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Pregnant women with small pelvises can have vaginal delivery if…

Medical experts have cautioned pregnant women with small pelvises against the risk of refusing caesarean section because of cultural and religious beliefs, warning that delivering a big baby through a small birth canal is fraught with complications that could lead to stillbirth.

According to the experts, if a pregnant woman has a small pelvis, the chances of vaginal delivery is limited and therefore, has to be offered a CS.

A professor of Obstetrics and Gynaecology at the Ahmadu Bello University, Zaria, Solomon Avidime, told PUNCH HealthWise during an interview that pregnant women who have small pelvises are those who are naturally not too tall.

Avidime, however, said women with small pelvises could still give birth vaginally, depending on the size of their babies.

The gynaecologist said, “When the pelvis is small and the baby is small, the woman can still have varginal delivery. So, the size of the baby is very important here. If a woman has a small pelvis and the baby is big, it will not be wise to allow the baby to pass through that small pelvis.”

Continuing,the physician said, “Occasionally, we encounter women that refuse CS if it is offered to them as a way to aid their delivery. But they refuse such offer because of their cultural and religious beliefs.

“Some of them had ended up losing their babies because by the time they agreed to have  CS delivery, the situation had become worse. They usually have unwanted outcomes.

“Now, if a woman that is to deliver through CS refuses, obviously, she cannot deliver on her own or even if she eventually delivers, she will have complications and the baby may die. Also, the mother can have injuries, bleeding, which may result in death.”

Avidime warned that some babies that were forced out of a small birth canal could have deformity later in life.

“You have seen some babies who have injuries in their hands or legs, which may be because of the way they were delivered. Short mothers will have small pelvises and the baby will not be able to pass through,” he said.

Experts say CS is a surgical procedure used when women experience complications during pregnancy and childbirth in order to save the lives of mothers and babies.

According to them, improving the access and availability of caesarean sections in the country is pivotal to reducing maternal deaths and to achieve the Sustainable Development Goal on maternal health of reducing maternal deaths to less than 70 per 100,000 live births by 2030.

Nigeria’s latest maternal mortality ratio is 512 per 100,000 live births, as contained in the National Demographic and Health Survey 2018, which shows that the country has a long way to go in meeting the global health target by 2030.

Avidime further said, “In some cultural settings, women still want to deliver babies by themselves despite high risk of complications.

“But education will go a long way to help people understand the fact that having caesarean delivery does not mean that the woman is weak because there are several reasons why caesarean sections are done.

“Some times, the babies are big and they may not be able to pass through the birth canal or they are too weak in the process of labour or they are not lying properly to be able to pass through the birth canal.

“So, in such circumstance, CS is offered to save the life of the woman and her baby.

The gynaecologist stated that apart from bleeding and high blood pressure, obstructed labour is another major factor contributing to high maternal and infant deaths in Nigeria.

He noted that CS should be made available and accessible to women requiring the procedure, revealing that many pregnant women and their husbands often refuse CS because of cost.

This, he said, had led to many avoidable deaths of women and their babies, especially in rural areas.

He, therefore, called on the government to establish a comprehensive healthcare centre in each political ward across the federation where CS and blood transfusion services are readily available to women.

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