The influences of native customs on obstetrics in Nigeria.

Obstetric practice in the tropical forest of Eastern Nigeria is still far from the reach of modern scientific techniques and equipment. Most of the women are anemic and malnourished and home deliveries by native doctors quacks and self-trained midwives are local customs. Evil spirits are blamed for obstetric complications and use of purgatives enemas and multiple skin incisions are the most practiced form of treatment. Frequent vaginal examination unnecessary maneuvering to dilate vagina pressure and manual pushing on the fundus are the more common means to assist delivery. Native custom of rolling the newborn babies in mud and cutting the cord with unsterile materials is one of the reasons for high infant mortality. Ignorance; native customs; prejudice against hospital treatment; and lack of communications are factors contributing to highest maternal mortality which would have been prevented with modern obstetric practice. At the end of all unsuccessful trials those who are taken to hospital are infected; dehydrated; and in shock due to maltreatment at home. They could be survived with extreme managements like venasection transabdominal aspiration of urine and assisting the delivery by vacuum extractor or forceps or symphysiotomy or perforation and extraction depending on the stage of labor. Due to prolonged and obstructed labor sufferings continue as V.V.F. cervical and vaginal stenosis and footdrop as a sequalae of pressure necrosis. Old customs consider twins as evil and kill the first twin or leave in the bush or hospital where it is delivered. Negative attitudes towards cesarian section adds to maternal mortality and morbidity from ruptured uteri. Another serious problem is antepartum and postpartum hemorrhage which is difficult to manage due to lack of blood donors. Postpartum depressions are rare and may be due to the practice of putting both mother and baby in an isolated fattening room which provides good care of mother and baby. To improve the obstetric practice increased efforts are made to educate the people which will help to abolish harmful practice and provide services to the target population.