Caséy Amaefule





LIKE I ALWAYS SAY, the fight against maternal mortality in developing countries like ours is, more often than not, hindered by three mighty monsters, which are:

R – Religious fanaticism
I – Ignorance
P – Poverty

These three monsters are more formidable enemies than the rest of our challenges put together, and victory isn’t assured until we put the three to death.

A few months ago, right there at the hospital, we nearly lost a 35-weeks-pregnant woman who was tormented by these three monsters.

She was a Gravida 9 Para 8+0 lady (was in her ninth pregnancy, with the delivery of 8) who had Type IV placenta previa and had had three warning bleeds, the latest occurring just three days before she came to see us.

Type IV placenta previa meant that her baby’s placenta was sitting over the opening of the cervix (gateway of the womb) instead of the roof and this meant that it would be impossible for the baby to come out of the womb naturally.

This was by all means a case of major placenta previa. It’s a huge Obstetric case and had to be handled carefully.

The major challenge with placenta previa was the likelihood of torrential bleeds which could happen at anytime and which could result in the death of the woman and baby if not handled immediately.

As was the usual way or managing such cases, the managing team instituted the famous management protocol known as McAfee’s Regimen. This would mean that she would be admitted in a hospital with 24-hour Obstetric and Neonatal services, including being on a ward close to the theater, with at least 4 units of blood available and on stand-by at the blood bank, as well as other components.

Now because she was admitted while she was still 32 weeks pregnant, it meant that she would be on admission for 5 weeks until she reached 37 weeks (term) after which she would undergo a Caesarean section to be delivered of her baby.

She was counselled appropriately about the diagnosis (plus the possibility of a torrential life-threatening bleed) and line of management but, not surprisingly, she vehemently refused, citing that she had a God who would ensure that she would not bleed and her delivery would be sound.

Very true.

The managing team told her that she would be on admission until her baby was born, but our dear lady refused. She called everyone she knew to come and intercede for her and save her from the wicked clutches of the doctors who wanted to hold her captive for 5 whole weeks.

If she stayed 5 weeks at the hospital, who would then take care of her kids? Her petty trade nko?

And to top it off, she lived in a remote area far away from any standard hospital. If she bled again, the bleeding which usually would be torrential like a rushing tap water, could kill her before any help could arrive, if ever.

Her family members and pastors did their best to intercede, assuring us that she wouldn’t bleed again cos they were sure that God would ensure she didn’t.

Monster: Religious fanaticism

I also reminded them that while God was capable of doing that and even more, He, in His infinite wisdom, had given the doctors the requisite knowledge to save the woman and her baby if only they would listen to their doctors.

Thankfully, her husband had a change of heart after our long counselling and insisted she remain at the hospital for the entire 5 weeks. If anything happened to his wife, who would help him take care of their eight other kids?

So we kept this beautiful woman at the hospital, maintaining strict bed rest and other protocols as the McAfee’s regimen demanded. She was doing fine and almost nearing the finish line of 37 weeks.

However, at 35 weeks and 3 days, right in the middle of the night, 1am to be precise, the torrential bleeding began.

Blood poured out of her vagina like water, quickly drenching the bedsheets and soaking the bed. It didn’t stop there. The abnormally-lying placenta then switched gears, letting out more torrents of blood and converting her bedside to a pool.

And while everyone else slept, the nurses on the ward swung into action, alerting us of the bleed (God bless our nurses) and the doctors wheeled her into the nearby theatre and within seconds, she was undergoing a CS.

But because of the torrential bleeds, we dashed into the blood bank and scooped six units of standby blood available and began transfusing her while still undergoing operation.

The emergency surgery lasted till almost 6am and the woman narrowly escaped death by the skin of her teeth. Her baby was saved as well.

And that was how maternal mortality, a very preventable killer of our beautiful pregnant African women, was averted.

Now imagine she was allowed to go home as she demanded and she bled in her remote house in the middle of the night? She would even die before help could come.

Thank God for our medical professionals.

So next time, even with your religious beliefs, remember to obey your doctors as well. They are God’s messengers to save you, and what they do ain’t of their power but of God as well.

Now the woman is happy and every time I see her, I remember why I always wanted to be a doctor. This is what we live for.

Maternal mortality is preventable and as an SDG Educator, I’ll keep doing as much social media campaigns as I can until we all get it.

That’s what Sustainable Development Goal 3 stands for: Good Health and Well Being.

Listen to your doctors. They are God’s gift to you.


+++Impossibility is nothing. Just believe+++


  • Caséy Amaefule