CHAPTER THREE

TRADITIONAL CHILD SERVICES AND ATTENDANCE IN IJEBU-LAND

Traditional child services and attendance in yorubaland generally is considered

as

one of the most important activities. For proper understanding of traditional

child services and attendance, the process by which this was carried out would
further be explained. These traditional child services were attended by
traditional midwives (iya Abiye’s) who took care of pregnant women, during
conception and after delivery.

TRADITIONAL BIRTH ATTENDANT (TRADITIONAL MIDWIFE)

In yorubaland generally, they are called the iya Abiye’s; they are described
as women who take care of pregnant women before birth and after, they also
assist in house hold chores. These women offer a comparatively reliable means
of protecting and improving the health of mothers and babies in most areas of
developing countries. Traditional midwives indicate measures that should be
taken to enhance the prospect of safe delivery and to protect the general health
of the family. They give advice on health and nutrition as part of antenatal
services in the home or in the clinic. Postnatal care for the mother and babies is
also taught. These women do not only care about women are pregnant, they help
people both men and women who have issues with their reproductive organs,
they depend mostly on traditional herbs to heal these people. They often learn
their trade through apprenticeship or self –taught.

In Ijebuland, the Iya –Abiye in the modern day varied in compositions

because those interviewed comprised of aged and in the middle age. This does
not imply that a young woman cannot be Iya- Abiye although age and experience
bring to bear on this indigenous setting.

The Iya-Abiye’s in Ijebuland interviewed had been in practice from 15 to

27 years. One of them even claimed to have been in practice while doing her
business or trading before she took formal training as a traditional midwife. With
these one could surmised that these traditional midwives have vast in the
experience of child delivery, if for nothing else for the long years that they had
been in practice. The Iya-Abiye’s interviewed opined that they do not accept the
underage and the overage as clients in their clinics. This they explained would
save them from having problems associated with that age group. For instance,
the underage expectant mothers are not accepted because of problems of
immature physical feature, which is likely to hinder easy labour.

PREGNANCY

In all areas studied, wives were expected to bear children as soon as

possible after marriage. It will be understood that conception can only take place
if a sperm (male cell) meets an egg cell and joins itself to it. Conception does not
take place if the sperm enters the vagina, womb and tubes at a time where there
is no egg cell in the tube. It does not take place if the father’s body is not making
live sperm cells. If conception does not occur after six month or after marriage,
the right course is to seek a qualified doctor or a trained midwife.20

The fact that pregnancy has a biological basis, and that sexual relations
create the condition for pregnancy to take place are fully realized in the Yoruba
society. It is believed that individuality entering the womb at conception is that
one who has lived on earth before, usually an ancestor, friend seeking
reincarnation21.A pregnant woman is therefore looked upon with respect in
ijebu land as well as other Yoruba society. Pregnancy to her marks a favour from
her creator and constantly prays against barrenness or miscarriage.

Childlessness is regarded as a great calamity in Yoruba society. Parents

are generally worried when their daughters do not become pregnant within the
fist six month or more of marriage. In ijebu land a pregnant woman is therefore
very happy because her condition is proof of her virility. Therefore childlessness
is not an odious condition in the cases of women with a history of first
pregnancies as it is with women who have never become pregnant.

In Ijebuland, pregnant women are well being taken care of by

traditional midwives or the husband’s mother, but mostly traditional midwives
who are called upon or employed to take care of the pregnant woman or the
pregnant woman is taken to the woman clinic. She is pampered and given a lot of
care both during pregnancy and after delivery. These traditional birth midwives
or attendants are sometimes untrained; they are persons who are not trained to
manage complications.23 A traditional attendant called (Iya Abiye) in Yoruba
land are usually employed to care for a pregnant woman, to look after her during
pregnancy and after birth. During the period the woman is pregnant, the Iya
Abiye, that is, the “traditional midwife” makes sure that the pregnant woman is
properly taken care of such as, in the morning (everyday before birth), the
pregnant woman’s stomach is rubbed with palm oil to avoid any complication
during birth and to ensure safe and easy delivery, and if the pregnant woman
feels any pain on her back, the Iya Abiye makes a concoction ( aseje) or Agbo (
traditional herb) and gives it to the woman to drink to stop the pain and this
herb is also given to her to wash her private part so that she will give birth safely
or she is given a bottle to put un her mouth to stop the pain.24 More
importantly, the medicine must be taken when the pregnancy is

or within the three, five, seven and nine months. The different types of herbs,
concoction and Soap are used to prevent miscarriage. The woman in turn
adheres to the use of the medication strictly.

Part of the traditional midwife job in the house is to ensure that the
woman does not lift heavy loads, or do any which involves much stretching
upwards either during pregnancy or after birth, the traditional midwife also
ensures that the woman takes a walk at least every six hours, this is also done so
that the pregnant woman will not have any complication or difficulty in giving
birth to her child and to make her muscles strong to make labor less painful.25

Proper diet was also prepared for the pregnant woman by the midwives;
the pregnant was allowed to eat any kind of food, except for salt26. The role of
the traditional midwife was to ensure that the woman had plenty of rest, if
possible sleep at least eight hours every night and try to rest for an hour during
the day.27 they also ensured that the pregnant woman’s cloths, hands, furniture,
walls, floor and room was always kept very clean for ventilation and sunshine.
She also makes time to get necessary materials for delivery such as mat for the
delivering, a big pot for making hot water and Agbo, a
clean towel, a basin for the placenta.28. All these were done before delivery by
the midwife.

ANTE-NATAL CARE

In Ijebuland, ante-natal care is very important for pregnant women, this

ante-natal care is usually handled by the traditional midwife (iya Abiye) in the
home or in the clinic. This traditional midwife has been trained to understand
what happens during pregnancy and child-birth, and how to care for mother and
the baby during that period. She has also be taught to recognize the signs that
something is not quite right either mother or the baby. She knows also what to
recommend whenever something goes wrong to the pregnant woman, so she
knows how to treat the condition herself with traditional herbs or concoctions
(aseje).

These traditional midwives during the ante-natal care services advise

these pregnant women to come to the clinic or the traditional midwife visits the
pregnant woman on a regular basis. Whenever she visits the woman, she will be
asked some question about her general health for instance; her age, her present
pregnancy, how she is feeling, and then she could be examined all over. In the
traditional way, to feel the baby, the traditional midwife uses her hand to feel the
baby to know if the baby is positioned well in the woman’s belly, if the baby is
not placed well in the belly, they make use of traditional herbs or a black soap
called (ose irapada) to turn the baby around with their hands.

As time goes on, pregnant women are told to return, usually they are told
to come every two weeks, and during the last month, every week. The
traditional midwife will then be able to check her general condition, and help her
over any of the common complaints such as loss of blood from the vigina before
birth which may lead to miscarriage; the traditional midwife will make a
concoction such as sejebi, or aruda to stop the blood from coming out . other
complaints such as nausea and vomiting, pains in the stomach, swelling in the
feet, pains in the legs and discharge from the vigina, severe headache, because
they depend on traditional herbs, they prepare traditional drink for the pregnant
woman to drink to heal her pain.

TRADITIONAL BELIEFS / TABOO AND CULTURAL PRACTICES WITH

PREGNANCY AND AFTER BIRTH

In the traditions and customs of the Yoruba, there are cultural practices known
as Oro-ile. The pregnant woman observes certain regulations and taboos in
order that all may go well with her and her baby. Some of the oro-ile prominent
among the pregnant Yoruba is not eating salted Meal, using of cold instead of
warm water for body massage and not using any edible oil for cooking. This is
known as j’ate etc. Among the Yoruba, the after-birth placenta known as ikeji-
omo literally second of the child is very important. Great care is taken on how to
dispose off the Ikeji-omo when a baby is born. Traditionally, the father of the
baby is expected to dig the ground where no one should know and bury it after
birth. The belief of the Yoruba is that, evil people could harm the child or change
its destiny pa kadara da through the ikeji -omo. The Iya-Agbebi opines that the
placenta is given to the father to do whatever pleases him with it.

When a woman is pregnant in ijebu land, it is commonly believed that,

she will not be allowed to eat salt or kolanut because her children may die
prematurely; also she is not allowed to sleep on her back to avoid damaging the
baby’s eyes. She is not to take any photograph of any kind to avoid death, she is
not to eat plantain or oranges, this to avoid any difficulties during child birth. She
is not also allowed to walk about the hot sun or at night, to avoid having the baby
in her womb being exchanged by evil spirit and she wants to go [1]out in the
afternoon, she is meant to put safety pin or stone on her cloth to avoid any
attraction of evil spirit. A pregnant woman’s legs while sitting must not be
crossed by anybody, else the baby will not look exactly like the person who
crossed her legs. It is also forbidden to beat a pregnant woman for any reason to
avoid the marks of the cane showing on the baby at birth. It is forbidden for her
to eat snails to avoid giving birth to a baby who spits all the time[2]. And she
must not sleep on her belly or the baby may die, and lastly she is not allowed to
make sexual intercourse with her husband, so that the baby will come out safely,
and it is not right for her to sit at a door post to avoid difficulties.

After birth, she is not allowed to eat salt, oil, and pepper for the first
seven days (7days), this is to avoid any complications and pain for the mother. In
ijebu land and other Yoruba tribes, it is a taboo for a mother to go out until after
seven to nine days (7-9days), and nobody is allowed to come and see her except
for her husband who will bring the necessary materials needed for the baby and
the mother. Also the mother is not allowed to put her hands inside water; they
believe her body is still fresh, so she is not allowed to do anything in the house,
which is usually done by the midwife. Furthermore, the baby’s cloth is not
always dried outside the sun to avoid the baby’s glory to be exchanged.

Taboo in yorubaland is therefore given with the aim of safeguarding the

death of a woman and to ensure a stable and balanced emotional composition in
the woman’s psychological life. Taboo therefore is to ensure safety of the
pregnant woman and the baby.
 BIRTH

Birth generally in yorubaland is seen as a thing of joy, which is usually

celebrated by the family of the pregnant woman or villagers, friends, and
relatives are usually invited at the arrival of a new born baby. The birth of the
child brought great joy to the woman’s husband and the family. The Yoruba’s
belief that a child coming into the world brings happiness, health and prosperity
into the family

In Ijebuland, traditional child birth usually took place in the woman’s

house; this delivery was usually done by traditional midwives, who took their
time in helping in delivery the child. Prior to this process, preparations were
already made, necessary materials were already put in place to avoid any
inconveniences or complications during birth. During this process, pregnant
women were usually encouraged by the midwives telling them to keep calm and
cheerful. During birth, whenever the woman was feeling any pain on her back, a
black soap (ose dudu) was prepared for her, or Agbo was prepared for her to
drink, or she will be told to take her bath before birth from her head to her leg
with a soap called awebi soap

It is very important to give a proper understanding and what’s happens to

a pregnant woman during different stages of labor.

The first stage involves when the woman feels back ache and the
beginning of contraction, if the contractions are too much for the woman, she is
placed on the mat on the floor to lie on her side and then rubbed with palm oil on
her back and her stomach during the contraction.

[3] At the second stage, usually the membranes rupture and the water
comes out at the end of the first stage but sometimes this happens earlier. Once
the second stage has begun, the pregnant is not allowed to move or walk any
more. Then she knees down, because in Ijebuland, they believe when a woman
lies down, she could give birth to a still born baby or may cause miscarriage.
While she is on her knees, the midwife (Iya Agbebi) helps her in the delivery,
during this process, she gives the woman some concoction to drink, bathe her
face with cool water from time to time, usually the midwife is also assisted by
traditional medicine man (herbalist) who is mostly needed if there is any
complication during labor, like if the woman is bleeding, the herbalist could
make some incantation and place his hand on the woman’s belly and the
bleeding stops immediately.

In the process of delivery, the midwife helps to massage the pregnant

woman’s belly downwards with black soap to help the woman to deliver her
baby, if the baby does not come out the way it should be, maybe the head is not
facing the virginal, the midwife will mix a traditional herb called ewe irapada (
means leaf for turn around) to make the baby turn the way its meant to come
out, when they see that the baby’s head is born, they take a clean cloth with
warm water and wipe the baby’s eyes, when the baby is finally born, the midwife
checks the baby, if the baby is breathing well and she cleans up the baby.

And if there is any further complication such as retained placenta, she is given a
concoction called ebu for her to drink to make deliver the placenta, or the
woman’s nipple is rubbed by the traditional midwife for the placenta to come
out, also if the placenta is stuck and it’s unable to come out or if bleeding persists
after delivery, the herbalist, if present will make some incantations on the
woman, he places his hands on the woman’s lower abdomen to stop the bleeding
and when the bleeding stops, the midwife draws the placenta slowly out of then
woman’s virginal or the midwife could render prayers to the woman and she
prevent objects into the vigina to prevent trouble or cause further complications.

CARE OF MOTHER AND BABY AFTER BIRTH

In the case of the mother, she is well treated and well taken care of, the
midwife will make sure that she rests on her bed or the mat, only getting up to
take her bath and to go to the latrine. She was also allowed to sleep as much as
possible. Her food given to her during this period was mainly pap (ogi) for her to
drink. Her baby was taken care of by the midwife, she was only allowed to carry
or see the baby only if she wanted to feed the baby. She also avoided the woman
from doing house holds jobs or doing any strenuous activities such as lifting
heavy loads. During this process, the woman and the baby were not allowed to
go outside the room or the house until after seven to nine days (7-9days) and
nobody except the husband was allowed to see the wife after delivery, while the
woman was in room, she was looked after by the Iya Agbebi (midwife) who
majorly took care of her and the baby.

If the woman feels any pain after birth, the midwife will rub the top of the
womb with palm oil regularly or with warm water to push out any thick clots of
blood. This process is done everyday until her stomach goes down and she also
gives her warm liquid drinks for her to drink everyday for her stomach mostly
Agbo (traditional herb).

Also the midwife keeps a watch on the woman’s breast for the first few
weeks, if the woman feels any pain; the midwife will try rubbing them firmly
with her hands with oil but gently with her hands, pressing towards the nipple.
Then she gets the baby to suck the breast, if it doesn’t come out well, the mother
is told to squeeze out the milk into a bowl to feed the baby.

While in the case of the baby, first of all, the baby is put to rest for
several hours before bathing. The child is believed to have been soiled by the
fluid associated with birth, so the first bath is always special. During the first
bath, pamloil, black soap, herbs, soft sponge and warm water is needed in the
bathing of the child and this done by the traditional midwife. The oil is used on
the baby’s body, then bath in a clean warm water or herb water, but the baby is
not usually dipped directly into the water, he is held by the midwife and bathed
with a soft sponge to avoid damage of the baby’s skin. After this is done, the baby
is dried with a soft towel and massage gently with Shea butter (ori), then the
naval of the baby is warmed with herbs tied in cloth, the cloth is held over his
stomach close enough so that it will warm the naval, this process will speed up
healing of the naval and the external belly button too.

During this same period the male child is being circumcised by a traditional
midwife, female children are not circumcised in ijebu land and yorubaland in
general, because they believe if this is done, she female child may find it difficult
to give birth later in future. The midwife ensures that during circumcision,
everywhere is kept clean, the knife or blade is sterilized in the fire to prevent
infection or damage to the child.

CHALLENGES/ WEAKNESSES OF TRADITIONAL BIRTH ATTENDANTS

 These traditional attendants are faced with several challenges and
weaknesses which has affected effective delivery of births. Most of these
traditional birth attendants are not trained, so therefore, they believe that the
signal to start practicing was a Supernatural call through prophecy and/or
dreams. The only "practical experience" they could lay claim on was what they
gained individually through childbirth, they claimed that they were
supernaturally endowed to practice their given profession.

This lack of training, in my opinion, is mainly responsible for the ignorance

displayed by the Traditional Birth Attendants in the study, especially in cases of
complicated pregnancy and labour. Another contributory factor is that their
practice is steeped in superstition, traditional religion, and suspicion - all of
which breed secrecy and preclude open critical appraisal. The high illiteracy rate
which militates against record keeping in their practice further compounds the
problem.

Another challenges/weakness of these traditional birth attendants is that they

use herbal medications in pregnancy and labour. The medicines are mostly made
from leaves, roots and/or bark and contain potent medicaments given in
unregulated dosages. These usually produce toxic effects which are difficult to
manage as antidotes are unknown. Moreover, some herbs are also given to
overcome obstructed labour, thus precipitating rupture of the uterus and posing
anesthetic risks when the patient eventually is referred to the hospital. Fundal
pressure, also used by Traditional Birth Attendants to overcome obstructed
labour, facilitates rupture of the uterus.

Other forms of management included prayers, fasting, and sacrifices. These are
usually prescribed when the Traditional Birth Attendants are confronted with
symptoms and signs they do not understand and which they attribute to "evil
forces", "attacks by wicked people", and/or infidelity; these all serve to waste
valuable time during which the patient could have been referred to the hospital.
Moreover, prolonged fasting is dangerous to the mother and the fetus.

Another alarming feature, given that ante partum and postpartum

hemorrhage are major causes of maternal mortality, is the ignorance about
hemorrhage and the first-choice interventions chosen by the group of
Traditional Birth Attendants. Again, valuable time is wasted before transferring
the mother to hospital.
[1]

[2]