'I know say I dey between life and death each time I enta labour room for Nigeria'
At di age of 24, Nafisa Salahu dey in danger of becoming just anoda number for Nigeria, wia woman dey die wen dem give birth evri seven minutes, on average.
Going into labour during doctors strike mean say, despite say you dey hospital, no expert go fit help on hand once complication start.
Her baby head hook and dem just tell am make she just lie down during labour, wey last for three days.
Eventually dem recommend Caesarean and dem prepare one doctor make im carry am out.
"I thank God becos I almost die. I no get any strength again, I no get anytin," Ms Salahu tell di BBC from Kano state for di north of di kontri.
She survive, but tragically her baby die.
Eleven years on, she don go back to hospital to give birth several times and take e dey depressing. "I know [each time] I dey between life and death but I no dey fear again," she tok.
Ms Salahu experience na normal tin.
Nigeria na di world most dangerous nation to give birth.
According to di most recent UN estimates for di kontri, wey dem compile from 2023 figures, one in 100 women dey die in labour or in di following days.
Dis put am at di top league table of kontris wey dey di data.
In 2023, Nigeria account for well ova one quarter - 29% - of all maternal deaths worldwide.
Dat estimate total of 75,000 women wey dey die in childbirth in one year, wey make am one death every seven minutes.
Warning: Dis article contain foto of new born pikin .
Di frustration for many be say large number of di deaths – nafrom things like bleeding afta childbirth (wey pipo sabi as postpartum haemorrhage) – e dey preventable.
Chinenye Nweze bleed to death at age 36 for one hospital in di south-eastern town of Onitsha five years ago.
"Di doctors need blood," her broda Henry Edeh tok. "Di blood wey dem get no dey enof and dem dey run around. Losing my sister and my friend na sometin wey no go wish on my enemy. Di pain dey unbearable."
Among di oda common causes of maternal deaths na obstructed labour, high blood pressure and unsafe abortions.
Nigeria "very high" maternal mortality rate na di result of a combined number of factors, according to Martin Dohlsten from di Nigeria office of di United Nations children organisation, Unicef.
Among dem, e tok say, na poor health infrastructure, shortage of medics, costly treatment wey many no fit afford, cultural practices wey fit lead to some distrusting medical professionals and insecurity.
"No woman deserve to die while she dey give birth to her child," Mabel Onwuemena, national co-ordinator of di Women of Purpose Development Foundation.
She explain say some women, especially for rural areas, believe "say visiting hospitals na total waste of time" and choose "traditional remedies instead of seeking medical help, and e fit delay life-saving care".
For some, dem no fit reach hospital or clinic on time becos of lack of transport, but Ms Onwuemena believe say even if dem manage to, dia problems no go finish.
"Many healthcare facilities lack di basic equipment, supplies and trained personnel, e make am difficult to provide quality service."
Nigeria federal goment currently spend only 5% of dia budget on health – well short of di15% target wey di kontri commit to in 2001 African Union treaty.
For 2021, na 121,000 midwives dey for population of 218 million and less dan half of all births na im skilled health worker dey involve. Di kontri need estimate of 700,000 more nurses and midwives to meet di World Health Organization recommended ratio.
Also dem dey experience lack of doctors.
Di shortage of staff and facilities put some off seeking professional help.
"I honestly no trust hospitals much, we get many stories of negligence, especially in public hospitals," Jamila Ishaq tok.
"For example, wen I born my fourth child, complications dey during labour. Di local birth attendant advise us make we go to di hospital, but wen we get dia, no healthcare worker dey available to help me. I go back home, and na dia I eventually give birth," she explain.
Di 28-year-old from Kano state dey expect her fifth pikin.
She add say she go consider going to private clinic but di cost dey high.
Chinwendu Obiejesi, wey dey expect her third pikin, fit pay for private health care for hospital and " she no go consider to give birth anywia else".
She tok say among her friends and family, maternal deaths dey rare, whereas she don dey hear about dem quite frequently.
She dey live in wealthy suburb of Abuja, wia hospitals dey easier to reach, good roads dey, and emergency services dey work. More women in di city also dey educated and know di importance of going to di hospital.
"I always attend antenatal care… E allow me to speak wit doctors regularly, do important tests and scans, and keep track of both my health and di baby," Ms Obiejesi tell di BBC.
"For instance, during my second pregnancy, di doctors dey expect say I fit bleed heavily, so dem prepare extra blood in case we need transfusion. Thankfully, I no need am, and evritin go well."
However, one of her family friend no dey lucky.
During her second labour, "di birth attendant no fit deliver di baby and try to force am out. Di baby die. By di time dem rush am to di hospital, e don late. She still undergo surgery to deliver di baby's body. e dey heart-breaking."
Dr Nana Sandah-Abubakar, director of community health services at di kontri National Primary Health Care Development Agency (NPHCDA), acknowledge say di situation bad, but e tok say new plan dey in place to address some of di issues.
Last November, di Nigerian goment launch di pilot phase of di Maternal Mortality Reduction Innovation Initiative (Mamii). Eventually dis go target 172 local goment areas across 33 states, wey account for more dan half of all childbirth-related deaths in di kontri.
"We identify each pregnant woman, know wia she dey live, and support her through pregnancy, childbirth and beyond," Dr Sandah-Abubakar tok.
So far, 400,000 pregnant women in six states wey don find house-to-house survey, "wit details of weda dem dey attend ante-natal [classes] or not".
"Di plan na to start to link dem to services to ensure say dem get di care [dem need] and dem go deliver safely."
Mamii aim to work wit local transport networks to try and get more women to clinics and also encourage pipo make dem sign up to low-cost public health insurance.
E dey too early to say weda this get any impact, but di authorities hope say di kontri fit eventually follow di trend of di rest of di world.
Globally, maternal deaths don drop by 40% since 2000, thank to di expanded access to healthcare. Di numbers also don improve in Nigeria ova di same period - but only by 13%.
Despite Mamii, and oda programmes, being welcome initiatives, some experts believe say dem need to do more – including greater investment.
"Dia success depend on sustained funding, effective implementation and continuous monitoring to ensure say di intended outcomes dey achievable," Unicef Oga Dohlsten tok.
In di meantime, di loss of each mother in Nigeria - 200 every day - go continue to be tragedy for di families wey dey involved.
For Oga Edeh, di grief ova di loss of im sister still dey fresh.
"She step up to become our anchor and backbone becos we lost our parents wen we dey grow up," e tok.
"In my lone time, wen she cross my mind. I dey cry bitterly."
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