Specialist Maternal Care Critical for Twin and Triplet Pregnancies, Experts Warn Amid Rising Risks!
Reported by Musa Antiketu, | Journalist at Sele Media Africa.
Maternal health experts across Nigeria and the wider African continent are reiterating a crucial message: women carrying multiple pregnancies such as twins and triplets must prioritise delivery in well equipped tertiary or specialist healthcare facilities to significantly reduce the risk of complications and mortality for both mother and child.
This renewed emphasis comes amid persistent concerns about maternal and neonatal mortality rates in sub Saharan Africa, where access to specialised obstetric care remains uneven. Medical professionals argue that while single pregnancies already require careful monitoring, multiple gestations present heightened risks that demand advanced expertise, technology, and coordinated care typically available only in teaching hospitals and specialised centres.
Elevated Risks in Multiple Pregnancies
According to obstetricians and gynaecologists, multiple pregnancies inherently carry higher risks compared to singleton pregnancies. These include preterm birth, low birth weight, preeclampsia, gestational diabetes, and complications during labour such as obstructed delivery or postpartum haemorrhage.
Dr. Amina Yusuf, a consultant obstetrician at a leading tertiary hospital in northern Nigeria, explained that “multiple pregnancies place additional physiological demands on the mother, increasing the likelihood of complications that require rapid, expert intervention.”
She noted that babies born from twin or triplet pregnancies are more likely to require neonatal intensive care, making proximity to facilities with neonatal intensive care units (NICUs) essential. Without immediate access to specialised neonatal support, survival outcomes can be severely compromised, she added.
Importance of Early and Consistent Antenatal Care
A key pillar of improving outcomes, experts say, is early registration for antenatal care (ANC). Timely and regular ANC visits allow healthcare providers to detect complications early, monitor fetal development, and plan for safe delivery.
In multiple pregnancies, antenatal care is not optional it is lifesaving, said Dr. Yusuf. From the first trimester, we need to monitor growth patterns, placental positioning, and maternal health indicators closely.
However, data from Nigeria’s health sector indicate that many women, particularly in rural and underserved communities, either delay ANC registration or rely on informal care providers due to financial constraints, cultural beliefs, or limited access to healthcare facilities.
Public health advocates argue that bridging this gap requires both policy intervention and community level awareness campaigns. We need to demystify hospital based care and ensure women understand the unique risks associated with multiple pregnancies, said a maternal health programme coordinator with a non governmental organisation working in West Africa.
Why Teaching Hospitals Matter
Teaching hospitals and tertiary healthcare institutions are uniquely positioned to handle high risk pregnancies due to their multidisciplinary approach. These facilities typically house obstetricians, neonatologists, anaesthetists, and other specialists under one roof, supported by advanced diagnostic and surgical equipment.
In cases of twin or triplet pregnancies, complications can escalate rapidly, requiring coordinated responses that are often beyond the capacity of primary or secondary healthcare centres.
Emergency caesarean sections, blood transfusions, and neonatal resuscitation are procedures that must be immediately available, said another senior consultant at a federal teaching hospital. Delays in referral or lack of infrastructure can be fatal.
Experts also highlight that teaching hospitals often serve as referral centres, meaning they are better equipped to manage complex cases transferred from smaller facilities. However, they caution that late referrals when complications have already progressed can limit the effectiveness of even the best equipped centres.
Socioe conomic Barriers and Health Inequality
Despite the clear benefits of specialist care, access remains a significant challenge. Financial barriers, distance to healthcare facilities, and inadequate health insurance coverage continue to hinder many women from seeking care in tertiary institutions.
Nigeria’s National Health Insurance Authority (NHIA) has made strides in expanding coverage, but out of pocket payments still dominate healthcare financing. For many families, the cost of delivering in a teaching hospital especially for a high risk pregnancy can be prohibitive.
Rural-urban disparities further compound the issue. While urban centres may host multiple tertiary hospitals, rural areas often rely on under resourced primary healthcare centres with limited capacity to manage complications.
Equity in maternal healthcare is a major concern, said a public health analyst. Until we address systemic inequalities, the benefits of specialist care will remain out of reach for many women.
Cultural Practices and Misinformation
Cultural beliefs and misinformation also play a role in shaping healthcare decisions. In some communities, home births or deliveries assisted by traditional birth attendants (TBAs) are still common, even in high risk pregnancies.
While TBAs play an important role in community health systems, experts caution against relying on them for complex cases such as multiple pregnancies.
There is a need for stronger collaboration between traditional and formal healthcare systems, said the NGO coordinator. TBAs can be trained to recognise danger signs and refer patients early, rather than attempting to manage high risk deliveries themselves.
Public awareness campaigns, particularly those leveraging local languages and community leaders, are seen as critical in shifting perceptions and encouraging facility based deliveries.
Policy Implications and Government Response
Nigeria’s Federal Ministry of Health has consistently identified maternal and child health as a priority area, aligning with global frameworks such as the Sustainable Development Goals (SDGs), particularly Goal 3, which aims to reduce global maternal mortality.
Recent policy efforts have focused on strengthening primary healthcare systems, improving referral networks, and expanding access to emergency obstetric care. However, implementation challenges persist, including funding constraints, workforce shortages, and infrastructure deficits.
Health experts argue that targeted interventions for high risk pregnancies such as subsidised care for multiple gestations could yield significant improvements in outcomes.
Investing in maternal health is not just a healthcare issue; it is a socio economic imperative, said the public health analyst. Healthy mothers and children are foundational to sustainable development.
Regional and Global Context
The concerns raised by Nigerian experts reflect broader trends across sub Saharan Africa, which accounts for a disproportionate share of global maternal and neonatal deaths. According to global health organisations, the region faces systemic challenges, including weak health systems, limited access to skilled birth attendants, and socio economic inequalities.
International agencies such as the World Health Organization (WHO) and UNICEF have long advocated for increased investment in maternal and newborn health, emphasising the importance of skilled care during pregnancy and childbirth.
Multiple pregnancies, while less common than singleton pregnancies, contribute significantly to neonatal morbidity and mortality rates due to their associated complications. As such, they require targeted attention within broader maternal health strategies.
The Role of Data and Research
Accurate data and ongoing research are essential for understanding and addressing the challenges associated with multiple pregnancies. Experts call for improved data collection on maternal and neonatal outcomes, particularly in rural and underserved areas.
“Without reliable data, it is difficult to design effective interventions or measure progress,” said a researcher affiliated with a Nigerian university teaching hospital.
Emerging technologies, including tele medicine and digital health platforms, are also being explored as potential tools for improving access to specialist care and monitoring high risk pregnancies remotely.
A Call to Action
As Nigeria and other African countries strive to improve maternal and child health outcomes, the message from experts is clear: women with multiple pregnancies must be prioritised within healthcare systems.
Early antenatal care, delivery in specialist facilities, and timely intervention are critical components of a comprehensive approach to reducing maternal and neonatal mortality.
For policymakers, this means investing in healthcare infrastructure, expanding insurance coverage, and addressing socio economic barriers. For communities, it involves raising awareness, challenging harmful practices, and supporting women in accessing appropriate care.
Ultimately, ensuring safe pregnancies and healthy births especially in high risk cases requires a collective effort from governments, healthcare providers, civil society, and communities.
Sources
World Health Organization (WHO)
United Nations Children’s Fund (UNICEF)
Nigeria Federal Ministry of Health
The Guardian Nigeria
Punch Newspapers
Premium Times Nigeria