Decolonizing childbirth: Women, traditional birth attendants and reproductive justice in Nigeria

This research study is a decolonial qualitative exploration of indigenous Yoruba birthing perspectives in Nigeria. Adopting feminist and African indigenous methodologies and using the theoretical framework of birth and reproductive justice, this study analyzes 25 in-depth interviews conducted in the Yoruba language with traditional midwives (agbebis) and birthing women (abiyamos) who use their pregnancy and childbirth services in the Ebute-Metta and Yaba areas of Lagos, Nigeria. Given that nonmedical attendants attend most of the childbirths in Nigeria and Africa more broadly, my research seeks to document and analyze the intergenerational indigenous knowledge of traditional midwives in Nigeria and the indigenous birthing perspectives of the women who use their services. It explores how the indigenous birthing knowledge of traditional midwives and the socio-cultural and spiritual birthing perspectives of the women who use their services may lead to more culturally appropriate and locally sustainable maternal health strategies, not only in Nigeria but also globally. It finds that the abiyamos describe their use of childbirth services with agbebis as a communal phenomenon, sustained by their birth attendants’ comforting care, their belief in traditional medicine, trust in agbebis’ birthing expertise, preference for vaginal childbirth, and overall resistance to compulsory and/or unnecessary medicalization of the child birthing process through a C-section. This research also finds that the agbebis utilize Yoruba indigenous birthing knowledge, practices, and procedures that have been historically passed down to them from the lineage of previous generations. They described their birthing practices as compassionate communal work and discussed the continued use of indigenous birthing know-how for successful pregnancy care and child delivery even with regard to physical conditions that have been assumed to be beyond the agbebis’ expertise. Overall, findings from the interviews with both the agbebis and the abiyamos document the desire for a mutually supportive and respectful coexistence of the indigenous and western medical birthing paradigms to enable birthing women to choose birthing approaches depending on their needs and preferences. As this study demonstrates, to improve maternal healthcare and reduce maternal deaths the perspectives of indigenous midwives and birthing women must be centered in research, policy, and advocacy work.