Unconventional

Why does the fight over "pregnancy is a death sentence" refuse to end? (2/2) Because the dead do not quote-tweet. Each survivor is a witness for the defence, and the women who did not make it cannot testify. A grandmother with every birth behind her is the defence's favourite witness. Any neighbour who died in her own second labour left no story to tell. Surviving is a lower bar than it sounds. Doctors have a name for the woman who nearly died but survived, the maternal near miss. Hospital studies in Nigeria have counted between two and ten of them for every woman who died. Not all of them heal. Some lose the womb. Across Nigerian teaching hospitals, emergency removal of the womb runs at around two to six in every thousand deliveries, most often to stop bleeding that would not stop. Others leave with a heart that failed late in pregnancy or soon after, a condition Nigeria records at the highest rate in the world, and not every heart recovers. In one Zaria hospital, half the women put on dialysis for kidney failure after childbirth were still dialysis-dependent at discharge and could not afford more. Rarer still, surgeons in Kano have reported a new mother who lost parts of both legs to gangrene. Each year about 12,000 women leave labour with a fistula, a hole between the birth canal and the bladder or rectum left by labour that went on too long, and leak urine or faeces until it is repaired. In one Sokoto study, more than half of the women with fistula also had foot drop, nerve damage from the same labour that leaves a foot dragging. As recently as 2017, repairs fell about 7,000 a year short of new cases. Every one of these women goes into the record as a woman who lived. The danger is unevenly shared. Just 172 local government areas, about one in five in the country, account for 55 per cent of maternal deaths. In Lagos, 86 per cent of births take place in a health facility. In Kebbi, fewer than one in ten do. A woman in Lagos and a woman in Kebbi are describing two different countries, and each is telling the truth about hers. Since 2000 the world has cut maternal deaths by 40 per cent. Nigeria's figures improved by 13 per cent. The federal government proposed about 4 per cent of this year's budget for health, against the 15 per cent Nigeria signed up to in 2001. That shortfall is one reason the hospital costs more than families have. Where is the other 11 per cent? I gave the word "sentence" one paragraph in part one. Every year the timeline gives it a week, and that week spares the government that question. Those gaps are the verdict, and the first defendant is the federal government. Years before any timeline fought over these words, a Nigerian state government vowed that pregnancy would no longer be a death sentence for its women. A government does not promise to end something that does not exist. The phrase was a confession before it was ever a tweet. 🐝🐆