Losing her seven unborn babies in a row was the most painful experience that Zainabu Issa, currently 43, could endure as a woman who always desired to become a mother.
“It was not easy for me to endure such pain to lose all those babies,” Zainabu narrates to Your Health in an exclusive interview.
Zainabu who is currently a mother of two--living with her husband and children at Mbezi in Dar es Salaam further evokes that the misfortune was attributable to health complications before she was blessed with two children.
“It all started when we lost our first baby, I was six months pregnant, but my husband (Amiri Mohamed) and I thought it was just God’s plan so we didn’t bother seeking for medical assistance,” Zainabu narrates.
After one year, she got pregnant for the second time and a similar disaster happened to her, the baby died before birth.
This time they went to consult a specialist at Magomeni Hospital, and Zainabu was diagnosed with chronic hypertension or high blood pressure— the leading contributor to the global burden of diseases, according to the medical sources.
Doctor’s advice on family planning
The specialist at the hospital had advised her to use contraceptive for a while to prevent another pregnancy until she completed her medication for hypertension.
Due to her health status, she was prescribed to use oral contraceptives-medications that prevent pregnancy.
“I used the pills, but it didn’t work. I still got pregnant for the third time and the child also died in the womb before birth,” Zainabu narrates the sad ordeal.
Zainabu recalls that all her seven previous pregnancies had failed, saying she was giving birth to dead babies—The condition is medically called ‘stillbirth’—defined as the delivery of a baby who has died, the sources indicate.
“My husband was supporting me throughout the difficult time. He kept telling me that we will have babies when the right time comes,” says Zainabu.
Following the persistence of health complications, Zainabu further re-counts that she once consulted a witchdoctor-- suspecting that she could have been bewitched.
“The situation became even worse when I started using traditional medicine. So I had to stop using them,” says Zainabu.
According to an expert in maternal health, Prof Siriel Massawe who doubles as an obstetrician and gynecologist from Muhimbili University of Health and Allied Sciences (Muhas), high blood pressure during pregnancy can be life-threatening to a woman in some cases, noting that if left untreated, the condition can cause harm to both the mother and her infant.
The gynaecologist further demonstrates that high blood pressure may cause reduction of blood flow to the placenta hence the baby receives less oxygen and fewer nutrients from the mother. She adds that the condition can also cause a baby to be born too small or too soon.
“It is true some babies die in the uterus (womb) before they are born (called an intra-uterine fetal death) attributable to high blood pressure. It can happen during the last half of pregnancy or, more rarely, during the labour and birth,” Prof Siriel explains in an interview with Your Health.
Adding: “Seeing a doctor early and often is so important in keeping both a mother and a baby healthy. The condition can only be controlled by medication especially before the woman diagnosed with high blood pressure gets pregnant.”
Other reasons why a baby may die in the womb
The medical sources indicate that the reasons include; how the placenta works, genetic factors, a mum’s health, age and lifestyle, and infection.
Cases of high blood pressure during pregnancy have increased dramatically in Africa, study finds.
A new study titled “The burden of hypertensive disorders of pregnancy in Africa” published in the Journal of Clinical Hypertension (JCH) in March this year, finds an alarming rise in high blood pressure among African women during pregnancy.
The study further demonstrates that Hypertensive disorders in pregnancy (HDP) is a major threat to global health.
According to the study, HDP complicate 5.2 per cent-8.2 per cent of pregnancies globally and are associated with an increased risk of adverse fetal, neonatal, and maternal outcomes including premature delivery, fetal growth restriction, intrauterine death, renal or hepatic failure, haemorrhage, and stroke.
According to the World Health Organisation (WHO), Africa has the highest age-standardised prevalence of hypertension with 46 per cent of adults older than 25 years being affected.
More importantly, previous reports have shown that in Africa where access to antenatal care (ANC) and emergency obstetric care services are limited, HDP are among the top leading causes of maternal and perinatal mortality.
Joy of becoming a mother
Still not losing hope, Zainabu recalls that in 2013, she got pregnant for the eight time, and managed to give birth to a boy--currently six years old.
“For all these years I have been using the medicine to control high blood pressure as prescribed by the doctor,” says Zainabu.
“I gave birth through the operation. It was joyful for all of us,” Zainabu tells.
God kept showering her with blessings as she got the second son who is currently three years old.
“I can’t thank God enough for all that he has done for me. Now I have two sons,” says Zainabu. While her face says it all how she feels blessed and honoured to be called a mother.
“Though, I still continue with medication for high blood pressure. And I thank God, I have been doing well,” says Zainabu.
She opted for contraception
Zainabu and her husband opted contraception to stop further reproducing on the grounds that they feared that she [Zainabu] could face death due to the health complications.
“We discussed and agreed together that she stops pregnancy permanently due to her health status. I was afraid I could lose her if she could keep reproducing, so I had to advise her to undergo the procedure,” says Amiri, Zainabu’s husband.
Therefore, Zainabu narrates that in 2018 she consulted Sarah Simama, a registered nurse at Malamba Mawili Health Centre in Dar es Salaam and received knowledge on family planning.
Later Zainabu had opted to undergo sterilization-- a permanent form of birth control that is extremely effective at preventing pregnancy, the sources say.
“She took me to Mwananyamala Hospital for the procedure. In early days after the procedure, I was experiencing pains, but later the pains disappeared,” narrates Zainabu.
Ms Sarah is among health care providers in Dar es Salaam who have benefited through comprehensive training on family planning under The Challenge Initiative (TCI) Tupange Pamoja project led by Jhpiego.
The project is supported by Bill and Melinda Gates Foundation, which among other main objectives, it serves to scale up effective programs leading to increased use of modern contraceptive methods among all women 15-49 years of age in urban poor areas by working closely with the local governments in Tanga, Arusha, Dar es Salaam and Mwanza.
“The project also focuses on enhancing the capacity of providers and facilities in specific intervention areas of FP or Adolescent and Youth Sexual and Reproductive Health,” says TCI program coordinator Rose Mnzava.
“The expectation is that local governments will show progress in the provision of quality family planning services,” adds Rose.
According to Demographic and Health Survey and Malaria Indicator Survey (2015-2016), total demand for family planning is high in Tanzania. Six in 10 currently married women age 15-49 have a demand for family planning; 39 per cent want to space births, and (22 per cent) want to limit births.
The report further indicates that the contraceptive prevalence rate (CPR) among currently married women in Tanzania is 38 per cent. Most women who are using contraception are using a modern method (32 per cent of currently married women).
In 2012, Tanzania pledged to increase the availability of modern contraception methods at all levels of its health system. With a promise to increase its allocation for family planning commodities from 14 billion to 17 billion by 2020.
Speaking to Your Health, Director of National Reproductive and Child Health Services Programme, Dr Ahmad Makuwani says Tanzania is committed to increasing the availability of modern contraceptive methods at all levels of the health system across the country.