Maternal Infant Mortality: Confronting the Excesses of TBAs, Clerics in C’River
By Isaac Aqua
Maternal and infant mortality remains one of the most persistent and painful realities in Cross River and Nigeria as a whole, a silent emergency unfolding across rural communities and urban settlements alike. In a state where childbirth should symbolize hope, renewal, and continuity, it has instead become for many families a moment shadowed by fear and, too often, grief. Women still lose their lives to complications that modern medicine can easily manage, while newborns perish from conditions that are both preventable and treatable. These losses are not only tragic, they are unacceptable in an era of expanding medical knowledge and increasing global attention to maternal health.
What makes the situation even more troubling is that these deaths continue despite growing awareness of safer alternatives. Health facilities exist, trained professionals are available, and evidence based interventions are well established. Yet, a significant number of expectant mothers still choose to rely on traditional birth attendants, commonly referred to as TBAs. While TBAs have historically played a role in communities, especially in areas with limited access to healthcare, their limitations become dangerously apparent when complications arise during pregnancy or childbirth. They lack the capacity to manage prolonged labour, respond to emergencies, or perform life saving procedures such as cesarean sections.
The problem, however, extends beyond traditional practices. It is compounded by the influence of certain clerics who, despite lacking medical knowledge, intervene in deeply sensitive health matters. There are documented instances where religious leaders discourage women from undergoing medically necessary procedures, including cesarean sections, branding them as unbiblical or as a lack of faith. Such teachings are not only misguided but also perilous. In some heartbreaking cases, women who had been scheduled for life saving surgery abandoned the hospital following religious counsel, only to later die while attempting unsafe deliveries under the supervision of untrained attendants. These are deaths that could have been prevented.
This troubling intersection of faith, tradition, and misinformation reveals a broader systemic failure. It exposes the absence of effective regulation, inadequate public health education, and insufficient enforcement of existing healthcare standards. It also highlights the vulnerability of communities where access to quality healthcare remains limited and where cultural beliefs continue to shape critical health decisions.
It is important to acknowledge that TBAs cannot be entirely eliminated from the healthcare ecosystem. In many remote and underserved areas, they remain the only available option for expectant mothers. Their familiarity within communities and accessibility make them a practical, though imperfect, part of the system. However, their continued involvement must be properly regulated. A clear framework is needed to define their scope of practice, train and formally register them, monitor their activities, track the pregnant women under their care, establish clear referral protocols, and ensure they do not handle cases beyond their competence. Without such regulation, they will continue to operate in ways that endanger lives rather than protect them.
The responsibility for addressing this crisis lies squarely with the government. There is an urgent need for legislative action to regulate the activities of TBAs and to prevent unauthorized interference by non medical actors in pregnancy and childbirth. Existing laws governing healthcare practice should be strengthened or amended to include clear punitive measures for violations, including sanctions for individuals who discourage women from accessing hospital care or who promote unsafe delivery practices. Just as medical professionals are bound by ethical standards and subject to disciplinary action, so too must all actors involved in maternal care be held accountable.
Equally critical is the need to strengthen the healthcare system itself. Many of the decisions that lead women away from hospitals are driven by structural deficiencies such as poorly equipped facilities, lack of skilled personnel, and limited access in rural areas. If government is serious about reducing maternal and infant mortality, it must invest in upgrading primary healthcare centres, ensuring the availability of trained midwives, and improving emergency obstetric services. When healthcare facilities are accessible, affordable, and reliable, the temptation to seek unsafe alternatives diminishes significantly.
The support of traditional rulers also provides a vital pillar for success. Their influence within communities cannot be overstated. When traditional institutions speak with one voice in favour of safe delivery practices, community attitudes begin to shift. Their commitment to mobilizing citizens and promoting health seeking behaviour is a powerful tool in the fight against maternal deaths. However, their efforts must be complemented by consistent government action and public enlightenment campaigns.
Public awareness remains a critical component of this struggle. Many families continue to make dangerous choices simply because they lack accurate information. Continuous education is needed to dispel myths surrounding pregnancy and childbirth, to correct misconceptions about medical procedures such as cesarean sections, and to reinforce the importance of antenatal care and skilled birth attendance. Religious leaders, in particular, must be engaged as partners in this campaign, not adversaries. Faith and medicine are not mutually exclusive. In fact, they can and should work together to preserve life.
Ultimately, the path forward requires a holistic and coordinated response. Government must lead with policy and investment. Healthcare institutions must deliver quality and compassionate care. Traditional and religious leaders must embrace responsibility and accountability. Communities must be empowered with knowledge to make informed decisions. Only through such collective action can the tide of maternal and infant mortality be reversed.
Cross River stands at a critical crossroads. It can continue on a path where preventable deaths rob families of their mothers and children, or it can choose a future where childbirth is safe, dignified, and supported by modern healthcare systems. The choice is clear. The time for half measures is over. What is required now is bold action, sustained commitment, and an unwavering determination to protect the most vulnerable members of society.
The lives of mothers and infants are not expendable. They are the foundation of families, communities, and the future of the state. Protecting them is not just a medical responsibility. It is a moral imperative.
