Maternal health experts say women with chronic diseases such as cancer, hypertension, sickle cell anaemia, diabetes and heart disease should avoid having too many children, warning that they are prone to serious complications during pregnancy and childbirth.
They said women with chronic diseases, who try to have many children stand the risk of death and advised on a maximum of three children.
The gynaecologists, however, said women giving birth to many children without underlying health conditions are likewise endangering their lives, as many pregnancies place a heavy burden on a woman, both physically and psychologically.
According to the British Heart Foundation, having five or more children is associated with a 30 per cent increased risk of heart disease – the major cause of heart attacks – as well as a 25 per cent increased risk of stroke, and a 17 per cent increase in the risk of heart failure compared to having one to two children.
The medical practitioners, who spoke exclusively to PUNCH Healthwise, said having many children comes with a lot of health consequences, noting that every pregnancy and birth comes with its own risk.
They also said having pregnancies too close together does not give the mother time to recover after losing nutrients such as iron and folate after pregnancy and during breastfeeding.
A Consultant Obstetrician and Gynaecologist, Dr. Joseph Akinde, revealed that pregnancy and childbirth complications are among the leading causes of maternal deaths in Nigeria.
The maternal health expert, who is a former Chairman, Society of Gynaecology and Obstetrics of Nigeria, Lagos chapter, said, “We have the psychological demand and of course, the health needs are there. There is the danger of having abnormal children when you continue to have children at a very late age.
“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 the 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 a woman gets pregnant, the womb expands to accommodate the baby and when the baby is expected, the womb must contract. That ability to contract is progressively weakening and the woman may have bleeding after delivery.
“In fact, 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.”
The gynaecologist pointed out that pregnancy puts a lot of pressure on a woman’s body system, a development he said would be 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 their body system.
“When you have hypertension, the condition might even get worse in pregnancy. When you have diabetes too, it will get worse in pregnancy.
“If you have diabetes or hypertension for example and you get pregnant, it’s like pouring petrol on a burning house. So, you put further pressure or 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, or a maximum of three. It is not advisable for them to have many children”, he explained.
Dr. Akinde urged pregnant women with chronic diseases to begin antenatal early and register with 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 per cent 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 stated.
In 2022, the WHO revealed that a woman in Nigeria has a one in 22-lifetime risk of dying during pregnancy, childbirth, postpartum, or post-abortion, pegging the figure of such occurrence at 917 deaths for every 100,000 live births.
Meanwhile, the UN Sustainable Development Goals target is 70 maternal deaths per 100,000 live births by 2030.
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 stated.
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.
He also pointed out that any pregnant woman with underlying health conditions should not use Primary Healthcare Centres for antenatal care, as the pregnancy is associated with high risk, especially during delivery, and cannot be managed at PHCs to avoid maternal and infant death.
The gynaecologist emphasised that it was crucial for such women to register at tertiary hospitals for their antenatal care so that they can access specialised care and reduce complications during delivery.
Dr. Egbogu said, “Women that have diseases like sickle cell, asthma, hypertension, diabetes and heart diseases before getting pregnant must not use PHCs for their antenatal. It is important they register in a teaching or specialist hospital for their antenatal because they need specialised 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 many complications during the pregnancy.”
