The Stakes Are High
Nigeria has one of the highest maternal mortality rates in the world. For every 100,000 live births, more than 500 Nigerian mothers die — a figure that is more than 100 times higher than the rate in most European countries. The vast majority of these deaths are preventable. They occur because of conditions that, when identified early, are entirely manageable: high blood pressure in pregnancy, severe bleeding, infection, obstructed labour. The difference between a complication that kills and a complication that is treated successfully is almost always the same thing: time. How quickly the warning signs were recognised. How quickly the woman reached appropriate care. This is why every pregnant woman — and every family member of a pregnant woman — needs to know what danger looks like.
Serious Warning Signs During Pregnancy
Severe headache that is not relieved by rest or paracetamol — particularly in the second half of pregnancy
Blurred vision, seeing flashing lights, or sudden visual changes
Swelling of the face, hands, or feet that has come on suddenly or is severe
Pain in the upper right side of the abdomen, below the ribs
Any vaginal bleeding at any stage of pregnancy — even if it seems small
Fluid leaking from the vagina (possible waters breaking)
Reduced or absent baby movements — if your baby has not moved as much as usual in a day, do not wait
Persistent high fever with chills
Difficulty breathing, chest pain, or severe weakness
These signs mean go to a hospital NOW — not tomorrow, not in the morning, now
Pre-eclampsia — The Condition Every Pregnant Nigerian Woman Must Know
Pre-eclampsia is a pregnancy complication characterised by high blood pressure and protein in the urine, developing after 20 weeks of pregnancy. It is one of the leading causes of maternal death in Nigeria. It can progress rapidly to eclampsia — seizures during pregnancy — which is a life-threatening emergency. The cruel reality is that many women with pre-eclampsia feel relatively well until the situation becomes dangerous. This is why blood pressure monitoring at every antenatal visit is not a formality — it is a lifesaving screening measure. Women who have had pre-eclampsia in a previous pregnancy, who are carrying twins, who are very young or over 35, who are obese, or who have diabetes or kidney disease are at higher risk. If you are pregnant and have not attended any antenatal visits, please start. Even one or two visits can identify a problem that would otherwise not be found until it becomes an emergency.
What Every Pregnant Woman Should Do
- Attend antenatal care visits — the WHO recommends at least eight visits during a normal pregnancy. In Nigeria, even four is better than none
- Go to your first antenatal visit in the first three months of pregnancy — do not wait until you are six or seven months along
- Deliver in a facility with a skilled birth attendant — a trained midwife, nurse, or doctor. Home delivery with an untrained attendant remains a major cause of maternal and newborn death
- Attend your postnatal check at six weeks after delivery — this is when many serious postnatal conditions are identified
- Know your blood group and HIV status before delivery
- Eat a varied diet with enough protein, iron-rich foods (beans, red meat, leafy greens), and folate especially in the first trimester
Postpartum Depression — When the Joy Does Not Come
Nigerian culture expects new mothers to be filled with joy. The pressure to appear happy, grateful, and capable — even when you feel overwhelmed, frightened, sad, or numb — is enormous. Postpartum depression is a real, recognised, and treatable medical condition that affects approximately 1 in 7 new mothers. It is caused largely by the sharp hormonal changes that follow delivery, compounded by sleep deprivation, physical recovery, and the enormous psychological adjustment of new parenthood. It is distinct from the ‘baby blues’ — the mild tearfulness and emotional sensitivity that is normal in the first week after birth. Postpartum depression is more intense, begins or persists beyond the first two weeks, and does not lift on its own. A mother may feel persistently sad, unable to bond with her baby, overwhelmed by guilt, severely anxious, or in some cases may have thoughts of harming herself or the baby. These are not signs of a bad mother — they are symptoms of an illness that needs treatment.
Signs of Postpartum Depression
- Persistent sadness or emptiness that does not go away in the weeks after delivery
- Feeling no connection or warmth towards the baby, despite trying
- Intense anxiety, a constant feeling that something terrible is about to happen
- Not sleeping even when the baby is asleep, or sleeping excessively and being unable to function
- Loss of appetite or eating compulsively
- Feeling like a failure as a mother, or that the baby would be better off without you
- Withdrawing from your husband, family, or friends
- Thoughts of harming yourself — if this is happening, please speak to someone today, it is a medical emergency
How Doc on Wheels Can Help
If you are pregnant and have noticed any of the warning signs above, you can speak to a doctor through Doc on Wheels immediately — day or night. Our doctors can assess the urgency of your symptoms and direct you to appropriate care. For mothers struggling with mood, bonding, or emotional health after delivery, we offer private, non-judgmental consultations from home. Blood tests relevant to pregnancy and postpartum health can be arranged at your doorstep. And for women in areas where getting to an antenatal clinic is difficult, we can support you in accessing care and understanding what questions to ask when you get there.