One death every seven minutes: The world's worst country to give birth

At 24, Nafisa Salahu faced a life-threatening situation in Nigeria. A woman dies every seven minutes during childbirth there, on average.

During a doctors' strike, she went into labor at the hospital. Unfortunately, no expert help was available when complications arose. Her baby's head became stuck, and she was told to lie still for three days.

Eventually, a doctor agreed to perform a Caesarean section. "I thanked God because I was almost dying," Ms. Salahu said from Kano state. She survived the ordeal, but sadly her baby did not.

Now, eleven years later, she has given birth several times. "I knew I was between life and death but I was no longer afraid," she shared.

Ms. Salahu's experience is common in Nigeria. It is the most dangerous country for childbirth globally. Recent UN estimates show that one in 100 women die during or after labor.

In 2023, Nigeria accounted for over 29% of all maternal deaths worldwide. This translates to about 75,000 women dying each year—one death every seven minutes.

Many of these deaths are preventable due to issues like postpartum hemorrhage. Chinenye Nweze bled to death five years ago in Onitsha hospital.

Her brother Henry Edeh recalls that doctors needed blood but couldn't find enough quickly enough. "Losing my sister is unbearable," he said.

Other causes of maternal deaths include obstructed labor and unsafe abortions. Martin Dohlsten from UNICEF cites poor health infrastructure as a major factor.

He also mentions a shortage of medical staff and high treatment costs as contributing issues. Cultural beliefs can lead some women to distrust medical professionals.

Mabel Onwuemena from the Women of Purpose Development Foundation emphasizes that no woman should die giving birth. Some rural women believe hospitals are ineffective and prefer traditional remedies instead.

For many women, reaching healthcare facilities is difficult due to transportation issues. Even if they arrive at hospitals, they often find inadequate equipment and supplies.

Currently, Nigeria spends only 5% of its budget on health care—far below the 15% target set by an African Union treaty in 2001.

In 2021, there were only 121,000 midwives for a population of 218 million people. Less than half of all births were attended by skilled health workers.

The country needs an estimated additional 700,000 nurses and midwives to meet WHO recommendations. There is also a severe lack of doctors available for care.

This shortage discourages some women from seeking professional help when needed. Jamila Ishaq expressed distrust towards hospitals due to negligence stories she has heard.

She recounted having complications during her fourth child's delivery at a hospital where no staff were available to assist her promptly.

Now expecting her fifth child, Jamila considers private clinics but finds them too expensive.
Chinwendu Obiejesi can afford private healthcare and prefers it over other options.
She notes that maternal deaths among her friends are now rare compared to before.
Living in Abuja's wealthy suburb allows easier access to hospitals with better services.
"I always attend antenatal care," she explained about monitoring her health closely during pregnancy.
During her second pregnancy, doctors prepared extra blood just in case it was needed.
A family friend faced tragedy when her baby died after complications arose during labor with an untrained attendant.
Dr Nana Sandah-Abubakar from the National Primary Health Care Development Agency acknowledges the dire situation.
Last November marked the launch of Mamii—a new initiative aimed at reducing maternal mortality rates.
This program will target areas responsible for over half of childbirth-related deaths across Nigeria.
"We identify each pregnant woman and support her through pregnancy," Dr Sandah-Abubakar stated.
So far, they have located around 400,000 pregnant women through house-to-house surveys.
The goal is linking these women with necessary healthcare services for safe deliveries.
Mamii will also work with local transport networks to improve access to clinics and promote low-cost public health insurance enrollment.
It remains early to assess Mamii's impact; however authorities hope it will lead toward global trends improving maternal health outcomes.
Globally since 2000, maternal deaths have dropped by 40%, while Nigeria's improvement stands at only 13%.
Experts believe more investment is essential alongside initiatives like Mamii for lasting change.
"Their success depends on sustained funding and effective implementation," Mr Dohlsten warned.
Meanwhile daily losses continue; approximately 200 mothers die each day in Nigeria—leaving families devastated by grief.
Henry Edeh still mourns his sister’s loss deeply: "She became our anchor after we lost our parents."
"In my quiet moments alone with my thoughts about her... I cry bitterly."