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Okaiwele: Early booking for antenatal is crucial’



Dr. Oseyomon Okaiwele is a senior registrar in the Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital (UBTH). He spoke to IJEOMA THOMAS-ODIA on the essence of antenatal, as well as attitude of pregnant women to appointments.

Some people are known to ignore antenatal appointments, especially after having the first childbirth. What is responsible for this?
Some women may delay registration for antenatal care after previous successful delivery (ies) because they become over-confident. They assume that because they have done it seamlessly before, they can always do it again. They forget that all pregnancies are not the same.

In some other cases, this delay may be due to poverty, as they do not readily have needed funds to register in a health facility, and they are apparently well. This situation may be more pronounced in areas, where there is lack of universal health coverage, and most medical bills are paid from out-of-pocket expenses.

When is it ideal to register for antenatal?
The ideal time to register for antenatal care is after the second missed period. At this time, the risk of spontaneous pregnancy losses (miscarriages) would be reduced, but there is still time to initiate other beneficial interventions. Bearing in mind that there is also the risk of procrastination, whereby women may not register, even when the first trimester is over because everything may seem to be fine. Pregnancies should be booked for antenatal care as early as possible.

Some women believe registration for antenatal should be done after the first trimester, by which time they are sure the foetus will survive. Do you agree?
The benefits of pregnant women having formal antenatal care cannot be overemphasised. It creates a channel by which the women can initiate and maintain contact with qualified healthcare personnel, as this would help to optimise their pregnancy outcome. There is an opportunity to receive health talks to dispel some myths associated with pregnancy.

It would also help them to avoid harmful traditional practices. Furthermore, they would know about beneficial practices, such as the appropriate use of hematinics and antimalarial in pregnancy.

In addition, they would know about the danger signs in pregnancy, which should make them report to the hospital without any delay. Women also have an opportunity for previously unrecognised health conditions, such as high blood pressure, diabetes mellitus or sickle cell disease to be diagnosed and managed properly, so that they do not adversely affect the woman or her baby. Early detection reduces the risk of complications from these conditions.

Any disadvantage of not attending antenatal?
Overall, the outcome of pregnancy is better in women who are “booked’’ for antenatal care than women who are “unbooked.” The chances of these women or their babies having serious illnesses or dying are very much reduced. For example, a preterm baby has the highest chance of survival, when born in a hospital with neonatologists, specialist nurses and incubators.

Outside this environment, the chances of the baby surviving are highly reduced. Bearing in mind that Nigeria has one of the worst neonatal and maternal mortality ratios in the world, all effort should be made towards preventing our women from dying due to pregnancy, by encouraging them to register early for antenatal care and to deliver their babies in accredited health facilities.

In this article:
Oseyomon Okaiwele
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