‘I wanted to be treated with dignity’: Why Nigerian women are returning to traditional birth attendants
- Nigeria is the world’s deadliest country for childbirth. Yet as overstretched hospitals push women toward traditional birth attendants, many say they are choosing the compassion and community they struggle to find in formal healthcare, even as health experts warn the trend could cost lives.
Illustration Description: A stylized illustration shows two adults (an elderly midwife and a young nurse) gently passing a newborn baby from one pair of hands to another. The baby lies on its back wrapped in a light cloth, with only the adults’ arms and parts of their bodies visible.
Bukola Osoba had prepared herself for the pain of labour. What she had not prepared for was the noise.
The ward was overcrowded, the air thick and stifling. Nurses moved between beds with the attitude of people who had long stopped seeing patients as people owed compassion. When she called out during a contraction, nobody came. When someone finally did, they spoke to her in a clipped, impatient tone. She left that hospital having delivered her child and feeling, somehow, that something had been taken from her.
“They’re very nonchalant,” she says.”That was why I opted for traditional birth care.”
Osoba is not alone in that conclusion. Across Nigeria, a quiet but growing number of women are turning away from the formal health system, reaching instead toward something older: herbalists, elder mothers and community midwives whose knowledge was passed down not in lecture theatres but through observation, repetition and inheritance. Women who, for generations before colonisation, held birth as their domain.
For Ugwuanyi Akubuenyi, the decision stemmed from both conviction and disillusionment in modern practice. She simply believed, deeply, that there was another way – one rooted in how her people had always lived.
“I sat down one day asking myself how our ancient women gave birth without the help of orthodox medication and hospital,” she says. “I just concluded I was going to follow the same procedure when I get pregnant.”
It is a conclusion that carries weight in a country where the stakes of childbirth could not be higher.
Nigeria is the world’s most dangerous nation in which to give birth. According to the most recent UN estimates, compiled from 2023 figures, one in every 100 women dies in labour or in the days that follow. That same year, Nigeria accounted for 29 per cent of all maternal deaths worldwide – an estimated 75,000 women, one every seven minutes.
Against that backdrop, the turn towards traditional birth care is not without controversy. Health authorities have identified it as one of the factors contributing to the country’s catastrophic mortality figures. The tension, then, is real and uncomfortable: how do you reconcile the warmth and dignity women describe finding in ancestral practice with the cold arithmetic of who is dying, and why?
Aderonke Abdul, a narrative strategist and researcher who has herself experienced the failures of Nigeria’s maternal healthcare system, both public and private, has spent considerable time sitting with that contradiction in her research, Herbal Wombs, Modern Medicine.
“Before modern medicine entered what we now call Nigeria, birthing was not an isolated medical event,” she explains. “It was a deeply communal, spiritual and embodied process. Care was held by experienced women: midwives, elder mothers, herbalists. They understood the rhythms of the body through observation, repetition, and inheritance. Birth happened at home, in familiar spaces, with hands that had done this work many times before.”
Before colonisation fragmented it, childbirth was understood as continuous and holistic. Care stretched from prenatal preparation through to postpartum recovery, attending equally to body, mind and spirit. Women were given herbs to strengthen the womb, guided through emotional and spiritual fortification, supported during labour with massages, chants and positioning techniques, then nurtured afterward with hot baths, abdominal binding, and nutrient-rich soups. At the centre of it all was community: midwives, doulas, herbalists, and daughters learning through proximity and shared knowledge across generations.
Colonisation reframed all of that as superstition.
Nkiruka Epechwao carries both worlds in her. A traditional herbalist and midwife from a lineage of healers, she runs her own maternal health clinic while holding modern certification and having previously worked inside the formal healthcare system.
“Most midwives and doctors in the hospital work carnally. And most of them are impatient,” she says.
The impatience, she argues, has consequences that show up on the operating table.
“Some doctors and nurses will shout at the patients and the blood pressure will shoot up by force. And you know a mother in labour whose blood pressure is very high cannot do vaginal delivery. You know what will happen after the delivery.”
In her own clinic, things move differently and more slowly, by design. She takes labouring women on walks near a riverside or along a hilly path, talking with them, moving with them and allowing the body to find its rhythm before it is asked to perform.
“But who has that time in the hospital?” she says.
Rahama Yelwa came to traditional midwifery through observation, watching her sister’s labour and later built her community, Jego Village. As a certified doula, she offers physical and emotional support throughout pregnancy, with more emphasis on postpartum care.
“I advocate a lot for postpartum care, because we do prepare for pregnancy and birth a lot of times,” she says. “But then there’s a vacuum in postpartum care, especially for mothers. You’ll find that there’s modalities of how to care for babies. Like everybody knows how to care for babies.”
The baby becomes the focus. The mother becomes the background. Yelwa finds this not just unfortunate but dangerous. “It’s not that we’re forgetting. We’re neglecting to care for mothers as well. And mothers are the first line of care, as far as I’m concerned. They are the line of defence to care for babies.”
It is a neglect, she argues, that modern medicine has institutionalised. As both a practitioner and a mother who has moved through the system herself, she has felt exactly where its attention runs out.
“Medical care has a limit especially in postpartum. And in a way, it kind of isolates or dismisses traditional care,” she says. “I think that if we actually took time to look at what traditional models of care were, it would be very beneficial to have access to both of them existing in one space so that it’s not one or the other.”
Not everyone is ready to hold both positions at once. Chijindu Blessing, a medical practitioner, is frank about where she stands. She does not support traditional birth care, and she worries about what gets lost and who gets harmed when women turn away from clinical medicine. But she is also honest about why they do.
“In the public health sector, we are severely underfunded in Nigeria,” she says. “As of 2025, the health budget was around 230 something billion, and what was released was just 36 million naira. Doctors are being owed salaries. Nurses are being owed salaries. There’s no employment ongoing. So there are like two doctors manning a 300-bedded unit. Of course, they are going to be impatient. Of course, they are going to be tired.”
She is not, she insists, asking traditional practitioners to disappear. She is asking them to know their limits.
“We are not entirely ruling them out. What we want is people who understand their limitations and understand that there’s an extent to which they can do their job,” she explains. “In medicine, the first thing they teach us in medical school is not to be a hero. Do not play the hero. Understand your limits and refer. The safest doctor is the doctor who refers – who says, ‘I don’t know,’ and who refers the patient.”
Abdul, too, resists the pull toward romanticisation, even as she insists on the value of what existed before.
“Traditional birth practices did serve women. In many ways they still do,” she says. “They centre the woman, they preserve dignity, they reduce unnecessary intervention, and they are culturally intelligent in a way modern systems often are not. However, they also existed in a context without access to surgical intervention, blood transfusion, or emergency care.”
The risk, she argues, was always present in both systems.
“When complications arose—obstructed labour, haemorrhage, infection—outcomes could turn quickly. So yes, there is both care and risk in that system. Just as there is care and risk in modern obstetrics today. The question isn’t which is pure. It’s what each system sees clearly and where each one is blind.”
Yelwa arrives at the same place from a different direction. “We just need to look at it from a respectful way, and figure out what the needs and the essence of it are, and integrate them in non-traditional ways. Because the whole point is to support birth and, most importantly, the mother.”
In a country where one woman dies every seven minutes bringing life into the world, that does not feel like too much to ask.
Edited/Reviewed by PK Cross, Uzoma Ihejirika, and Caleb Okereke.
Illustrated by: Rex Opara
