She knew she had HIV yet she went to a birth attendant during labor. Now her baby is HIV-positive.
He was delivered less than 2 hours ago, a skinny pale-looking baby boy with low birth weight. When I first set my eyes on him, he was wrapped in old towel from previous births and was grunting with all his strength as he was rushed to the hospital.
The baby was delivered by a community birth attendant that we can call Mrs. Adewale (not real name) who is a young woman in her twenties and recently completed artisanship training at a mission house known for delivering babies. Adewale is now operating independently in her neighborhood with numerous success stories to her name.
According to her, the baby was delivered, cleaned, dressed and handed over to the relatives in order to help the mother that had retained placenta. All focus was on saving the mother who spent about one hour to successfully deliver the placenta after losing substantial quantity of blood.
“On getting back to the baby, I noticed he was grunting and I didn’t want to lose him like I lost one yesterday. We had to quickly rush to the nearest hospital for help,” Adewale said.
At the health facility, the baby’s breathing was quickly aided by suctioning the blocked airway with a machine, and we immediately commenced oxygen therapy. After running all the necessary investigations, it was discovered that the baby had very low blood glucose and more importantly, he is HIV positive.
“How did it happen? We had no idea as the mother was left at home,” she continued.
According to the doctor in charge, Dr. Adesina, 70% of deliveries occur at the community level and are supervised by the traditional birth attendants and at mission homes.
“We tracked this from the number of children that present for treatments and immunization because we have space for place of birth in our records. We realized that majority of children we see were delivered outside the hospital,” he said.
After several denials, the mother admitted she knew about her HIV status. This is her story.
She initially registered at the at the state government hospital in Ibadan, southwest Nigeria. She was asked to undergo a series of tests but could only get the HIV screening result since the test was free.
Since she became aware of her HIV status, she blamed her lack of funds as the reason for her inability to return to the HIV clinic, choosing instead to be under the care a community birth attendant who did know about her HIV status nor had to conduct any tests.
It was the baby that exposed her kept secret.
“I thought they would not let me go,” she said.
This is one of the numerous myths surrounding the management of HIV/AIDS in Nigeria. Some people still believe they will be isolated and discriminated; some gave up on life because, to them, a positive HIV test is a death sentence.
For those that are already pregnant, such fear would prevent them from visiting hospitals where they would be cared for and could access special care to prevent the transmission of HIV from pregnant mother to the baby. This is a major reason why thousands of HIV-positive newborns are delivered annually in Nigeria.
According to the recently released UNAID 2018 report, 1.8 million children are living with HIV globally with 180,000 newly infected in 2017. In Nigeria, 220,000 children are living with HIV with 36,000 new infections in 2017.
The African Development and Empowerment Foundation is training community birth attendants with the goal of reducing maternal mortality rate in Nigeria.
The foundation affirmed that most of the children were delivered in communities where there are no top quality antenatal care and prevention of mother-to-child transmission of HIV/AIDS.