Traditional Birth Attendants

At 15, Hajara was already married and began having children a year later. Now 32, she has had five children all of whom were delivered by a Traditional Birth Attendant (TBA) resident in her Ibwa village in Gwagwalada Area Council of the Federal Capital Territory (FCT).

Like her, so many other women in the community and beyond, as well as in other States in northern Nigeria do not deliver their children in hospitals.

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Culture and Religion

Zaria's Hauwa'u Al-Amin, a mother of four, delivered of all her children by a highly revered near seventy year-old TBA. Al-Amin explains that her upbringing has taught her that it is a taboo for a male to touch a woman who is not his wife or sister, and since delivery involves a lot of body contact, she would prefer to employ the services of Traditional Birth Attendants.

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Attitude vs Attitude

Attitude of TBAs compared to the attitude of nurses, is a significant factor in the choices available to an expectant mother when she goes for her delivery. Recounting her experience, Larai Patrick said: "When I went to have my first baby, the pain was unbearable. The nurse kept slapping my thighs and raining abuses on me. Even after the labour pains ended, I was still writhing in pains from the slaps and her very unkind words."

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Hospital vs TBA Demands

"When you go to the hospital, they ask for so many things and even if you cannot afford them, you have to buy," said Ajumma Idris. According to her, "the painful thing is that those government nurses don't always return what you didn't use."

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Proximity and Availability of Health Centres vs TBAs

Another drawback for many mothers is that "staff who work in the health centers usually close at 4pm," Lawal Ibrahim said. In some places, they close earlier, he added. "It is a lot easier to access the TBAs because they are in the community with us.

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Contending With Complications

It was a relief to realise that both the women and TBAs know that they should go to hospitals when there are complications. But with zero antenatal sessions during pregnancy, how do the women know a potentially complicated pregnancy?

According to Adamu: "When we massage, we can tell if the baby is well positioned or not, or if there is any other problem with the pregnancy." She however admits that her diagnoses haven’t always been correct, but fortunately, rescue came and there have been no recorded mortalities so far.

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Not all that glitters is gold

Although the women tell glowing tales of their TBA encounters, and others justify their visits to them, there are some others who tell a different story.

Madam Jane, a mother of three in Maraba, a suburb near the FCT, recalled her ordeal in the hands of the TBA and vowed never to visit any again.

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What the Experts are Saying

Dr Theo Ochonu, a family medicine physician with the Federal Medical Centre, Keffi explains: “There is no comparison between services rendered to an expectant mother by professional medical personnel, and what the traditional birth attendant does.

But the bottom line is that the TBAs need to be trained and retrained from time to time, because of the important role they play in society."

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