Too Many Pregnancies, Too Many Deaths: Why Nigeria Must Rethink Maternal Health Urgently
When people talk about motherhood in Nigeria, it’s often with reverence. From cultural expectations to religious values, having many children is still widely considered a blessing. But behind this sentiment is a sobering, often overlooked reality: too many pregnancies are costing women their lives.
Leading gynaecologists across Nigeria are sounding the alarm — and it’s time we all listened.
The Hidden Cost of High Fertility: Lives Lost
Nigeria’s fertility rate is one of the highest in the world — at 5.3 children per woman. That might seem like a badge of cultural pride, but it comes with a tragic cost: a maternal mortality ratio of 512 deaths per 100,000 live births, according to the National Demographic and Health Survey (NDHS) 2018. That’s more than seven times the global target set by the UN Sustainable Development Goals (SDG).
According to Dr. Joseph Akinde, a veteran obstetrician and former chairman of the Society of Gynaecology and Obstetrics of Nigeria (SOGON), excessive bleeding (postpartum haemorrhage) is a leading killer of Nigerian women during childbirth — and it’s far more common among women who have had multiple pregnancies.
“Every pregnancy takes a toll on the woman’s body. The more children she has, the higher her risk of complications — especially bleeding. And once the womb loses its ability to contract effectively, the danger multiplies,” Dr. Akinde warns.
The Role of Chronic Illness: A Deadly Combination
Nigeria’s maternal health crisis is made worse by another factor: the rising number of women with pre-existing health conditions. From diabetes and hypertension to asthma and sickle cell anemia, more women are becoming pregnant while battling life-threatening diseases — a combination that can turn deadly.
“When you mix chronic illness with pregnancy, it’s like pouring petrol on a fire,” says Dr. Akinde. “These women should have a maximum of two or three children — not five or six.”
Unfortunately, many of these women still seek antenatal care at under-resourced Primary Health Centres (PHCs) that lack the expertise to manage high-risk pregnancies. Dr. Stanley Egbogu, a Consultant Obstetrician from Nnamdi Azikiwe Teaching Hospital, insists that these cases belong in specialist or teaching hospitals, not rural clinics.
What’s Really Driving This Crisis?
Beyond biology, Nigeria’s high maternal mortality rate is rooted in deep social and systemic issues:
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Cultural pressure to have many children, often to “prove” fertility or secure family legacy.
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Limited access to contraceptives and reproductive health education.
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Home births still dominate, with about 80% of Nigerian women delivering without skilled medical support.
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Low healthcare funding, especially for maternal and neonatal care.
It’s a dangerous mix — and the outcome is painfully clear.
Where Do We Go from Here?
This crisis is not irreversible. In fact, it is preventable.
Here’s what needs to change:
🔹 Encourage family planning education: Both men and women need to understand that fewer, well-spaced pregnancies save lives.
🔹 Invest in maternal healthcare infrastructure: From equipping PHCs to training midwives and obstetricians, the system needs more than band-aid solutions.
🔹 Early antenatal registration: Women with chronic conditions should begin care early and be referred to tertiary hospitals, not left in poorly staffed clinics.
🔹 Break the stigma around contraception: Religious and traditional leaders must step up and educate their communities.
🔹 Policy change and implementation: Nigeria must align its maternal health efforts with the SDG goal of reducing maternal deaths to below 70 per 100,000 live births by 2030. Right now, we’re not even close.
Conclusion: When a Blessing Becomes a Risk
Motherhood should be a celebration of life — not a death sentence. But for too many Nigerian women, that’s not the reality. Behind every maternal death is a family broken, a child orphaned, and a future lost.
The message from our gynaecologists is clear: we must rethink our approach to childbirth, family size, and maternal health — now. Not every woman needs to bear six or seven children. Sometimes, one or two healthy births can be more meaningful than many that come with risk and loss.
Because every life matters. Especially the ones who give us life.
