Pregnancy is not a death sentence: Time to halt the deaths

It is a measure of how deep our crisis has become that the most senior voices in the land are saying the same thing months apart with the same anguish. In April 2025, as the world marked World Health Day, Nigeria’s First Lady, Senator Oluremi Tinubu, looked at the nation’s record and called it what it is – unacceptable and preventable. Too many women and babies, she said, die from avoidable complications. Her plea was piercing: “No mother should have to risk her life to bring a child into the world, and no newborn should be denied a fair chance at survival.”

Seventeen months later, she was back on the same podium in the State House with the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, to launch the second batch of incentives under the Maternal and Neonatal Mortality Reduction Innovation Initiative, MAMII. The language had not changed because the reality had not changed enough. “Pregnancy is not a disease, and no woman should lose her life while giving birth,” Pate declared. The First Lady, while distributing 215,000 Mama kits and newborn sets, described it as a further step to ensure that every Nigerian child has a healthy start and that no woman loses her life while giving birth.

When the First Lady and the Minister agree, the nation must listen. For too long maternal death has been normalised as fate, spiritual attack or the will of God. It is none of those. It is a failure of systems.

The numbers strip away any excuse. Nigeria today records about 1,047 deaths for every 100,000 live births, one of the highest rates on earth, and accounts for nearly 29 per cent of all maternal deaths globally. A Nigerian woman faces a one-in-19 lifetime risk of dying from pregnancy-related causes. In real terms that is an estimated 75,000 mothers every year. Every day, 2,300 children under five and 145 women of childbearing age are lost. This newspaper recalls that ten years ago as a Senator, Oluremi Tinubu had already warned that Nigeria was the second largest contributor to maternal and under-five deaths. Today we are first. That progression from second to first is not a statistic. It is an indictment.

To be fair, this administration has not looked away. MAMII itself is an admission that the old approach failed. By concentrating on 172 local government areas in 33 states that account for roughly 55 per cent of maternal deaths though they represent only 20 per cent of LGAs, government is finally targeting the wound rather than spraying plaster everywhere. The deployment of over 19,000 skilled birth attendants, the raising of midwifery enrolment from 28,000 to over 110,000, the revitalisation of hundreds of primary health centres and thousands of free caesarean sections through NHIA-empanelled facilities are not trivial. The minister’s claim of a 17 per cent drop in maternal deaths and 12 per cent fall in newborn deaths in those high-burden areas, if sustained and verified, shows that progress is possible.

But progress in 172 LGAs is not victory for 774. A Mama kit does not stop postpartum haemorrhage on a bad road at 2 a.m. Food packs do not replace blood banks, functional operating theatres and midwives who are present, skilled and respected. Pate himself has admitted that despite ongoing efforts, Nigeria still ranks among the countries with the highest number of maternal and infant deaths globally. That honesty must lead to harder questions about money and accountability.

The care that would save most women – early antenatal booking, skilled birth attendance, emergency obstetric care – is cheap and largely preventable. Yet budget analyses show actual health expenditure falling 30 to 50 per cent below approved allocations, with counterpart funding from states inconsistent and local government funds for primary health care diverted. The Basic Health Care Provision Fund suffers delayed releases. An expert estimate recently put Nigeria’s funding gap for maternal health alone at N720 billion out of the N3.68 trillion needed to achieve a 30 per cent reduction. No amount of flag-offs can cover that.

This is why this newspaper believes the moment calls for more than lamentation, however sincere. The First Lady is right that prioritising maternal health is a moral obligation and a foundation for national development. The Minister is right that pregnancy is not a disease. The next step is to make those words enforceable in Birnin Kudu, in Ogbadibo, in Ede and in the creeks of Bayelsa.

That will mean making free emergency obstetric care, including caesarean sections and referral transport, a permanent entitlement, not a project tied to donor cycles. It will mean ring-fencing and publishing every kobo meant for primary health care with quarterly public audits. It will mean marrying the surge in midwifery training to rural retention, decent accommodation and security. And it will mean listening to rural women who know that distance, disrespect and cost kill as surely as eclampsia.

A nation that prays at every birth for safe delivery cannot accept that giving life has become one of the most dangerous things a Nigerian woman can do. If we can find resources to subsidise other sectors, we can find the will to fund mothers.