Family structures and healthcare decision-making in many Nigerian communities are relational and communitarian, with care, shared understanding, and togetherness as common.[1] Once a woman becomes pregnant in this system, she mostly receives the support of the elderly members of the family, who piece together information from their own experience as a template for ensuring she has a safe delivery. This is usually accompanied by spiritual preparations, including prayers and novenas. In typical Nigerian Christian homes, these prayers for the safe delivery of the mother and the baby often contain the following lines: “you will deliver like a Hebrew woman,” and declarations such as: “[Having a] Caesarian Section (CS) is not your portion”. This use of the biblical description of the Hebrew women, as expressed in Exodus 1:19, has moved beyond its original narrative context in many Nigerian Christian communities and has become a prescriptive cultural ideal for childbirth. To “deliver like the Hebrew women” in these communities is celebrated as delivering vaginally. At the same time, those who undergo CS may face stigma and subtle or explicit questioning of their faith, strength or womanhood.
This has created a hierarchy around childbirth where vaginal delivery is often perceived to be superior, and contributes to cases where some women delay or refuse medically indicated CS. These decisions have contributed to preventable maternal and neonatal morbidity and mortality, together with cases of birth trauma, brain injury, prolonged obstructed labour, as well as other psychological distress. The irony in all of this is that, if a Hebrew woman in today’s world living in Tel Aviv, for example, goes into labour in a well-equipped hospital and is supported by skilled professionals, has emergency care on standby, while the Nigerian woman in labour anchors her faith strongly to deliver like the Hebrew women, the actual Hebrew woman receives emergency care, gives birth and is discharged within a couple of days. The Nigerian woman, on the other hand, may experience prolonged labour in a maternity home and after hours, leading to days of labour in pain and faith; she may pass away, and her baby may not make it either.
This paper is charged with arguing to show that this prevailing interpretation of the Hebrew women narrative does not represent an ethically ideal position, but rather a problematic appropriation of Scripture that undermines the dignity and well-being of mothers and their infants. It is important to show that, in the paper strategising to accelerate the reduction of maternal mortality in the African Region[2]. Dr Owen Kaluwa, WHO Representative in South Africa, reported that obstructed labour amounts to one of the major factors that account for almost 50% of maternal deaths. Most recently, the WHO, in its write-up, Maternal Mortality,[3] reported that approximately 260,000 women die during or following pregnancy and childbirth in 2023 and stated that about 92% of these deaths occurred in low- and middle-income countries, with Sub-Saharan Africa and Southern Asia together making up 87% of that percentage. Additionally, a WHO-led study[4] that involved Nigeria, Ghana, and Guinea-Bissau equally found that 42% of 2,016 women experienced physical or verbal abuse, stigma and discrimination or other forms of maltreatment during their childbirth.
An important ethical question is raised for Christian communities: how should religious interpretations of childbirth be evaluated when they may influence the decision of a mother about medically indicated care? This concern is not aimed at opposing faith or religious conviction, but calls for the examination of interpretations of scripture and how they can unintentionally contribute to decisions that may place maternal or fetal life at avoidable risk. The question is equally paramount in these communities because religious beliefs often shape perceptions of childbirth, medical intervention, suffering and the exercise of personal agency. Hence, Catholic theological ethics becomes a necessary framework for this examination, as it places human dignity and responsible decision-making at the centre of its moral reasoning.
Although Catholic Theological ethics does not provide a specific teaching that states women must undergo CS or not, rather, the Catholic moral teaching provides principles that can be used in evaluating a medically indicated CS, confirming its position as assenting to the sanctity of maternal and foetal life, proportionate medical treatment, informed consent, parental responsibility and the dignity of women. Hence, the Catholic position begins from the understanding of the equal dignity of human life, Donum Vitae[5] This is particularly important for this argument since a medically indicated CS cannot be understood as an attack on the natural process of childbirth but as a therapeutic intervention that is aimed at preserving the health and/or lives of the mother and the child.
In Donum Vitae, the Congregation for the Doctrine of Faith explicitly recognises that medical or surgical interventions can be morally legitimate when they are therapeutic, respect the dignity of the human person and do not involve disproportionate risks. Therefore, indicating that there is nothing intrinsically immoral about caesarean delivery, since this principle extends to obstetric surgery. Thus, the Nigerian belief that accepting CS somehow demonstrates inadequate faith in God’s power becomes flawed and the whole discussion on the delivery, like the “Hebrew women” idea, becomes particularly interesting since the Catholic moral theology does not teach that trusting God means rejecting medicine.
It is in fact important to show here that the Church understands healthcare as a legitimate human participation in the preservation of life.[6] Pope Saint John Paul II, in addressing the International Healthcare Conference of 1997, describes healthcare workers as those saving life and collaborating with God, whom Scripture presents as the lover of life.[7] Pope Francis extends this description in his message to mark International Nurses Day 2020 by referring to nurses and midwives as particularly “guardians and preservers of life”, and specifically addresses midwives by describing their vocations as among the noblest professions because it directly operates in “the service of life and of motherhood”.[8] The theological argument, therefore, is that faith in divine Providence and acceptance of appropriate medical interventions are not necessarily contradictory. Christian women should be allowed to pray for safe vaginal delivery while being encouraged to simultaneously accept CS if competent medical professionals determine that it is necessary, as this theologically does not translate into a lack of faith but can be understood as one of the ordinary means through which human beings exercise responsibility for the life God has entrusted to them.
In the end, this paper argues that there is no need to construct a hierarchy of good or less birth; instead, it proposes an ethics that recognises all medically appropriate childbirth as an equally valid and authentic expression of the mother’s courageous stewardship and her participation in God’s gift of life. Thus, the paper challenges harmful childbirth narratives around CS and advances a life-affirming ethics that safeguards maternal dignity and understands that the stereotypes associated with CS and the refusal of medically indicated interventions may expose the mother and baby to serious harm. Such refusal may rest on misinformation, underscoring the need for health workers to provide truthful information that can help in correcting these misconceptions. In cases where this refusal is based on fear, medical counselling should be followed with appropriate pastoral and psychological support. Where refusal is based on religious belief, it is important to register in the minds of the people that religious beliefs should be respected only within the context of religious freedom and personal dignity. Hence, religious convictions should not be presented as necessitating the rejection of legitimate medical care, especially when the proposed intervention is proportionate and is directed towards the preservation of life. In this regard, the Catholic ethical response will call for neither coercion nor uncritical acceptance of refusal, but rather will preference compassionate accompaniment that prioritises the protection of both maternal and fetal life.
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[1] Onyemaechi, C., Onwudiwe, A., & Sunday, A. (2025). Community support as a buffer against economic stress: Strengthening mental health resilience among Nigerians. Journal for Social Sciences (JSS), 2(2), 337-350.
[2] World Health Organization Regional Office for Africa. (2022, April 29). Strategizing to accelerate the reduction of maternal mortality in the African Region. World Health Organization.https://www.afro.who.int/news/strategizing-accelerate-reduction-maternal-mortality-african-region?utm_source=chatgpt.com
[3] World Health Organization. (2025, April 7). Maternal mortality. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality?utm_source=chatgpt.com
[4] World Health Organization. (2019, October 9). New evidence shows significant mistreatment of women during childbirth. World Health Organization. https://www.who.int/news-room/detail/09-10-2019-new-evidence-shows-significant-mistreatment-of-women-during-childbirth?utm_source=chatgpt.com
[5] Congregation for the Doctrine of the Faith. (1987, February 22). Instruction on respect for human life in its origin and on the dignity of procreation: Replies to certain questions of the day (Donum vitae). Vatican.https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html?utm_source=chatgpt.com
[6] Kelly, D. F., Magill, G., & Ten Have, H. (2013). Contemporary Catholic health care ethics. Georgetown University Press.
[7] John Paul II. (1997, November 8). Address of His Holiness Pope John Paul II to an International Health-Care Conference. The Holy See. https://www.vatican.va/content/john-paul-i i/en/speeches/1997/november/documents/hf_jp-ii_spe_19971108_pastorale-salute.html?utm_source=chatgpt.com
[8] Francis. (2020, May 12). Message of His Holiness Pope Francis to mark International Nurses Day. The Holy https://www.vatican.va/content/john-paul-ii/en/speeches/1997/november/documents/hf_jp-ii_spe_19971108_pastorale-salute.html?utm_source=chatgpt.com