Pregnant women with small pelvises, big babies shouldn’t refuse caesarean section, gynaecologist warns


A Professor of Obstetrics and Gynaecology at the Ahmadu Bello University, Zaria, Solomon Avidime, has advised pregnant women with small pelvises to stop refusing caesarean section delivery because of cultural and religious beliefs.

The gynaecologist cautioned that such refusal comes with many risks, warning that delivering a baby through a small birth canal when the baby is big could cause serious complications, including death of the baby.

Prof. Avidime noted that if a pregnant woman has a small pelvis, the possibilityof vaginal delivery is limited, noting that such women are usually offered a CS option to avoid complications.

Speaking in an interview with PUNCH HealthWise, the professor, however, said women with small pelvises could still give birth vaginally, depending on the size of their babies.

Giving insight into the risk of forcing babies out of a small birth canal, Prof. Avidime said, “When the pelvis is small and the baby is small, the woman can still have a vaginal 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.

“Occasionally, we encounter women that will refuse CS, if it is offered to them, as a way to aid their delivery.

“They often refuse such an offer because of their cultural and religious beliefs.

“Some of them have ended up regrettably losing their babies because, by the time they eventually agree, the situation would have become worse. They usually have an outcome that is unwanted.

“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 and may die.”

He pointed out that babies forced out of a small birth canal could also have deformities later in life.

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

According to experts, there is a need for massive education and enlightenment on the benefits of caesarean section to improve its acceptability.

In a 2015 article published in PubMed Central journal, titled, “Socio-cultural factors, gender roles and religious ideologies contributing to Caesarean section refusal in Nigeria”, the authors said socio-cultural norms hinder the acceptance of CS in the country.

PubMed Central is a free full-text archive of biomedical and life sciences journal literature at the United States National Institutes of Health’s National Library of Medicine.

The authors stated that 22 per cent of maternity clients refused CS and more than 90 per cent of the CS’s in the focal hospital were emergencies which may indicate late arrival at the hospital after seeking assistance elsewhere.

“The qualitative analysis reveals that socio-cultural meanings, informed by gender and religious ideologies, the relational consequences of having a C-section, and the role of alternative providers, are some key factors which influence when, where, and whether women will accept C-section or not”, the researchers said.

“There is a need to find means of facilitating necessary CS by addressing the prevailing socio-cultural norms and expectations that hinder its acceptance.

“Engaging and guiding alternative providers (traditional birth attendants and faith healers) who wield much power in their communities, will be important to minimise delays and improve cultural acceptability of CS”, the authors concluded.


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