Cesarean Section Gone South

“Our surgery is neat. It’s just temptation… and the devil.”

When 34-year-old mother of 3, Irene Emmanuel scheduled her cesarean section at Raylife Global Hospital, Kubwa, Abuja, she expected that it would be just like her first 2, smooth. However, her experience in the hands of Dr Okoh Anthony Ewere and his staff, as reported by The Scoop, was far from that.

Irene delivered her first and second child via c-section at General Hospital  Kubwa and was prepared to have her third the same way. However, as she approached her due date, she went to the hospital and was turned back because of the ongoing doctors’ strike. Irene informed the doctor at the primary health care centre where she received her antenatal, and he suggested a private doctor, whom he said would carry out the surgery “well”.

This private doctor, Okoh Anthony Ewere, led Irene and her husband to his hospital at         El-Shadai Close, Byazhin close, Kubwa – Abuja, where he carried out the c-section and delivered her baby boy. Things took a sharp turn when 2 days after the surgery, Irene noticed some abdominal swelling and general discomfort. She was also unable to pass gas or faeces, despite the effort of the medical team. After 6 days of no observable improvement,  Dr Okoh informed Irene that she would be taken in for a second surgery to bring out her intestines and “wash it”.

Dr Okoh performed the second surgery and on the following day, faeces began to come out uncontrollably from her vagina and the site of the initial surgery. The doctor then instructed Irene’s husband to purchase adult diapers to manage this situation – in the time she was there, Irene used nearly 3 packs of adult diapers.

The situation grew worse, as Irene began to lose strength, was unable to talk, and had difficulty breathing. Dr Okoh then referred her to Specialist hospital Gwagwalada, where she was immediately scheduled for emergency surgery the next day. At Gwagwalada, the surgeons explained to Irene that the first doctor mistakenly cut her intestines and while they could not attempt to fix it, as that would be too risky, they would bring it out, and she would need to use a colostomy bag for 6 months.

A colostomy is a surgical procedure that redirects the colon from its normal route down the anus to an opening in a person’s abdominal wall. This opening is called a stoma and the colon (where poop is formed), will now expel poop through the stoma, instead of the anus. The poop is collected in a colostomy bag.

The financial implications of the events following Irene’s C-section placed a huge burden on her family. After her surgery at Gwagwalada, her husband sought financial help from Dr Okoh but was met with hostility. They paid a visit to Raylife Global Hospital but Dr Okoh was not on seat, and when contacted, sent a series of texts saying

“I don’t blame you. You are taking my good heart for a ride…Don’t let anybody deceive you, the same thing would have happened anywhere,  even in Gwagwalada. “

The nurses at Raylife tried to calm Irene and her husband by reassuring them that their surgery at Raylife is usually “neat” and “perfect”. One of them said

“Leave it for God. Since I resumed here, we are not having any issue in surgery. Our work is neat. It’s just temptation, you understand?”

Multiple C-sections are associated with an increased risk of complications with each subsequent CS. Some of these complications include excessive blood loss, uterine rupture and abdominal adhesions. There is no definite upper limit for the number of cesarean deliveries a woman can have, and it is important to inform patients of the related risk.

A study carried out in North-Western Nigeria revealed a 13.3% complication rate of C-section, with the main complication being haemorrhage. Complications were more associated with emergency C-sections compared to elective surgery.

With evidence suggesting that Irene’s surgery was high-risk, the question is did she suffer unavoidable complications of high-risk surgery or was she the victim of a negligent doctor?

Document Women contacted the chief reporter of this story, Zainab Bala, and she confirmed that Irene was in good health before the C-section and it was not emergency surgery. She also revealed that Dr Okoh never explained to Irene the associated risks of her surgery, nor did he take written informed consent before the surgery. There is no record of Raylife Global Hospital on the Nigeria Health Facility Registry (HFR). However, it has an inactive corporate affairs registration. 

Maternal mortality in Nigeria is an urgent problem, as Nigeria alone accounts for about 20% of global maternal deaths. The lifetime risk of a Nigerian woman dying during pregnancy,  childbirth, postpartum, or post-abortion is 1 in 22, in contrast to the lifetime risk in developed countries estimated at 1 in 4900.

Conversations like this one, on maternity and its complications, are urgent because the lives of Nigerian women are at stake. Any indication of negligence on the part of health professionals, while delivering care to expecting mothers, should be reported, investigated, and resolved appropriately.

Dr Okoh has been given a court notice but did not show up. The hearing is scheduled to be held on 25th February 2022.

See full story here