Abdominal massage: another cause of maternal mortality

BACKGROUND: Abdominal massage is an age long practice among obstetric and non obstetric patients in different parts of the riverine areas of Southern Nigeria. AIM: To highlight the consequences associated with this practice in pregnancy and labour even among literate clients. METHODS: Two hundred and eighty four pregnant women who presented as obstetric emergencies in pregnancy and labour at the University of Port Harcourt Teaching Hospital from 1st May 1988 to 31st July 1998 were studied. RESULTS: Forty two (14.79%) of the 284 patients had abdominal massage. Maternal mortality rate was 4.76% while the perinatal mortality rate was 14.29%. Twenty four of the patients were literate though 15 of them only had primary education. Most of the patients were unbooked (76.19%). The complication of pregnancy noted were cephalo pelvic disproportion /obstructed labour (28. 57%) and abruption placenta (23.80%); placenta previa (9.52%); retained placenta (4.76%) abortion / preterm labour (19.04%); genital injuries and tears (7.14%); perinatal death (14.28%); uterine rupture (9.52%); maternal mortality (4.76%). CONCLUSION: Abdominal massage is a silent killer, which has added to matemal and perinatal mortality and morbidity in this region. Ignorance, illiteracy and poverty have sustained this practice, while underdevelopment, inaccessibility and ill-equipped medical facilities have kept this traditional practice flourishing even amongst the educated group. The time to stop this form of avoidable losses is now. This can be achieved through public health approach, mass literacy, even distribution of affordable healthcare services, improved social services and transportation, robust economy and a grass root involvement of rural programmes aimed at eradicating harmful traditional practice.