Population growth projections indicate that more than 5 billion people will be living on the African continent by the end of this century. Despite this, infant mortality on the continent remains the highest in the world. The World Health Organization said the probability of an African child dying before the age of five is five times greater than in Europe. Reasons include endemic poverty, lack of medical care, and conflict. Furthermore, many pregnant women and their unborn children are at risk due to persistent myths and superstitions. Superstitions guide pregnancy A storm sweeps over Soshanguve, a township about 32 kilometers north of Pretoria. Pitch black clouds pour more misery over the poor residents, their homes already flooded after days of constant cloudbursts. Inside her rusty shack, 36-year-old Cynthia Mohape breastfeeds her 3-month-old son Jeremiah. Like many South African mothers, several superstitions guided her pregnancy. “I kept the pregnancy secret as long as I could. I only visited the doctor when only I was seven months pregnant,” said Mohape. Mohape believes that revealing a pregnancy early could be extremely dangerous. “If your enemies find out you are pregnant they will pay a witch to bewitch you. If that happens then I will lose my baby or I will die myself,” she said. Maternal health expert Dr. Ashley Mthunzi said Mohape is fortunate she and her baby are healthy. Mthunzi is an expert in maternal health at Wits University’s Reproductive Health and HIV Institute in Johannesburg. Mthunzi said many of his patients only consult him shortly before they are due to give birth out of real, but misguided, fear. “She would say to me, ‘No; I will be jinxed [if I tell anyone]. Somehow my baby will be born dead, or I will have a stillborn; the outcomes will not be good,’ ” said Mthunzi. Mthunzi said this can have “terrible consequences” for mother and child, which often could have been prevented earlier in the pregnancy. “If you cannot pick it up early in pregnancy, because you (the woman) have not accessed antenatal care, it will mean that it has dire consequences for the passenger, the baby. The baby can lose sight. They can be born with congenital syphilis,” said Mthunzi. HIV pandemic He added that late medical intervention for expecting mothers also fuels South Africa’s HIV pandemic. “You would actually have transmission of HIV in particular - transmission of HIV to the unborn baby, because the mother is really not controlled on ARVs (anti-retrovirals), or was not on ARVs when they presented themselves in antenatal care, or in antenatal clinics,” said Mthunzi. ARVs can drastically reduce the chances of an HIV-infected pregnant woman transmitting the virus to her baby. Mthunzi is also concerned about another myth he says is spreading fast in South Africa: “the myth is that when you are pregnant you need to sleep with a different man. The reason is that you need to make the baby to be strong... That is absolutely ridiculous.” He laments that many HIV-infected women visit traditional healers for herbal concoctions, some of which he labels “poisonous.” “You see a patient is not getting better, but you are giving them ARVs, because they are taking this imbiza, or this traditional medicine, that is not coordinated in terms of toxicity, so that would actually even render your ARVs sub-therapeutic,” he said. Mthunzi wants the state, the medical profession and traditional healers to cooperate to prevent the spread of harmful superstitions. But at this stage, he said, there is no sign of this happening. “Now we’re not taking necessary drastic steps to bring on board these traditional healers at a scale which will actually be acceptable in curbing maternal mortality in South Africa,” said Mthunzi. Infant mortality rate South Africa ranks 51 out of 224 countries for the highest infant mortality rate. Back in Cynthia Mohape’s hut in Soshanguve, the rain and thunder endure. The mother entertains her baby with a toy dog. Mohape said she plans to become pregnant again, as soon as possible. She smiles and adds that she wants a girl. Again, Mohape maintains she will keep the pregnancy secret “until the last moment.” “I must follow my culture. I must listen to what the traditional healer says about my baby. If I don’t do this, the ancestor spirits will be angry with me,” she said. And so the lives of Mohape and her unborn child will again be at risk, like so many others across South Africa, where superstitions about childbirth persist.

• published: 29 Dec 2014
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