Aisha Umaru, a 38-year-old mother of three, had her dreams of a perfect family shattered when a traumatic hot water bath experience left her with devastating burns. The agonising pain and emotional scars lingered, a constant reminder of the fateful day her dreams were reduced to ashes.
By Shafa’atu Suleiman
It has been two years after the tragic event, but Aisha’s wounds are yet to heal with her heart heavy with grief.
The hospital visits, the endless waiting, and the failed attempts to recover again had taken a toll on her spirit. The bitterness of her experience had consumed her, leaving her disheartened and lost.
Aisha’s ordeal began on a fateful Thursday morning, a week after Aisha’s third child birth, when Inna Fati, an elderly woman who had been assisting with her postpartum care, arrived with a different therapy.
Instead of the usual routine of massaging her stomach and other parts of her body with hot water, Inna Fati insisted that Aisha undergo a sit-bath, a treatment that would supposedly ease her postpartum pains. But unknown to Aisha, this therapy would become a nightmare she would never forget, a heavy heart Aisha told ASHENEWS how it happened
“A boiling pot of water was poured into a large container, and I was forced to sit in the scalding hot water, with my screams and pleas for mercy falling on deaf ears.” Aisha’s mind raced as Inna Fati’s words echoed hauntingly, “Endure it, my child, it was done to your mother.”
The scalding hot water felt like a branding iron, searing her skin and soul. The trauma of that moment etched a permanent scar in Aisha’s memory, a constant reminder of the cruelty and ignorance that had robbed her of her fertility and dreams.
The hot water bath, seen as a traditional remedy for postpartum pains, had become a tool of torture, leaving Aisha with physical and emotional scars that would haunt her forever.
When the ordeal finally ended, Aisha couldn’t walk without excruciating pain in her thighs and abdominal area. But everyone dismissed her concerns, saying it was normal. This is despite when boils appeared around her thighs and vaginal area within an hour making the pain became unbearable for her.
Aisha suffered in silence, too afraid to speak out, fearing further harm. Urination became an agonising task, and she endured the pain until the next day when Inna Fati returned to bathe her.
Inna Fati’s face contorted in shock and disappointment as she saw Aisha’s condition. Yet, despite the severity of her burns, Aisha was not taken to the hospital. Instead, she was treated with traditional herbs, which only worsened her condition.
It wasn’t until two weeks later, when her burns had become severely infected, that Aisha was finally taken to the hospital. The delay in medical attention had devastating consequences. Aisha’s burns had become severe, and she required extensive treatments.
What is a hot water bath?
Hot water baths are one of the ancient cultures of most people in Nigeria that involve the use of boiled water for women to bathe after child delivery. This bath is usually performed twice daily using leaves or a towel for 44 days depending on the culture. It is a traditional practice that is common among different tribes in Nigeria.
This practice involves the use of boiled water to bathe specific areas of the female body that have given birth to a new baby, particularly the lower abdomen and pelvic region. The belief is that these baths help alleviate postpartum pain, promote healing, and aid the uterus in returning to its normal shape.
The practice is done by pouring boiled water into a large container while the new mother is either made to sit in the scalding hot water or the water is applied to her body using leaves or a towel. This process is typically repeated twice daily for a period ranging from a few days to several weeks, depending on the cultural practices of the specific tribe.
Aisha’s experience is not an isolated incident. Research shows that 56.8 per cent of women in the North practise hot water baths after delivery, with 73.9 per cent willing to abandon it for alternative practices. While in the South 80.2 per cent of women use hot water compressors on the lower abdomen which they believe helps the womb to return to its normal shape.
The use of boiled water can lead to severe burns, infections, and long-term health complications. Common immediate risks include burns, dehydration, and headaches. Long-term risks include chronic skin infections, adhesion bands in the vaginal area, recurrent infections, chronic pelvic infections, and potential fertility issues.
Experts speak on the hot water bath
Saidu Isa, a medical practitioner from Gidan Dahala PHC told ASHENEWS that hot water baths are not advisable for women because they come with many complications and short and long-term effects. According to him, increased blood pressure, dizziness, and oedema are part of the complications that arising from hot water baths.
He said pregnant women who attend antenatal care are usually advised to stop the use of boiled water to bathe as it gives rise to many health complications.
Dr Jamila Garba, a Gynaecologist Consultant at Usmanu Danfodiyo University Teaching Hospital, in an interview with ASHENEWS, linked the practice of hot water baths to the cultural belief that a woman would always have a wound after child delivery and that the hot water may likely heal it.
The Gynaecologist, who is also the founder of ‘Beautiful Mind for Reproductive Health’ said hot water baths have both short and long-term negative impacts on women’s health. According to her, the immediate risks include burns, dehydration and headache, while in the long term, hot water baths can cause equipped chronic skin infection. And, in a situation where there are wounds in the vaginal area, it can cause adhesion bands.
“Adhesion band is when there is a wound in the vagina and the use of extremely hot water prevents it from healing or infection sets in so that poor healing blocks the back canal and affects penetration during coitus. It can also affect the flow of menstrual blood if the vagina is completely blocked. It can even affect the chances of getting pregnant. This condition is called Gynatresia in medical terms.”
She explained how hot water baths may also cause recurrent infection, vaginal infection, chronic pelvic infection and subsequent infection that may ascend upwards.
Garba told ASHENEWS that hot water may not directly affect the fertility of a woman, but the long-term complications, which she has mentioned, have a key role to play. She further explained how the adhesion barn can completely block the vagina and there will be no passage for the sperm, and as such the woman will not be able to conceive.
According to her, the use of contaminated water could lead to chronic pelvic infection, which will result in blocking the tubes. If they are blocked, the sperm will not pass and her eggs will not come to meet with the sperm. In the long term, it will lead to her inability to conceive.
But all hope is not lost, as, according to Garba, the injuries and infertility caused as a result of hot water bathes can be treated. “It can be treated. The most important aspect is for the patient to identify it at an early stage, and then it can be prevented.
“If it is presented at a time when the burn has just occurred, it is something that we can treat with immediate medical attention, adequate wound care, antibiotics and then the patient will not have subsequent complications that will lead the vagina to close up. So, if care is taken at the active stage when the burn has occurred, the long-term complications can be averted.”
She said in cases where it is presented late when the vagina is already blocked, a Caesarean would be done by a Gynecologist to break the adhesion bands, adding that it has to be a surgery.
“After breaking the adhesion band and making sure that there is communication between the vagina and the womb, dilators will immediately be used to prevent the walls from coming together. Then, the patient will be able to regain her fertility”, Garba said.
She established the fact that hot water baths cannot be completely abandoned at once because of the strong cultural hold that people have. Garba, however, advised that there should be adequate counselling and modifications. She also highlighted some measures including modifying the hot water instead of using very hot water, to be used.
“We advise them to allow the water to cool down. The water should be allowed to cool down to the extent that they can put their hands in it without having the urge to remove it. This way, the temperature is suitable for them to bathe with it and then if they want to sit in the water (sit-bath), they should use warm water with hypertonic salt.
“They should also have adequate hygiene because immediately after delivery is a time that women do have lochia (that is the bleeding after birth), which is normal. So, we educate them on perineal hygiene, changing the perennial pad at least four or six times depending on the frequency. But they should not stay with one pad for more than six hours because it can get soaked and bacteria will start growing and then infection can set in.
“Also, pelvic floor exercise is an evidence-based practice that helps to set the tone of the pelvic floor muscle. This is important because, after delivery, a woman might feel as if childbirth has caused the muscles to relax. Pelvic floor exercise will make a woman feel tight enough and not feel as if she is having prolapse of the uterus or the bladder”, she stated.
Garba emphasises the need to drink a lot of water, have adequate nutrition, light exercise, and breast care pointing out that all these are evidence-based practices that women should practise instead of hot water baths alone.