dignity. If you are planning a pregnancy, currently pregnant, or have recently given birth – do not hesitate to seek help. I am here to listen and to walk this journey with you.
