How many children should a woman have?

RACHEL Hamani has an in-law problem. Her husband’s parents want more grandbabies, but she doesn’t want any more children right now. She has already given birth four times; one of the babies died so now, she has three, ages seven, five and 16 months. She’s 27 years old.

But Hamani is unusual in that three babies are enough for her. Nigeria’s fertility rate is put at 5.3 per woman. In fact, in Nigeria, a survey indicated that 49.3 per cent of the couples reported husbands desired more children and 43.9 per cent claimed wives desired more children.

The ideal number of children women and men desire differs, for men it is 7, while women want 6. The fertility desire of husbands in a polygamous marriage was about four children compared to the fertility desire of one child of husbands in a monogamous marriage. The survey, in the 2020 journal, Reproductive Health is based on the Nigeria Demographic and Health Survey (NDHS) of 2018.

What is the ideal number of children for a family to have? How many children can women safely have and should have? But increasingly, some women responding to this question are saying, “2” or “3,”or by simply saying, “As many as you want.”

Howbeit, the growing trend is two children among the elites who are regularly questioned about their procreation plans.  Two children still seem to the ideal number for “happiness”, because being a mother is not easy work, medical disabilities and financial stress. They want to be able to give each child enough one-on-one time.

There is a safe limit on the number of children a woman can have. The miraculous process of childbirth is as natural but it can be one of the toughest and most challenging phases in a woman’s life that even if successful can leave behind marks.

Girls generally start menstruating at the age of 13 and this continues till she becomes 51, which gives her 38 possible years of reproductive action. However, counting that every delivery requires nine months, a limit of about 40 pregnancies actually seems probable. But these are mathematically possible pregnancies, not safe ones.

For one, multiple pregnancies can be life-threatening and with every pregnancy, the mother’s risk of dying increases. The risks of her womb rupturing and bladder injuries are high and so is the chance of her having an abnormal placental and ectopic pregnancy.

Not just this, Dr Steven Lemadoro, a consultant obstetrician and gynaecologist, stated that it is difficult to prescribe a particular number of children that a woman should have because the moment a woman is having her fifth pregnancy and beyond, certain complications become more common.

He declared that complications such as excess bleeding becomes an issue, likewise, the ability of the womb to contract after delivery is impaired as it were.

Lemadoro stated that the risk of complications happening tend to increase as the woman gets older and several diseases begin to show up that is associated with age, having too many children and too frequently such as anaemia, hypertension and diabetes.

Besides, Mrs Stella Akinso, a nurse/midwife and Oyo team lead, Sustaining Programmes and Partnerships in Reproductive Health Transformation (SUPPoRT) initiative, said it is not possible to predict the outcome of every pregnancy.

According to her, “a woman may have a baby and die. She may die in her second pregnancy or even after having her sixth baby. We cannot tell a woman that is going to die or the kind of complications that may arise.

“We have seen even doctors having her first pregnancy dying; we have seen doctors who also died in the process of giving birth. We cannot predict the outcome of a pregnancy, but we can say that some measures can be put in place to ensure that a pregnancy is safe and that the process of delivery is also safe.”

Mrs Akinso declared that the possibility of complications occurring with more and frequent pregnancies is the reason women need to ensure that they register for and attend antenatal care as well as have a skilled birth attendant.

During antenatal visits, potential risks in such pregnant women can be prevented or managed in a way that will not result in her or her baby dying.  Also, complications during childbirth are better managed by a skilled birth attendant.

According to her, the four major causes of death in pregnancy and childbirth are bleeding during or after childbirth, infection, high blood pressure during pregnancy and obstructed labour. There are different tests to identify a pregnant woman that has the potential for these major killers of women during pregnancy and childbirth.

Not just this, researchers at the Columbia University say that when a woman has given birth more than five times, there is the greatest chance of severe bleeding. This is a condition where due to multiple births, the woman’s womb has become inelastic and its muscles weak and they are unable to contract after the placenta is cut, leading to excessive bleeding.

Another study at the University of Texas Southwestern Medical Centre has shown that just after the third childbirth, a woman’s arteries thicken and the blood pumping increases by more than 50 per cent, doubling the risk of a heart attack. So a safe limit on the number of children is at three and traversing beyond this mark can mean serious complications for the mother and the family.

The WHO reports that pregnancy and childbirth are among the biggest causes of death for women in developing countries like Nigeria. It’s not just the massive strain on the mother but also on the national resources and the state’s ability to provide a cause of concern.

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