




































Article 8.cdr


RISK FACTORS ASSOCIATED WITH PREGNANCY AND MATERNAL 
MORTALITY AMONG GWANDARA WOMEN IN KOKONA LOCAL 

GOVERNMENT AREA OF NASARAWA STATE, NIGERIA

By 
        Mamman Matthew Samuel

Department of Sociology
Nasarawa State University, Keffi -Nigeria

matthewsamuel@nsuk.edu.ng
 +2348031851387

Abstract
n emerging societies, large percentage of women lose their lives as a result of pregnancy related Icomplications due to early marriage, non-attendance of antenatal clinic, non-utilization of 
maternal healthcare services among other factors. This paper examines risk factors associated 

with pregnancy and maternal mortality among Gwandara women in Kokona Local Government 
Area of Nasarawa State, Nigeria. A social survey design was adopted for this paper. A sample of 262 
respondents was drawn, using multi-stage sampling techniques involving electoral wards, 
towns/villages, main streets, houses, households and individuals. Primary data were utilized in the 
study. The primary data were generated through the use of questionnaires and in-depth interview 
(IDI). The questionnaires were carefully analysed quantitatively using tables' frequency and 
percentage while data generated through in-depth interview (IDI) were analysed to complement the 
quantitative method using content analysis. Findings from the study revealed that existing health 
conditions is the major risk factor associated with pregnancy and early marriage as the main 
determinant of risky pregnancies. The findings equally show that maternal mortality is the effect of 
risky pregnancy. The paper recommends the need for more awareness on importance of utilizing 
maternal health care services during pregnancy hence government should organize monthly 
seminars, lectures and symposiums aimed at encouraging pregnant women to utilized maternal 
health care services and there is the need for improved educational opportunities for women to be 
encouraged to dispel ignorance thereby discouraging early marriage. Also, women should be 
supported and encouraged to start antenatal care early in pregnancy to allow for sufficient time to 
identify and treat problems thereby preventing maternal mortality
Keywords: Risk Factors, Pregnancy, Maternal Mortality, Gwandara Women. 

Introduction
In the world today, maternal mortality has been on the increase in modern time with unfavourable 
effects on the health care system. The current rate of maternal deaths in Nigeria indicates that 
Nigeria is far from ending the problem of maternal mortality. Maternal health constitutes delicate 
aspects of every nation's health that requires adequate attention. A society is known and measured 
by the way the most vulnerable segment of its population is treated, in this case, women and infants 
or children. With only two per cent of the world's population, Nigeria contributes ten per cent of the 
world's maternal death. Each year as many as 60,000 Nigerian women die due to pregnancy-related 
complications. Universally only India has a larger number of maternal deaths from pregnancy-
related complications as many as 136, 000 annually. Maternal death is one of the world's health 
concerns hence the United Nations has called for "Safe Motherhood". Despite such early awareness, 
very little improvement is seen in maternal health care delivery in most developing countries in 
Africa as well as Nigeria (World Health Organisation Factsheets, 2021). 

Mortality associated with pregnancy and delivery complications is highest among poor and less 

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Coou Journal of Arts and Humanities (CJAH) Vol. 5 No. 4, 2023 

http://matthewsamuel@nsuk.edu.ng


privileged women in Nigeria (Olusola, 2011). Kassebaum, Lopez, Murray, & Lozano(2014)noted 
that the maternal mortality ratio in Nigeria is estimated to be 545 deaths per 100,000 live births (Ogu 
& Ephrain, 2018).Large number of Nigerian women dies as a result of complications associated 
with pregnancy or child birth, as about one woman dies every three minutes due to pregnancy and 
child birth related issues. This suggests that the maternal mortality rate in Nigeria is about 100 times 
worse than in the industrialized countries, highlighting what is one of the widest disparities in 
international public health. Nigeria is ranked second in the world behind India and Nigeria is part of 
a group of six countries in 2008 that collectively accounted for over 50% of all maternal deaths 
globally, Nigeria is ranked eighth in Sub-Saharan Africa behind, Angola, Chad, Liberia, Niger, 
Rwanda, Sierra Leone and Somalia as shown in (Macro & Commission, 2009). 

Maternal mortality has been on the increase in recent times with detrimental effects on the socio-
economic development of many nations. Approximately 830 women die globally every day from 
preventable causes related to pregnancy and childbirth. More worrisome is the fact that 99% of all 
maternal deaths occur in developing countries. It mainly occurs in resource-limited settings from 
preventable causes and affects women of childbearing age (15-49 years of age) with poorly met 
health needs. Maternal mortality is unevenly spread geographically with stark differences between 
developed and developing countries. Developing nations bear the brunt (99%) of maternal deaths, 
with over 50% occurring in sub-Saharan Africa. From 1990 to 2015, the global maternal mortality 
ratio declined by 44 per cent; from 385 deaths to 216 deaths per 100,000 live births. This translates 
into an average annual reduction rate of 2.3 per cent. While this looks impressive, it is less than half 
of the 5.5 per cent annual rate required to achieve the three-quarters reduction in maternal mortality 
target for 2015 in the rested Millennium Development Goal five and nowhere close to the goal three 
(3) of the Sustainable Development Goals targeted at reducing the global maternal mortality ratio to 
less than 70 per 100,000 live births (UNICEF, 2017). 

Almost all maternal deaths can be prevented, as evidenced by the vast disparities found between the 
richest and poorest countries. The lifetime risk of maternal death in high-income countries is 1 in 
3,300, compared to 1 in 41 in low-income countries. The number of women and girls in the world 
who die each year from complications of pregnancy and childbirth declined from 532,000 in 1990 to 
303,000 in 2015 (APHRC, 2017). According to current world statistics, over 800 women die each 
day from complications in pregnancy and childbirth; and for every woman who dies, approximately 
20 others suffer serious injuries, infections or disabilities (World Health Organization Factsheets, 
2021).

World Health Organization (2021) reports that, one out of every 22 women in Africa dies from 
pregnancy-related complications (Ezeh, Agho, Dibley, Hall, & Page, 2014; & UNICEF, 2014), For 
every woman who dies, about 50 to 100 other women suffer from an illness or disability due to 
childbearing. This implies that every 8 years, more than 150,000 African women die and millions of 
women suffer a serious illness, because of pregnancy and child birth complications. Based on the 
foregoing, the study examines the risk factors associated with pregnancy and maternal mortality 
among Gwandara women in Kokona Local Government Area of Nasarawa State, Nigeria.

Statement of the Problem
Maternal health care services are a contemporary issue with vast universal implication on the 
continued existence of human society. The health of women during pregnancy and post-natal is 
essential to ensure adequate well-being of the home and family especially in matters relating to 
childbirth, child care, breastfeeding, home care etc. In Nigeria the number of maternal deaths has 

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Coou Journal of Arts and Humanities (CJAH) Vol. 5 No. 4, 2023 



remained high, with maternal mortality ratio of 814 per 100,000 live births despite the administration 
of wide range of maternal health service strategies that include free antenatal care, training of skilled 
birth attendants just to mention a few as well as availability of resources, the situation of maternal 
health remains one of the worst in Africa as evidenced by prevailing maternal mortality ratio. Nigeria 
contributes greater than 10% of maternal deaths globally, this prevailing issue in Nigeria is strongly 
linked to the weak implementation of maternal health policies and services as well as the presence of 
a number of cultural and socio-economic factors including lack of funds, lack of birth preparedness 
(Oladineji, Pius, Adekunle,Temi, Abiodun, Peter, & Babatunde, 2013).

The maternal health care system in Nigeria is one which is characterised by the presence of factors 
such as traditional and faith based and orthodox health providers. The present of factors such as 
traditional, faith based health provider linked with the socio-economic and deleterious cultural 
determinants of maternal health can be implicated as a plausible reason for the seemingly weak 
health system. This implication is evident in the number of pregnancies being managed by these non-
orthodox methods their inability to recognize danger signs in pregnancy and ensure high maternal 
death rate (Oladineji, et al2013).

Apart from the problems posed by these factors, maternal health care services are also plagued with 
problems of poverty, illiteracy lack of knowledge, delay in reaching health facilities either due to 
inaccessibility, poor roads, poor communication networks, poor transportation system or long 
distance to be covered as well as delays in receiving appropriate care at health facilities which is 
characterised by absence of quality maternal health services, inadequacy of skilled birth attendants, 
inadequate medical supplies during labour, delivery and after the delivery, there is thus the need to 
focus on prevention of maternal deaths in Nigeria by tackling these issues affecting the ability of 
pregnant women to access timely and quality maternal health service.

In spite of policies, declarations, conferences and other efforts aimed at reducing the scourge of 
maternal deaths across the globe, only modest gains in maternal mortality reduction appear to have 
been achieved in many countries in the past 20 years (Shah & Say, 2007) countries in Africa may 
have actually lost ground while many developing countries have fallen far short of the standard set by 
the world health organization's initiatives on safe motherhood. In Nigeria, the federal ministry of 
health had set year 2006 as the target year that maternal mortality would have reduced by 50%. 
However not only were these targets not achieved but also the maternal health situation in Nigeria is 
now much worse than in previous years (Ujah, et-al 2005). Past efforts to reduce maternal mortality 
ratio in Nigeria were concentrated on making direct improvements to the health system. These 
efforts have not involved enough resources to successfully reduce maternal mortality in the country. 
In view of these lacks of success, Okonofua (2007) noted that the high maternal mortality in the 
country will have to be tackled by generating sufficient political priority to make governments 
deploy enough resources to successfully reduce maternal mortality in Nigeria. 

Several studies in the Nigeria (Ogu & Ephrain, 2018; Oladineji, Pius, Adekunle, Temi, Abiodun, 
Peter, & Babatunde, 2013; Ujah, Aisien Mutihir, Vanderagt, Glew, &Uguru, 2005; Okeke, Oluwuo 
& Azil, 2016; Nwokocha, 2012) have been undertaken on risk factors associated with pregnancy and 
maternal mortality, but none of these have examined the risk factors associated with pregnancy and 
maternal mortality among Gwandara women in Kokona Local Government Area of Nasarawa State, 
Nigeria. This study, therefore, intends to fill these gaps.

Research Questions
The paper attempts to answer the following research questions:

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Coou Journal of Arts and Humanities (CJAH) Vol. 5 No. 4, 2023 



i. What are the risk factors associated with pregnancy among Gwandara women in Kokona 
Local Government Area of Nasarawa State, Nigeria? 

ii. What are the determinants of risky pregnancies among Gwandara women in Kokona Local 
Government Area of Nasarawa State, Nigeria?

iii. What are the effects of risky pregnancy and maternal mortality among Gwandara women in 
Kokona Local Government Area of Nasarawa State, Nigeria?

Conceptual and Theoretical Review 
Risky Pregnancy  
 Like other societal issues, scholars or intellectuals have variegated views on risky 
pregnancy. In other words there is no consensus or generally accepted definition of the concept. But 
this study will dwell on those definitions that are widely accepted. Risky pregnancy refers to any 
pregnancy associated with an increased risk for adverse outcomes. The incidence of risky 
pregnancies varies from society to society. Risky pregnancies are associated with a higher incidence 
of low birth weight babies (LBW), a high pre-natal mortality (PNM), and an increased pregnancy-
related maternal morbidity and mortality. The maternal and prenatal mortality reflects the quality of 
health of a community. Prenatal mortality is the best indicator to measure the quality of maternal and 
child health (MCH) cares in a community. Risky pregnancy within the context of the paper is any 
pregnancy accompanying with an increased threat for adverse results.

Maternal Mortality

It is rather difficult to point out a single holistic definition of maternal mortality despite its 
significance and wide usage in the field of demographic and population studies. This has left 
scholars, researchers, intellectuals and authors to defining maternal mortality from different 
perspectives and perceptions. World Health Organization refers to maternal mortality as the death of 
woman while pregnant or within forty-two days after termination of pregnancy, irrespective of the 
duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its 
management but not from accidental or incidental causes and also maternal death as the death of a 
woman from direct or indirect obstetric causes occurring more than 42 days but less than one year 
after the termination of the pregnancy (WHO, 2014). 

Similarly, Ibrahim (2016) asserted that maternal mortality refers to any loss of a woman's life 
resulting from pregnancy complication or death within 42 days after childbirth, notwithstanding the 
period or site of the pregnancy, emanating from issues that are linked or escalated by the 
management of the pregnancy but not from accident or incidental factors (Ibrahim, 2016). Maternal 
mortality can be distinct as either direct or indirect. Direct maternal mortality result from 
complications and difficulties of the pregnancy (pregnancy, labour and post-delivery), from 
interventions, omissions, incorrect treatment, or from a chain of measures ascending from any of the 
above. Indirect maternal mortality is due to hitherto the existing diseases or diseases that advance 
during pregnancy, and not as a result of direct obstetric causes (Oxaal & Baden, 1996). 

Within the context of this paper, maternal mortality denotes the death of woman while pregnant or 
within forty-two days after termination of pregnancy, irrespective of the duration and site of the 
pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from 
accidental or incidental causes and also maternal death as the death of a woman from direct or 
indirect obstetric causes occurring more than 42 days but less than one year after the termination of 
the pregnancy.

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Theoretical Framework
This paper is positioned within the Health Belief Model. The health belief model (H B M) was 
developed as an attempt to explain the decision of an individual with respect to preventive health 
care (French, Kurczynski, Weaver & Pituch, 1992).This model was developed for the first time in the 
1950's to evaluate why screening of tuberculosis was not successful in the USA (Hayden, 2009). 
Personal beliefs influence on a person's health choices and behaviour. Health Belief Model explains 
that health behaviour is determined by an individual's beliefs and perception about particular health 
problems and illness, and available resources address these problems (Calnan, 1984, Champion & 
Skinner, 2008). In this study, HBM was adopted in order to understand women's thoughts, behaviour 
and decision with regard to providing health care related to risk factors in pregnancy and maternal 
mortality among Gwandara women in Kokona Local Government Area of Nasarawa State-Nigeria.

Health Belief Model mainly builds on the following four components which make theoretical 
constructs for the exploration of the perception of women in this study. These components together 
assess the women's understanding of risks and explain decisions of health behaviour (Champion 
&Skinner, 2008, Hayden, 2009).

Perceived Susceptibility: Perceived susceptibility refers to the belief about the livelihood of getting 
a disease or risk of being exposed to threat for a particular person in particular circumstances. This 
means how much risk a person perceives he/she has (Hayden, 2009). Recognizing a danger sign 
brings about the realization of needs for care. Women may be aware of the risk but it does not 
guarantee that they will act for biomedical care. It is essential to see to what extent women see the 
risks how they confront the problems related to pregnancy and obstetric complications. The greater 
the risks are perceived as susceptible, the greater livelihood that they will seek for care (Hayden, 
2009).

Perceived Threat/ Seriousness: If an individual does not see a health problem as risky or 
threatening, there is no stimulus to act. Perceived feeling about the seriousness of risk includes 
evaluation of both the medical consequences including pain, disability, death and social 
consequences such as impact on work, family and social relations (Hayden, 2009). Perceived threat 
explains a woman's belief about the seriousness, and how severe it can harm her. To make a decision 
on whether to seek medical care or not one must believe in both susceptibility and severity. So health 
choices can be weighed. Pregnancy is a risk and there is a 10-15 percent chance of unexpected 
complications. (Van den Broek & Falconer, 2011).

Perceived Benefits: A person's belief of giving importance to certain health actions decreases the 
risk of potential complication. A person's tends to make a decision and adopt a healthy practice, when 
he/she believes that the decision taking would benefit them (Champion & Skinner 2008, Hayden, 
2009). When a person perceives a threat, whether such perceptions lead to behavioural change will 
be affected by the person's belief with respect to perceived benefits of the various measures available 
to reduce the threat (Hayden, 2009).

Perceived Barriers: These explain that decisions on health action are influenced by perceived 
barriers to change. When an individual evaluates an obstacle on his/her way of determining health 
behaviour, decision may not be made. Perceived barriers play a significant role in behavioural 
outcome (Hayden, 2009). Fear of pain and embarrassment are also common issues women perceive 
as barriers in seeking for health care. Perception of women is different in diverse ethnic groups and 
so is women's decision making power within their household (Suwal, 2008). 

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The Health Belief Model (HBM) has been adopted in the paper for the following reasons:
i. Women perception about the risk of pregnancy will inform health care-seeking behaviour or 

to seek for antenatal care.
ii. Beliefs regarding therapeutic/healing effectiveness of health care options will inform health 

care seeking behaviours.
iii. Beliefs regarding barriers to some health care options such as higher cost of care, availability 

and distance to care facilities will inform health care seeking behaviour.
iv. Previous experience with different care options and observation of treatment outcomes of 

other women from different care options will inform health care seeking behaviour for 
current and future complication (cues to action).

Methodology
Gwandara is the major tribe with large number of women of child-bearing age in Kokona Local 
Government Area of Nasarawa State, Nigeria. The paper adopted social survey design. The social 
survey entails a research design that allows the collection of data from a fraction of a study 
population, which can be seen as truly representing the larger population using the questionnaire and 
in-depth interview. The population for this study consists of women of childbearing age of 15-49 
years from Gwandara ethnic group who registered for antenatal care services in various electoral 
wards in Kokona Local Government Area of Nasarawa State-Nigeria between the periods of 
November 2021 to January 2022. The total of one thousand six hundred and seventy two (1672) 
women of childbearing age was registered across the electoral wards in the study area (Primary 
Health Care, Kokona Local Government Area, 2022). The sample size was determined using Krejcie 
Morgan's formula (1970) which is given as:

Table 1 indicates the responses on the risk factors associated with pregnancy in the sampled 
population of the study. Data from the study revealed that majority of the respondents accepted that 
existing health conditions (High blood pressure, diabetes, kidney disease, autoimmune disease, 
thyroid disease, obesity, HIV/AIDS, depression and infections) are the common risk factors 
associated with pregnancy in the study with an affirmation of 46.9 percent of the respondents. This 
clearly shows that existing health condition is the main risk factors associated 
with pregnancy in the study area. 

Data Analysis and Results  
Table 1: Response on the risk factors Associated with Pregnancy  
Response Frequency Percentage (%) 
Mother’s age  51 

 
19.5 

Existing health conditions (High Blood Pressure, 
Diabetes, Kidney disease, Autoimmune disease, Thyroid 
disease, Obesity, HIV/AIDS, Depression and infections)   

123 46.9 

Condition of Pregnancy (Multiple gestational, Gestational 
diabetes, Preeclampsia and Eclampsia, Previous birth 
defects)  
 
Others  

72 
 
 
 
16 

27.5 
 
 
 
6.1 

Total 262 100 

Source: Field Survey, 2022 

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In the in-depth interview (IDI) conducted, there was clear consensus that existing health conditions 
such as high blood pressure, diabetes, kidney disease, autoimmune disease, thyroid disease, obesity, 
HIV/AIDS, depression and infections are the risk factors associated with pregnancy. An 
overwhelming proportion of the interviewees' stated that these risk factors are mostly experienced 
by pregnant women in the study population. Two interviewees, a gynaecologist and a mentor mother 
captured the general position of the interviewees' as reported below. 

A gynaecologist reported that:
The common risk factors associated with pregnancy in this area is the existing health conditions 
such as high blood pressure, diabetes, kidney disease, autoimmune disease, thyroid disease, obesity, 
HIV/AIDS, depression and infections. These are doing more harm on the pregnant women and a lot 
of complications are as a result of these risk factors 

This point was further buttressed through a statement made by a mentor mother who said:
Pregnant women in this village suffer from serious risk factors during pregnancy. This has serious 
implication on the health of the pregnant women and the unborn child. Mostly, the risk factors are 
existing health conditions like depression, diabetes, high blood pressure and others. 

Table 2 shows the responses on the determinants of risky pregnancies in the study area. The table 
illustrates that early marriage is a major determinant of risky pregnancies. This was established by 
27.9 percent of the total respondents in the sampled population of the study. This denotes that early 
marriage is a key determinant of risky pregnancies in the area of the study. 

During the in-depth interview (IDI) a nurse pointed out that early marriage is a principal determinant 
of risky pregnancies. Even though, there are other determinants like poverty, maternal age, socio-
cultural and religious influence, non-use of contraceptives and inadequate comprehensive sexuality 
education. The participant explained as thus: 
One prime determinant of risky pregnancies in Kokona Local Government Area of Nasarawa State 
is the issue of early marriage. In this area, many young girls are married before the age of 18 years. 
Within this age bracket their body system is not well developed. Having pregnancy will come with a 
lot of complications. This is a serious problem and a major determinant of risky pregnancies.

Table 2: Responses on the determinants of risky pregnancies  
Response Frequency Percentage (%) 
Early marriage  73 27.9 
Poverty  38 14.5 
Socio-cultural and religious factors  57 21.8 
Non-use of contraceptives 39 14.9 
Maternal age  
Gender power relation 
Inadequate comprehensive sexuality education  
Others  

22 
09 
18 
06 

8.4 
3.4 
6.8 
2.3 

Total 262 100 
Source: Field Survey, 2022 

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Table 3 is a presentation of the effect of risky pregnancy and maternal mortality in the sampled 
population of the study. Data from the study established that maternal mortality is a strong and 
leading effect of risky pregnancy among Gwandara women in Kokona Local Government Area of 
Nasarawa State, Nigeria. This was affirmed by larger percent of the respondents with 55.3 percent of 
the response in the area of study. 

This attracted strong support from interviewees during an in-depth interview (IDI) conducted in the 
sampled areas. The overwhelming proportion of the interviewees accepted with one voice that 
maternal mortality is a major effect of risky pregnancy. An interviewee, a midwife netted the wide-
ranging position of the interviewees' as thus: 
Not only in Kokona Local Government Area or Nasarawa State but Nigeria in general, maternal 
mortality has negative effect on pregnant women. Larger proportion of pregnant women is dying on 
daily basis as a result of complications during pregnancy. Maternal mortality has been on the 
upsurge in contemporary time with disparaging effects on the pregnant women. 

Discussions of Findings
Regarding the risk factors associated with pregnancy in among Gwandara women in Kokona Local 
Government Area of Nasarawa State, Nigeria, study findings revealed that the existing health 
conditions such as high blood pressure, diabetes, kidney disease, autoimmune disease, thyroid 
disease, obesity, HIV/AIDS, depression and infections are the common risk factors associated with 
pregnancy in the area of study. This was affirmed by Achama, Emmanuel and Moses (2015) that the 
significant factors associated with pregnancy is the existing health conditions of the pregnant 
woman. These factors include high blood pressure, diabetes, kidney disease, autoimmune disease, 
thyroid disease, obesity, HIV/AIDS, depression and infections. Every pregnancy faces high-risk 
and low-risk during the childbearing period.

On the determinants of risky pregnancies in among Gwandara women in Kokona Local 
Government Area of Nasarawa State, Nigeria, study findings unraveled that early marriage is a 
prime determinant of risky pregnancies in the study area. This was established by Ezeh, et al (2014) 
that age of pregnancy is considered high-risk when there are potential complications that could 
affect the mother, the baby, or both. Some of the risk factors associated with high-risk pregnancies 
are: maternal age, medical conditions that exist before pregnancy, medical conditions that occur 
during pregnancy and pregnancy related issues. One of the most common risk factors for a high- risk 
pregnancy is the age of the mother-to-be. Women who will be under 17 or over 35 when their baby is 
due are at greater risk of complications than those between their late teens and early 30s. Conditions 
such as high blood pressure; breathing, kidney, or heart problems; diabetes; autoimmune disease; 
sexually transmitted diseases (STDs); or chronic infections such as human immunodeficiency virus 

Table 3: Responses on the effect of risky Pregnancy and Maternal Mortality  
Response Frequency Percentage (%) 
Maternal mortality  145 55.3 
Health risks e.g. obstetric fistula  62 23.7 
Still born  17 6.5 
Premature birth  11 4.2 
Complication at birth  
Others  

06 
21 

2.3 
8.0 

Total 262 100 
Source: Field Survey, 2022  

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(HIV) can present risks for the mother and/or her unborn baby. A history of miscarriage, problems 
with a previous pregnancy or pregnancies, or a family history of genetic disorders is also risk factors 
for a high-risk pregnancy -risk pregnancies, such as: early child bearing, late child bearing, poor child 
spacing, large number of children, non-attendance of ante-natal clinics, poor nutrition, and poverty.

Concerning the effects of risky pregnancy and maternal mortality among Gwandara women in 
Kokona Local Government Area of Nasarawa State, Nigeria, the study findings discovered that 
maternal mortality is the main effect of risky pregnancy in the sampled population of the study. This 
was supported by World Bank (2011), maternal mortality is the most extreme consequence of risky 
pregnancy. Complications of pregnancy and childbirth are the leading cause of disability and death 
amongst women between the ages of 15-49. Maternal mortality is the death of a woman during 
pregnancy, delivery or six weeks following the birth of the baby. Every year, it is estimated that 
approximately 500,000 women die as a result of pregnancy and child birth; one woman dies every 
minute. For every woman that dies, it is estimated that more than 25 others suffer a debilitating injury 
often with lifelong consequences. Further, maternal death often results in death to the new born and 
increases risk of survival for the older children. It is estimated that 4 million new-borns die in the first 
week of life every year, mostly due to problems during pregnancy and childbirth. 
 
Conclusion and Recommendations 
The rising challenges that come with lack of utilisation of maternal health care services by women 
pose a great threat to the future generation, this can be attributed to belief model of such an individual 
or awareness on high risk of pregnancy and maternal mortality, the health benefit for antenatal care 
utilization, for Nigeria to reduce its maternal mortality and infant mortality there is an urgent needs 
for more expectant mothers to learned how to utilized the antenatal care service. Nigeria today is 
saddle with the high rate of risky pregnancies and maternal mortality. This may be due to women not 
utilising antenatal care despite the fact that antenatal care has been given top priority by government 
and Non-Governmental Organization (NGOs) and stakeholders. This paper recommends that:

i. There should be more awareness on importance of utilizing maternal health care services 
during pregnancy since most of the pregnant women are still ignorant of services. Therefore, 
government should organise monthly seminars, lectures and symposiums aimed at 
encouraging pregnant women to utilise maternal health care services, where they will be 
taught on all the activities involved during pregnancy.

ii. There is the need for improving educational opportunities for women to dispel ignorance, 
thereby empowering them to make independent decisions. This would discourage early 
marriage which is the major determinant of risky pregnancy 

iii. Women should be supported and encouraged to start antenatal care early in pregnancy to 
allow for sufficient time to identify and treat the problems so that the effect of risky pregnancy 
and maternal mortality would be prevented. 

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