By Dr. Amina.M.Hassan and Okereke Chisom Confidence
Nigeria remains one of the most dangerous places in the world to give birth, with maternal deaths accounting for more than one-quarter (28.3%) of the global total. According to the World Health Organisation (WHO), the country’s current maternal mortality ratio (MMR) stands at 1,047 deaths per 100,000 live births, one of the highest in the world.
In 2023, Nigeria recorded an estimated 993 maternal deaths per 100,000 live births, underscoring the slow progress in reducing preventable deaths.
Maternal Mortality in Northern Nigeria
The northern region bears the heaviest burden, with states such as Katsina, Zamfara, Kano, Sokoto, Kebbi, and Jigawa consistently reporting ratios above 1,000 deaths per 100,000 live births according to MNCH2.
In Zamfara, although official statistics are yet to be published, local authorities revealed that over 950,000 women remain at high risk of maternal death.
In Katsina, the situation is equally dire, with April 2025 data confirming that the state’s MMR surpasses 1,000, placing it among the highest nationwide.
Experts point to deeply rooted cultural and traditional practices as major drivers of these alarming figures. In many Hausa and Fulani communities, women must obtain permission from husbands or mothers-in-law before seeking medical care. This delay in decision-making often proves fatal when complications arise.
Furthermore, home births are still widely glorified as a sign of courage, while women who deliver in hospitals are sometimes labeled as weak. This perception encourages unassisted or poorly supervised deliveries, significantly increasing the risk of death.
Harmful practices also persist in the postpartum period. For instance, the consumption of kunun kanwa (a potash-based gruel) and prolonged hot-water baths are believed to restore strength after childbirth but, in reality, can worsen hypertension and trigger postpartum cardiomyopathy, a leading cause of sudden maternal deaths.
Traditional Birth Attendants and Rising Deaths in the South-East
The South-East also struggles with dangerously high maternal mortality rates.
According to Sabinet African Journals in 2023, Enugu had an Maternal Mortality Ratio of 768 per 100,000 live births, Ebonyi was 574, Abia was 602, and Imo was 564.
A significant portion of these deaths has been linked to the activities of Traditional Birth Attendants (TBAs). TBAs are local women who assist with childbirth using traditional methods but lack formal medical training or access to essential equipment.
Women patronise TBAs because they are cheaper and more accessible than hospitals. They enjoy community trust and familiarity. Many women face long distances, high hospital fees, and, in some cases, disrespectful treatment in health facilities.
Delays in referring women to hospitals during emergencies. Unsafe delivery practices that increase the risk of infections. Inability to provide life-saving interventions such as surgery, blood transfusions, or emergency medications.
A Call for Action
Health experts emphasised that every pregnancy deserves skilled care, not guesswork. They urge governments to register and retrain TBAs, restricting their role to referrals rather than deliveries. At the same time, investments must be made to ensure that hospitals are affordable, accessible, and respectful spaces where women feel safe to seek care.
Unless Nigeria confronts these cultural practices and systemic gaps, the cycle of preventable maternal deaths will persist—robbing thousands of families of mothers each year.
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