I once got a message from a friend that read like “to realize the value of nine months, ask the mother who gave birth to a stillborn”. This message got me thinking…
Despite the increasing access to health care services and the so many interventions geared at reducing stillbirth rates, the situation is still alarming in Ghana. As I reviewed data on some health indicators and in particular stillbirth, so many questions spin in my head why this should be happening. Journeying from one hospital to the other on support visits, I try to understand the primary causes for the prevailing stillbirth rates in our health facilities. Issues such as pregnant women refusal to attend antenatal care, delay in seeking care during labour, the use of herbal concoction/enema, medical and nutritional status of women, the nonuse/incorrect use of partograph and system set ups were mentioned. Many of these causes can be attributed to sub-causes like inadequate knowledge, traditional beliefs, finance, transportation, monitoring and supervision among others.
In this blog, my focus is about the use of concoction in pregnancy. Concoction is some form of suppository/herbs that people take to clear the colon. The mode of administration varies from oral to anal (enema). “Enema” is the introduction of suppository concoction into the rectum and colon through the anus. Concoction/Enema in pregnancy are used as last resort for treating constipation and also to induce labour close to the due date. Frequency of consumption varies from woman to woman mostly three times or twice or once depending on the reason of use. However, of concern, is the content of the concoction and how it is performed. In the process to induce labour the concoction causes the uterus to contract. This type of contraction is not natural – happening in a wave pattern- resulting in likelihood of delay in delivery. This can cause the loss of the baby in the process.
Madam Ama went to deliver in hospital B, after having taking some form of concoction to induce labour. She was able to put to bed safely but the medical officer could not remove the placenta because it had contracted. Measures were taken in attempt to remove the placenta and in the process, there was no record of the woman bleeding. Under normal circumstances according to the medical officer, the woman should have bled which never happened. The medical officer became interested and persuasive to know what herbs the woman took. For him, such herbs can be used to stop postpartum haemorrhage in women.
Upon discussing this episode with a midwife, she debunk the reaction of the medical officer saying that, the women not bleeding could have been as a result of other conditions not necessarily the concoction the woman took. For her, concoction is bad and should be discouraged. She went further to express her disappointment in what she termed “even knowledgeable female health workers take enema when they are pregnant”. The general notion that, concoctions are taken due to inadequate knowledge among pregnant women is defeated inferring from above.
In my view, though I do not condemn concoction intake, I support the view of the midwife on the use of concoction during pregnancy. The reason is that, the content and how the concoction should be used is uncertain. Also, concoction is noted to account for postpartum haemorrhage which is one of the leading causes of maternal mortality by WHO.
Concoctions are supposed to be natural remedies avoiding unnecessary medications during pregnancy, however, since the content and how it is used is uncertain, I would personally discourage the use of concoction during pregnancy.