Preg­nant women with small feet turned away from clin­ics

Sunday News (Zimbabwe) - - Front Page - Robin Muchetu Se­nior Re­porter

PREG­NANT women with small feet, putting on size four shoes and be­low and are less than 1,5 me­tres tall have high risks of com­pli­ca­tions dur­ing labour and should not de­liver at a clinic, a health of­fi­cial has said.

This comes amid com­plaints from women that mu­nic­i­pal and pri­vate clin­ics were turn­ing them away from their fa­cil­i­ties cit­ing pos­si­ble com­pli­ca­tions dur­ing child­birth. Although some of the women said this was not prop­erly ex­plained to them, Sun­day News sought an­swers from ex­perts.

Con­sul­tant Ob­ste­tri­cian and Gy­nae­col­o­gist, founder and chief ex­ec­u­tive of­fi­cer for the Royal Women’s Clinic, a ma­ter­nity clinic in Bu­l­awayo Dr Sol­wayo Ng­wenya said there was a cor­re­la­tion be­tween these fac­tors.

“These women are not ly­ing at all. There is a cor­re­la­tion ac­tu­ally be­tween the height of the woman, her shoe size and pelvic area. If a woman is less that 1,5 me­tres tall and wears a shoe size from four go­ing down­wards there is a po­ten­tial com­pli­ca­tion risk when she is giv­ing birth. Such peo­ple have com­pli­ca­tions be­cause the birth canal will be much smaller than a woman who is taller and has a big­ger foot,” he ex­plained.

Dr Ng­wenya ex­plained that there was a ten­dency to have ob­structed labour when a woman was faced with these three dilem­mas.

Ob­structed labour is when the uterus is con­tract­ing nor­mally but the baby can­not exit be­cause they are phys­i­cally blocked, the head of the baby and the pelvic brim will be a mis­match and the baby can­not exit smoothly. Dr Ng­wenya hints that in such cases the baby then gets stressed and may not have ad­e­quate oxy­gen lead­ing to death. He said it was es­sen­tial that such women reg­is­ter to give birth at a hos­pi­tal rather than a clinic.

“Why we say these women reg­is­ter at a hos­pi­tal is that they need a place where an emer­gency Cae­sar­ian Sec­tion can be done by a spe­cial­ist in the case of a prob­lem. Our clin­ics do not have that ca­pac­ity so it is safe for women with this chal­lenge to just reg­is­ter at a place where the op­er­a­tion can be done,” he added.

Dr Ng­wenya said when clin­ics at­tempt to de­liver some of these cases there were chances of the baby get­ting stressed as it tries to worm it­self out of the small birth canal.

“When some of these women de­liver nat­u­rally at clin­ics there are some­times com­pli­ca­tions and in some cases, end up giv­ing birth to chil­dren with brain dam­age be­cause the de­liv­ery was not cor­rectly ex­e­cuted,” he added.

He said it is es­sen­tial for women to get vi­tal in­for­ma­tion when they visit clin­ics in or­der to pre­pare ad­e­quately for child­birth at the cor­rect health fa­cil­ity. He said doc­tors and mid­wives must ex­plain to preg­nant women who have this predica­ment that they should brace them­selves for Cae­sar­ian Sec­tions when there are com­pli­ca­tions in child birth.

Dr Ng­wenya said some of the chal­lenges that come with forc­ing a nor­mal de­liv­ery for women in this cat­e­gory in­clude in­fec­tions and com­monly ob­stet­ric fis­tula which is an ab­nor­mal open­ing be­tween the gen­i­tal tract and uri­nary or rec­tum tract.

The de­vel­op­ment of ob­stet­ric fis­tula is directly linked to the ma­jor causes of ma­ter­nal mor­tal­ity which is ob­structed labour. Women who de­velop ob­stet­ric fis­tula suf­fer from un­con­trolled pass­ing of urine which may lead to skin in­fec­tions, kid­ney prob­lems, so­cial iso­la­tion and death if left un­treated.

The Min­istry of Health and Child Care des­ig­nated Chin­hoyi Pro­vin­cial Hos­pi­tal as the cen­tre for the re­pairs of ob­stet­ric fis­tula in Zim­babwe as hun­dreds of women have been on a wait­ing list for the cor­rec­tive surgery.

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