For maternal care, hospital’s antecedents matter

We can’t forget in a hurry the sad story of 30-year-old Omowumi Shonuga, who died while attempting to have her second child.

Omowumi died in the premises of Rauf Aregbesola Health Centre in Egbeda, Alimosho Local Government Area of Lagos — a public hospital that was built with taxpayer fund and which was supposed to serve as an avenue for reducing maternal deaths in Lagos.

Of course, Omowumi’s widower should not rest until the moribund hospital and its killer squad who goes by the name of medical workers are duly punished. But beyond seeking redress for a deceased mom and her late infant, pregnant women and their families must have certain facts on their fingertips as they access antenatal care in any hospital around the country.

To start with, pregnant women and their families must realise that no pregnancy is safe. And until a woman is safely delivered of a healthy baby, the job remains unfinished.

Country Project Manager, Fistula Care Plus, Dr. Habib Sadauki, says, “No two pregnancies are the same; and again, no pregnancy is safe. That is why an expectant mother must seek good medical care in duly accredited hospital.”

Based on this, the Number One thing expectant couples should do is to register in a very good hospital.

In a nation like ours where everything isn’t what they seem, you may rely a little bit on word of mouth, but you must open your eyes wide to see what your hospital doesn’t want you to see, or hear what they would rather want to remain a secret!

Now, how does your hospital treat its patients? Do the doctors poke insulting fun at patients? Do the nurses shout you down when you complain about a treatment, such as administering injection?

Does the pharmacist feel insulted each time you ask him to tell you the name of a prescription and its likely adverse effects?

Does your hospital talk too much about money and very less about the treatment you’re being given?

More important, what is your hospital’s mortality rate? While you may definitely not find this in any public documents, people living near your hospital of choice can reasonably tell you how often they hear the lamentations of patients’ relations, indicating loss of life.

If a hospital’s mortality rate is high, you may do well to seek your maternity care somewhere else.

Of course, opinions differ as to whether a pregnant woman should register in two hospitals, so that if, on the day of delivery, one fails to live up to expectation, as was the case with the Rauf Aregbesola Health Centre, the other could be the saviour.

One caution, though, you cannot take medications from both hospitals at any point in time. Rather, one hospital is like a spare tyre — to be used if the other fails. And, ideally, they should be within reach in minutes.

What a good maternity care entails

According to Dr. Idayat Bello, a good hospital should provide the following care:

Visits once a month until the 28th week or seventh month of pregnancy.
Fortnightly visits (once every two weeks) in the eighth month of pregnancy.
Once a week visit from the 37th week or ninth month of pregnancy until delivery.
Again, your hospital must do certain screenings at decisive stages of your pregnancy. These include:
An interview with the doctor, who will ask basic questions about how you feel and baby’s movements).
Consultation with the in-house doctor at each visit.
Urine test for protein and glucose.
Blood pressure check.
Body weight measurement.
Palpation (feeling your tummy) to check your baby’s position, size and development.
Listening to your baby’s heartbeat.
Checking for any swelling in your legs, arms or face.

Bello says there are also basic tests your hospital must do. They include a blood test to check for your blood group, Rhesus factor and any infections, including HIV, syphilis and hepatitis B.

“You should also undergo blood test to check your haemoglobin level once every three months. If you are found to be anaemic, the doctor may decide to test you more frequently,” she counsels.

Know your rights

Whether this is categorically stated in the constitution or not, the Hippocratic Oath that physicians depose to at graduation already makes them liable to prosecution when they fail to attend to a patient in timely and appropriate manner.

For avoidance of doubt, a part of the Oath states:

“I will apply, for the benefit of the sick, all measures which are required…

“I will remember that … warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug

“I will remember that I remain a member of society, with special obligations to all my fellow human beings…”

Nurses’ equivalent, called the Practical Nurse Pledge, also states:

“I solemnly pledge to adhere to the code of ethics of the nursing profession. I shall be devoted towards the welfare of those committed to my care. I will not do anything evil or malicious…”

Obviously, the doctors and nurses at Rauf Aregbesola Health Centre were too intoxicated with disdain that they can’t remember this aspect of their practice!

Indeed, they seem to have taken for granted the fact that malpractice carries a wide range of punishment — from legal action to civil penalties.

Hospitals, public or private, are constitutionally mandated to respect your human rights when making decisions. It also means that caregivers working in public hospitals must respect patients’ human rights as they go about their work.

Again, you do have a right to receive maternity care, especially in this country where you pay out-of-pocket for everything, including services or drugs that state governments say should be free.

The bottom line: Pregnancy is not a disease. As such, it has no business killing you.