COMMUNITY-LEVEL ANATOMICAL VARIATIONS AND THEIR IMPLICATIONS FOR MATERNAL MORTALITY IN RURAL NIGERIA

Abstract

Maternal mortality remains a significant public health challenge, particularly in rural Nigeria, where women face disproportionate risks during pregnancy and childbirth due to limited access to skilled obstetric care. While socio-economic, cultural, and health system-related factors are well-documented contributors to maternal death, biological and anatomical influences, specifically pelvic anatomical variations, have received less attention. This study investigates the role of community-level anatomical variations, particularly pelvic morphology, in influencing obstructed labor, referral delays, and maternal mortality in rural Nigeria. Through a mixed-methods approach combining quantitative and qualitative data from six Nigerian geopolitical zones, the study examines the prevalence of pelvic anatomical types, the occurrence of obstructed labor, and the systemic delays in seeking and receiving appropriate care. The findings reveal that pelvic anatomical risks, particularly the prevalence of android and anthropoid pelvis types in certain regions, significantly increase the likelihood of obstructed labor. Additionally, delayed decision-making, transportation barriers, and inadequate health system infrastructure exacerbate these risks, contributing to high maternal mortality rates. This study highlights the need for targeted interventions that integrate anatomical screening with improved referral systems, community awareness, and enhanced health facility capacity to reduce maternal deaths in rural Nigeria.