Abstract

To estimate the maternal mortality ratio, identify the contribution of Type III delays and assess the status of emergency obstetric services in a Nigerian Teaching Hospital,service delivery records of all maternities over 2 years were analyzed. Emergency care facilities in the hospital were physically verified and 10 senior medical/midwifery staff were interviewed in-depth. The maternal mortality ratio was 2,356/100,000 deliveries. The leading causes of death were HIV/AIDS (20.2%), eclampsia (12.4%), puerperal sepsis (11.9%), unsafe abortion (9.5%), and postpartum hemorrhage (4.8%). Associated causes of death were Type III delay (61.9%), Type I delay (28.6%), Type II delay (0%) and 9.5% of the women had no delay. Type III delay was due largely to delayed referral. Other causes were lack of blood, oxygen and necessary equipment in the hospital. Although the hospital had relevant emergency obstetric care facilities, there is inadequate midwifery staff, blood, oxygen supplies and intensive care facilities. Tertiary health institutions engaged in maternity care in Nigeria should step up their emergency obstetric services and reach out to other care providers to build greater understanding of issues relating to safe motherhood.

Key words: Maternal mortality, Nigeria, emergency obstetrics care, safe motherhood, millennium development goals, Type III delay.