KONDUGA, Nigeria (AP) — Aisha Muhammed was in the third trimester of her pregnancy when she had the convulsions and high blood pressure of eclampsia, a leading cause of maternal death. Her village’s only health clinic had no doctor, and the only medical help was 40 kilometers (25 miles) away in one of the world’s most dangerous places.
More women die giving birth in Nigeria than anywhere else in the world, according to the World Health Organization. But Muhammed managed to reach the city of Maiduguri and have a cesarean section the next day, delivering twins in April.
“Even though children are a source of joy, if I will have to go through the same ordeal again, I am afraid of getting pregnant,” she said, fighting back tears.
The odds are stacked against pregnant women in Nigeria’s northeast like never before. The deadly Boko Haram militant group is making a resurgence. And hundreds of millions of dollars in foreign aid from the United States, once Nigeria’s biggest donor, have disappeared under the Trump administration this year.
Roads are closed by fighting. Many doctors and other health workers, as well as aid organizations, have fled.
Even before these developments, Nigeria had over a quarter of the world’s maternal deaths in 2023 — 75,000 — according to the WHO.
At least one in every 100 women dies giving birth in Africa’s most populous country, which faces chronic underfunding for health systems that cater to 220 million people.
“If you count five people away, you know a woman who has probably had an issue with maternal morbidity or mortality,” said Jumoke Olatunji, a cofounder of the Lagos-based Alabiamo Maternal and Child Wellbeing Foundation. Maternal morbidity refers to the health problems caused to the mothers who survive.