International Day of Zero Tolerance for Female Genital Mutilation

Image:Feminist.org

FGM is a practice that is deeply rooted in culture, and several scholars have associated this action to a high maternal death rate (Paul, 1993; Marchie and Anyanwu, 2009; Lawani, 2014). There are 4 types of FGM: type 1 involves the removal of the prepuce with partial or full excision of the clitoris; type 2 involves removal of the clitoris and prepuce in addition with the partial or full removal of the labia minora; type 3 involves removal of part or all of the external genitalia and stitching of the vaginal opening (infibulation); and type 4 involves all other procedures, for example, pricking and piercing (Gruenbaum, 2001; Rouzi et al., 2001).

FGM is identified as a risk factor for haemorrhage, and a reason for common early complication in circumcised pregnant women (Toubia, 1994; Dare et al., 2004; Mandara, 2004; Olusegun et al., 2012).

I join the global community in commemoration of the International Day of Zero Tolerance for Female Genital Mutilation & Cutting, and to build a bridge between Africa and the world, geared towards accelerating an end to FGM&C by 2030.

Diet, "Window of Vulnerability" and Pregnancy

Image credit: Winrock.org

Several studies have indicated that a mother’s diet in pregnancy may have lasting effects for the off spring. A poor diet during pregnancy can cause biological changes that last throughout life.

“There are around 100 imprinted genes, about 0.4% of the total in the genome, and most appear to have their greatest impact during pregnancy. The pattern by which imprinted genes are ‘set’ in early life plays an important part in the development of healthy offspring. If a gene is ‘miss-set’ then problems may occur later,” says Dr Mathew Van de Pette, a lead author based at the MRC LMS.

He added: “We found that mice fed a low protein diet in pregnancy produced offspring in which the father’s copy of the gene became active and stayed that way. This demonstrates a clear link between early life adversity and later life outcomes.”

“We were surprised that this change in diet permanently affected the expression of this imprinted gene,” said Professor Amanda Fisher, who led the study and is director of the MRC LMS. “Our work suggests there may be a window of vulnerability when diet can indeed have an effect, and that once these genes are set, they’re set for life,” Professor Fisher said. “The good news is that we’ve also shown that it’s possible to avoid this with a normal diet". Read more here.

Now the good news as mentioned above is the fact that a normal diet can limit such vulnerabilities. However, a “normal diet” is a luxury the poor and needy women back in Africa cannot afford.  Diet within the countries with the greatest burden of maternal and child death is complex, because it depends on multiple factors such as economic, social and cultural.

Sustainable strategies have to be put in place to help pregnant women to improve their nutritional wellbeing, and that of their unborn babies. It is paramount that pregnant women and the precious life within them begin to be recognized as part of the vulnerable portion of the society.

As always I am an avid advocate for the increased assistance to these women, in the form of reducing their financial burdens, improving their access to education, and information. This education should include the importance of health and nutrition, utilization of maternal health services, and good child spacing.

Please feel free to drop your comments.

Popular British TV Drama to Feature Female Genital Mutilation Plotline

Image: Sharia unveiled

Female genital mutilation/cutting refers to "all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons. 

This practice is a violation of girls and women's fundamental human rights, and it is encouraging when the media highlights such sensitive issues in its plot. See recent news below.

Popular British period drama "Call the Midwife" is to feature female genital mutilation (FGM) in a storyline about a pregnant Somali woman living in east London in the 1960s.

Campaigners against FGM welcomed the news, saying the mainstream show would help boost awareness of the widely condemned practice, which has long been shrouded in secrecy.

"I'm over the moon. It's amazing," said British activist Hibo Wardere whose FGM prevention work includes training medical staff.

"Five years ago no one wanted to talk about FGM but everyone is waking up now and finally seeing this as child abuse," added Wardere who nearly died when she was cut as a child in Somalia.

A 2014 study estimated 137,000 women and girls in England and Wales have undergone FGM and 60,000 girls are at risk.

The ritual, which involves the partial or total removal of the external genitalia, often causes serious physical and psychological problems and can lead to childbirth complications.

"Call the Midwife", which is broadcast by the BBC, returns for a sixth series this weekend and is likely to air on PBS in America.

Creator Heidi Thomas said the story would not "impose a modern mindset", but would reflect the 1960s setting.

Continue here for the full article.

News credit: Allafrica.com

The Global Epidemic of Unnecessary Cesarean Sections (Part 1)

Medical Daily

Cesarean section surgery, when medically indicated and performed by trained staff with the necessary equipment and supplies, can be a life-saving procedure for the mother and baby. However, compared to vaginal delivery, cesareans are associated with a higher risk of maternal and neonatal death; numerous maternal morbidities including infection, uterine rupture and amniotic fluid embolism; neonatal morbidities often related to iatrogenic prematurity; and potential complications in subsequent pregnancies. Studies have also observed that children born via cesarean are more likely to develop respiratory problems, diabetes and obesity later in life. Therefore, cesareans should be considered a major surgical intervention and only be performed when clinically necessary. 

Furthermore, to minimize the risks associated with cesarean section, the surgery should only be performed by skilled health workers in high quality facilities.

For many years, researchers have debated the optimal cesarean rate for maximizing maternal and infant health outcomes. Since 1985, the World Health Organization has estimated the ideal population-level cesarean rate at 10-15%, although some scientists have suggested a higher figure. Further investigation of an optimal rate is certainly warranted. Theoretically, the optimal population-level cesarean rate should be calculated based on the proportion of laboring women who have a medical indication for cesarean delivery. But, unfortunately, the high and increasing levels of cesarean delivery rates around the world illustrate that the procedure is not always medically indicated.

Clinicians sometimes disagree about what constitutes a medical indication, and in some cases lack the necessary tools to identify a complication. For example, fetal distress is a commonly reported reason for performing a cesarean—but how exactly does one measure fetal distress? How long should a provider wait for an abnormal fetal heartbeat to return to normal before deciding to perform a cesarean? How can clinicians in low-resource settings without access to fetal monitoring technology accurately assess these situations?

Before developing consensus on the optimal population-level rate, the global maternal health community must agree upon the medical indications for cesarean delivery and ensure that clinicians around the world are adhering to standardized, evidence-based guidelines.

This is the part one of a very interesting debate, please click here and here for part two and three .

News credit : Maternal Health Task Force Blog

Nigeria: Contraceptive Use Among Nigerian Women On Increase

The Federal Government's advocacy on the use of contraceptive among sexually active women in Nigeria for the prevention of unwanted pregnancy and abortion is beginning to yield positive results as more women are recorded to be embracing the method.

Compiled data from the 2015 report of the National Bureau of Statistics, NBS, on health shows that contraceptive use among sexually active women of child bearing age increased by seven per cent compared to 2014.

In 2014, 23 per cent of sexually active Nigerian women used contraceptives, while 30 per cent used in 2015, the Bureau's latest data showed.

Contraceptive are methods, devices or drugs used among sexually active people to reduce or prevent unwanted pregnancy and unsafe abortion.

A cross section of women interviewed in Abuja on family planning methods showed that most women engaged in one form of contraceptive method, either modern or traditional, to prevent unwanted pregnancy.

Aisha Jamiu, a plantain trader, said what she used to do to prevent pregnancy was count the days of her safe period with her husband and abstain from sex when she is not safe.

This is one of the traditional forms of contraceptive method to prevent pregnancy. The NBS data also showed a 2 per cent increase in use of traditional contraceptive methods between 2014 and 2015.

Read complete article here

News credit: Premium Times

Do Rwandans still need to travel abroad for child birth?

Photo: Newtimes

Rwanda has reduced both under-five mortality and maternal mortality by approximately three-quarters. This achievement has been attributed to improved maternal health care over the years. But despite this milestone, some women still prefer to travel out of the country to give birth.

Melisa Agasaro (not real name) delivered her first baby at a hospital in Australia and her second born in the US. Agasaro had a reason for choosing to travel far to give birth. She was diagnosed with a potentially life-threatening health condition, gestational diabetes, that couldn’t easily be dealt with in the country.

“I travelled to the US to have my second born in 2013, my pregnancy was a little bit complicated and the doctors here couldn’t trace the issue. When I went to the US, I was diagnosed with gestational diabetes, they also checked other complications but the condition was at a dangerous stage, so I was put on medication immediately,” the mother-of-two narrates.

She says she got outstanding care while in America.

Agasaro is just one of the many women who decide to have their babies abroad for various reasons. Some expecting women travel to give birth abroad as a matter of choice while others have no option since their condition cannot be managed locally.

For Lillian Mugabo, some women actually go abroad to give birth because of the way some local hospitals treat expectant mothers.

Referring to her experience, the mother of two supports women who choose to go abroad because she wouldn’t wish for any other woman to experience what she went through.

Mugabo had her second child two months ago, but the pain she experienced made her doubt the nurses who attended to her, and she wondered if they were skilled enough.

Vestine Uwamahoro echoes similar sentiments. She says that the process of giving birth is agonising enough and that a woman in labour deserves the best care from anywhere she believes she can get it.

“I wouldn’t say our system is bad, but I think those who go to other countries in most cases are seeking special care from more qualified doctors,” she says. 

Continue here to read more

News credit : The NewTimes