Majority of women go through a lot of challenges and complications during pregnancy. As if that is not enough, labour and child-birth is the most painful experience a woman goes through in her life, of which most mothers testify true.
As a result, it has come to Your Health’s attention that many women in Tanzania decide to use traditional medicine or herbs without consulting a health expert so as to ease pregnancy complications or fasten the labour process without considering the health dangers associated with it.
About three months ago, Velena Thomas* lost her sister Sara, a first-time mother. Sara died due to complications during birth. Velena till date is not sure what caused her death but her sister had a big baby that was to be delivered by caesarean section.
“She was advised by her doctor to go for C-section and was given a specific date for the surgery. Sara was always against surgery and had always wanted a normal delivery. So what Sara did was go look for traditional herbs to help her induce labour naturally before the given date for C-section,” Velena tells Your Health.
Velena furthers narrates the sad ordeal that when Sara began experiencing labour pains, none of them were aware of the herbs she had taken. She kept it as a secret. They only came to realise when the nurses began perusing Sara’s clinic bag for clothes and other necessities.
“We found a well wrapped piece of paper with directions written in Kiswahili on how to use the powdery substance and it was stated that it is specifically for fastening labour process. It is when we realised why she went into labour early before the given dates. Both my sister, and the unborn child died,” says Velena.
Dr Marie Voeten, Chief Medical Officer at the Sengerema District Hospital in Dar es Salaam reveals to Your Health that the use of traditional medicines during pregnancy and labour are very common in Sengerema. She says, it is a practice that needs to be stopped urgently as they pose health risks for mothers-to-be and their unborn child.
Commenting on what would have been the cause of Sara’s death, Dr Voeten says, it is not possible to suggest what might have caused Sara and the baby’s death. However if her bag was found with traditional medicines, health experts can link the death to its use.
She says, “At Sengerema hospital, we always find expectant mothers with traditional roots from home claiming that after eating them, it helps to fasten their labour pain process. Instead of waiting for 8 hours for the first birth, it takes up to 3-4 hours.”
Dr Voeten adds, “This seems to be good news to the pregnant women, but it is not medically right, in fact it is a risky affair. It is advised for women to wait for natural process to take its course as it comes with right process of the baby to slowly come to its right position, waiting for the water bag to rupture and when the baby is ready, it will just come out healthy without jeopardising the mother and its life.”
Adding to that, Dr Voeten says, researches that are aimed at revealing direct cause of death and other side effects resulting from the traditional use of herbs are very limited that doesn’t allow health workers to give data on deaths and side effects due to traditional medicine.
“As health experts, all we can do is to take away the traditional medicines if it happens they [expectant mothers] are found with them in the labour ward.”
A common practice
Georgina George, 34, a business woman in Kariakoo still remembers the tough experience she went through during her first pregnancy six years ago. Georgina always worried about having baby number two. Hormone changes due to pregnancy hit her badly.
During her first trimester, she survived on drips as she could not manage to eat anything. Morning sickness being accompanied by spitting and unable to eat are the memories that her mind refused to let go.
On this, she is not walking alone. A brief survery by Your Health reveals that majority of women go through a very challenging journey of pregnancy.
As a way of calming the discomforts, majority of women opt for unprescribed traditional medicines during pregnancy to ease the discomforts during pregnancy as well as during labour.
But is the practice of having traditional medicine/herbs safe to take during pregnancy/labour and approved by the medical doctors? Are the women putting their lives at risk and increase chances of them losing their lives? Interviewed health experts warn against the use of traditional medicine during pregnancy and labour as they can result to the increase of maternal deaths.
A 2017 report titled ‘Prevalent use of herbs for reduction of labour duration in Mwanza, Tanzania: Are obstetricians aware?’ aimed to determine the prevalence and factors associated with the use of herbs during labour among women in Mwanza, Tanzania.
The report shows the use of herbs during pregnancy and labour is rapidly increasing because the herbs are considered to be natural and therefore free of risks. The report shows despite of this perception, a number of herbs have been reported to have negative effects to the new-borns and the mothers.
Traditional herbs which were only identified by local names were ekakwingili, matola, makarekambona, akabindizi, ekinunulizi, enyabashumi, binzari nyembamba, mgagani, mshana and msuana. Among those reported to use herbs, 12 (29.3 per cent) reported to use herbs, which could not be identified by their generic or local names as the users did not know what they were given and ingested.
Georgina is one among the women who used traditional medicine as soon as she was introduced to a WhatsApp group by a friend. The group advises and encourages pregnant women to use traditional medicine from Lake Zone to stop early discomforts as well as prolonged labour.
“I was talking at a ladies outing on the challenges that come with pregnancy. Two of the women who attended the outing told me about a WhatsApp group that directs women on the usage of traditional medicines during pregnancy and even when they are in labour,” says Georgina.
To her that was good news. In an instant, she joined the group by just paying Sh1,000 as a monthly fee and she was added. The group, according to Georgina, consists of more than 200 members. The traditional medicines being given starts from those who are unable to conceive for years, hormonal imbalance, problems around menstruation as well as those of using during pregnancy and labour.
Adding to that she says, she then decided to purchase traditional medicine as advised by the admin, which she had to boil and drink two glasses a day. She was also given another medicine and was told to mix in her food whenever she felt like vomiting after eating. Both medicines were dried leaves and they worked best for her.
“I had a pleasant experience with my second child. I got none of the challenges and discomforts during pregnancy,” adds Georgina.
Georgina might have been one of the few fortunate ones to deliver safely, but it’s not the case for many.
Why it’s dangerous?
Health experts say that labour is supposed to be progressive, with the cervix becoming thinner and wider (dilating) gradually. But most women don’t adhere to the natural process.
Dr Colman Matunda, a consultant gynaecologist based in Dar es Salaam, says traditionally, women use the herbs to ease discomfort during pregnancy, widen the birth canal and speed up labour.
Dr Matunda doesn’t advise expectant mothers to use any type of traditional medicine or herbs to induce labour because it may result to complications during birth.
In an article published in New Vision, Dr Evelyn Nabunya, a gynaecologist/obstetrician was quoted explaining the risk of eating or drinking labour-inducing herbs.
The herbs cause hyper-uterine stimulation, where by contractions occur frequently and do not allow the baby to rest, Nabunya explains.
The frequent contractions put the baby at risk of distress because there is no time for the uterus to recover. The mother may also end up distressed. Under normal circumstances, a mother should not exceed five contractions in 10 minutes, she affirms.
The mother is also prone to miscarriage, suffering a uterine rupture because of hyper stimulation, which may lead to severe bleeding and premature birth, Dr Matunda warns.
In addition, Nabunya says some mothers may present with cervical dystocia, a condition where the cervix fails to dilate even with normal contractions.
If a mother is unlucky, she may end up with a tear of the cervix extending down to the vagina. Usually when such a condition presents, operation is done to deliver the baby, Nabunya says.
A way forward
Vestina Rugasha, a midwife at Maddona hospital says that in her 36 years experience of working in the labour ward, she has seen a lot of women who attend monthly clinics as well as in the labour ward walk in with traditional medicine.
She says, it is very difficult to stop women from using traditional herbs as they claim even their mothers used the same and are the ones advising them.
“We try to educate these women during their clinic sessions, yet there is always a new bad case indirectly linked to the use of herbs at the hospital,” Rugasha says.
More needs to be done in terms of spreading awareness on the risks of ingesting herbs during pregnancy and labour, Rugasha says. She suggests, hospitals should play videos or edutoons on this kind of information when mothers-to-be queue during clinics so that they can make informed decisions.
How to ease labour without the use of herbs
Health experts advise the following:
• Moving around: Walking, swaying, changing positions, and rolling on a birthing ball can not only ease the pain but can help your labor progress.
• Team: Having partners or loved ones around can play essential roles on your birth team. Choose people who will treat you with respect and patience. The proper support can help decrease stress and inhibitions, so you can find your best coping mechanisms more easily.
• Breathing: Whether you’re hee-ing or haa-ing, panting or deep inhaling, as long as you’re focusing on your breath and releasing it, you’ll find some relief.
*Not her real name