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Childbirth is more than a dream to the African woman. It is a duty placed on her by society; a task to provide companions and grandchildren to her parents in their lifetime.

Therefore a woman who refuses or can’t give birth is given negative tags and names, whilst those with several children, including twins are celebrated in some traditional settings across the continent. So, pregnancy is a great celebration. Once confirmed, that state is celebrated in varied ways. It calls for new dresses, hairstyles and fanciful walking techniques.

In modern times, young ladies go a step higher, checking on the Internet on how to give birth, and looking out for babies’ dresses and names in anticipation of welcoming that beautiful child. But a number of such expectant mothers go home with no babies due to stillbirth. Stillbirth is giving birth to a baby with no signs of life at or after 28 weeks’ gestation.

The major causes include child birth complications, post-term pregnancy, maternal infections in pregnancy such as malaria, syphilis and HIV and maternal disorders especially hypertension, obesity and diabetes), foetal growth restriction, and congenital abnormalities. There were 2.6 million stillbirths globally in 2015, with more than 7,178 deaths a day, says the World Health Organisation.

It said majority of the deaths occurred in developing countries, with 98 per cent occurring in low- and middle-income countries. In Ghana, institutional stillbirth figures went up nationally to 11,976 in 2013, with 274 stillbirths more than recorded in 2012, according to the Ghana Health Service. Kay, 35, a career woman was among cases recorded in 2013. Unknown to her, her baby died between her thighs during delivery on a Sunday morning.

Kay said hours earlier, her doctor said all was well and she massaged her belly with smiles, waiting to carry little “GG” soon. Whilst in pain, she wrote, “Little GG, I love you. Even though am going through pain, I can’t wait to see your beautiful face…” She however left the hospital without seeing the beautiful face of GG and was traumatised by the loss.

The trauma was heightened when she was taken into a room where her colleagues who had delivered were kept, with some asking her what she got. Soaked in tears, Kay was wheeled into the theatre for an operation to address a complication with her placenta. That was successful but after a few days of compassion from relations and friends, Kay was left to herself.    Martha, 25, a trader, perhaps had a more traumatising experience.

It was her first pregnancy too, and Martha was filled with anxiety to meet the condition of her husband to be- to marry her only after she had given birth. She was rushed to the hospital with signs of labour, but midwives on duty claimed, she wasn’t due. After she screamed that the baby was in between her thighs, they rushed to her and started giving her lashes of the cane and instructing her to push.

Martha did push but alas, Kofi came out dead. The nurses then started pouring invectives on her, calling her a witch and a murderer, as Martha broke down in tears. After a while the midwives called Martha’s husband and lied that she deliberately killed her baby. The man hurried to the hospital, took pictures of the dead baby and went to where Martha sells in the Market to inform her colleagues, she had killed her own baby.

That same day, the man and his relations organised a burial service for the baby and buried him with pictures of Martha, asking the spirit of the child to deal with her. Martha didn’t see the face of her baby. She was only told he died and was buried by her husband who asked the baby’s spirit to deal with her. Everything went bad. No baby, no marriage, as her fiancée evicted her from their chamber and hall apartment. She was also rejected in her father’s house because she was warned against that relationship and had to start life all over again, perching with a friend.

“I am yet to come out of that hell of stillbirth,” Martha told the Ghana News Agency, sounding angry.
Irrespective of these and many other pitiful stories, stillbirths do not attract the needed attention and investment in addressing causes of giving birth to dead babies. Stillbirths remain hidden to policy makers and implementers. It is not counted in the Sustainable Development Goals (SDGs) but maternal, neonatal and child health continue to receive great attention.

Experts say one-third of stillbirths are estimated to occur intra-partum (during labour), in low/middle income countries like Ghana and caused mainly by complications arising during labour and childbirth, such as prolonged or obstructed labour or umbilical cord accidents. This is an indication that, expectant women are not receiving quality intra-partum care in health facilities in the country. The health and pregnancy of our sisters, daughters, wives and mothers are simply confronted by lack of caregivers.

The few who are available in peri-urban and city centres are overburdened and hardly give quality service. Health facilities in the country lack proper supervision and sufficient supplies, with some facilities asking expectant mothers to buy essential drugs and items whilst in labour. BMC and Childbirth online journal says “where women receive quality intra-partum care, as in many high-income countries, the proportion of intra-partum stillbirths is less than 10 per cent of all stillbirths”, meaning, a good number of intra-partum stillbirth can be prevented.

It is worth noting that maternal mortality and stillbirths are important adverse pregnancy outcomes, especially in developing countries and must be given equal attention, because underlying causes of both outcomes appeared similar. For instance, macerated stillbirth-death of a baby in the womb, could affect the clotting system of an expectant mother, leading to maternal mortality, which is said to have gone up from 350 per 100,000 live births to 380 in 2013 in Ghana. Pre-eclampsia and eclampsia,-hypertension in pregnant woman, could also cause stillbirth.

Dr Atsu Seake-Kwawu, Ho Municipal Director of Health Services said stillbirths are serious concerns to health authorities and underscored the need for families to take good care of pregnant women and also asked midwives to up their work with keen attention on risk factors associated with pregnant women. He agrees that stillbirths could be reduced towards meeting the SDG targets for child and maternal mortality if good attention is given to addressing causes of stillbirth like the lack of information and education on the subject.

This is because stillbirth remains shrouded in secrecy with city dwellers and especially people in rural areas still believing stillbirths are caused by evil spirits and gods as punishment. It is therefore important that the situation is demystified. Pregnancy case tracking, where nurses keep contacts of pregnant women and regularly check on them must be made to work effectively. In many cases, the nurses do not call or check on the expectant mothers.

They simply ask them to rush to the facility if they had any health concerns. So supervision from superiors could help ensure the system works well to avoid some obstetric emergencies. Clinical psychologists could also be engaged in labour wards to help expectant mothers develop the mental toughness to handle complications and come out victorious.

The facilities must also be provided with electronic heart monitors so caregivers stop relying on Fetoscope, manual heart monitors, said to be less effective in monitoring the heart beat of babies. Stillbirth is a thief in the delivery ward and must be arrested now in a bid to enhance maternal and child health.