Pregnancy, childbirth and children’s mental health

Mrs Bolanle Tunde: My Dear, will you be going with me for antenatal clinic today?

Mr Tunde: I am so sorry. Darling, I can’t make it as I have an emergency to deal with in the office. Can I plead with your Mummy to go with you instead?

Mrs Bolanle Tunde: Ok, no worries. I will go with Mummy then.

Two hours later, at the clinic.

Doctor: Mrs Bolanle Tunde, your pregnancy is almost term now and the last ultrasound scan you did last week has shown that the baby is still lying horizontally in your womb, instead of coming down with the head. So, the way forward is that once you complete nine months (36 weeks), we will not wait for you to go into labour, as the chances of the baby coming out via a normal delivery is very slim. We will arrange to perform a caesarean section (C&S) so we can safely bring out the baby without any complications.

Bolanle’s Mummy: Erh, Doctor, did you just say operation for her to give birth?

Doctor: Yes, ma, the reason is because…….

Bolanle’s Mummy: Cuts in rudely: “Doctor, there is no need. In my family, we always give birth normally without operation. I gave birth to her normally and by the special grace of God, she will also give birth normally. My daughter, let’s go.” Gets up and drags Mrs Bolanle Tunde out of the consulting room.

Once outside, she calms down and faces her daughter. “Bolanle, the devil is a liar. I will call my priest now and he will pray for you. There is nothing beyond the power of God. Prayer can overcome any problem. Just relax and trust me. You must give birth naturally”.

Five weeks later, Bolanle falls into labour and promptly head to church for prayers to allow her deliver naturally. After 24 hours of labour pains, and when she was completely exhausted and on the verge of collapse, the pastor and her mother eventually decided to take her to the hospital. The doctors assisted Bolanle- as the baby’s shoulder and one arm were already out, and they managed to eventually deliver her of a baby boy after another two hours. The baby is alive but, very weak and had to be taken to the special care baby unit (SCBU). Everybody is relieved at the eventual good outcome. The boy is named Oriyomi. The new grandmother is proud that her daughter eventually delivered ‘naturally’.

Fast forward to 10 years later. Mrs Bolanle Tunde presents at the clinic with Oriyomi on account of poor academic performance and not being ‘smart’. He is still in Primary 2, as he struggles to recognise the alphabets correctly. He also has difficulty with basic sums and subtractions. The mother complains that he cannot be sent on an errand as he does not understand the value of money. The doctor takes a detailed history and it then becomes clear that Oriyomi did not start walking until the age of three years; and he was almost eight years before he could communicate and speak properly. Compared to his other siblings and other children of his age, he is also very slow. The parents are worried that something might be wrong with him.

The doctor sent them for an assessment of his Intelligence Quotient (IQ). The results indicated that Oriyomi has a low IQ which has accounted for his very poor academic performance. Thus, in the context of the history and the results, the doctor then counsels Mrs Bolanle Tunde, that her son, Oriyomi, may have suffered some brain damage as a result of the prolonged labour during his delivery. He further explains that this may have explained the slow development (walking at three years and speaking at eight years) as well as his not being as smart as other children of his age.

Mrs Bolanle Tunde: Hmm, Doctor. So, what is the solution? Will you prescribe some drugs for him to take so that everything can normalise?

Doctor: I am so sorry Ma, unfortunately, there is no medication for this problem. The brain has no replacement, and once damaged in this manner, drugs can’t help. But what we can do is to try and identify his strengths and see how we can build upon them. We will need other people to work with him, as well as special teachers too.

Conclusion: Pregnancy, child birth and early life (first two years in particular) are crucial time for a child’s brain development. It is therefore very important to have regular antenatal care; ensure that delivery is in hospital; and it is supervised by competent medical personnel. Performing a C&S when necessary should not be stigmatised, to avoid these types of complications. In any case, good medical care can always be supported by prayers.