Mother with PPH

Labor Room: Jan 7th/2011

First time working in the labor ward with our new staff. It felt totally different entering the hospital this time. New staff, new year, a new beginning all around. I’m also starting to feel more comfortable and confident being there. Especially in the labor ward. It feels like home. Strange, but true. I love it! I feel like I sort of have a grasp on what to do while I’m there. Both bek and sarah were there as our staff. We all got ready, prayed together –asked God to bring life, peace, and hope over that ward, and the hospital as a whole –and broke up into pairs to begin checking on the women that were there. Was quite slow to begin with, but it turned out to be a crazy morning. I started on one woman. She was 28 years old and it was her sixth pregnancy! I am always amazed by the societal/cultural differences when I’m working in the hospital. We see girls as young as 14/15 -- the majority of them being in their early twenties. It is evident that a woman’s worth, value, and status are often wrapped up in her ability to bare children. I’m realizing that this is why maternal health is such a huge concern in the developing world. It all comes down to the extreme and rampant undervaluing of women. When women aren’t given the same opportunities and privileges that men are, such as education, work etc, --they are ultimately (or often) limited in what they can contribute to their societies and communities. This leaves them with their uterus being their main contribution and their only source of worth, meaning and value. A woman’s significance is bound up in her ability to bare children and this can sometimes be a problem. I mean, of course there is nothing wrong with having children… or many children for that matter. But when you are living in extremely impoverished conditions and you are limited in your ability to provide and care for numerous children, it is often unwise to be having so many. Here, it is almost like a status thing for a woman to have children. One of the first questions people often ask here is regarding the number of children you have quickly followed by “Are you married?” and it is no coincidence or accident that the questions are asked in that order considering the fact that it is very normal for women to have children outside of marriage.

 Anyways. I’m getting off topic. I spent probably an hour or so with this one woman and started to really connect with her. I went to the canteen and got her some water and just stayed with her through each contraction, monitoring and trying to bring comfort and peace. At some point, there was a woman across from us who starting screaming for a nurse –the kind of scream that indicates that the baby’s head is coming. I rushed over and called for Bek or Sarah to join me. Sarah came over and there was also a male and female doctor there. I knew it was going to be a challenge doing the delivery with so many people giving different input. The mother was being coached and yelled at in Swahili by the two doctors and I of course didn’t know what they were telling her to do which made it challenging for me to do the delivery because my main role became just catching the baby without being able to talk the woman through each contraction, each push. She was a very large woman and it was obvious that the baby was going to be large as well. My first three deliveries have been primigravidas so it was very different for me to deliver a woman who had had previous pregnancies. Not quite as challenging or seemingly impossible. For some reason, the doctors and nurses here seem to be of the belief that every baby is in distress and they make it their goal to get him/her out as swiftly as possible. They were shouting at her to push while I was thinking that we should allow the birth to happen more gradually and give the woman the chance to rest and recover in-between each push and contraction. It all happened so fast. Too fast. The head was out within a couple of minutes and the doctors continued to yell at the woman and at me which only made everything worse. I had three different people saying different things to me in different languages and it was difficult to know which voice to listen to. Once the head had come I pulled the remainder of the body out and placed the newborn boy on his mother’s belly—he was breathing and crying normally. Praise the Lord! The process of delivering the placenta proved to be a challenge since the two doctors continued to give their input. For some reason they seemed to be in a hurry to get that process over with as well. Sarah and I went back and forth discussing the delivery of the placenta. The hospital was out of oxytocin this week but one of the doctors managed to find one vile which she injected into the woman’s thigh. I stayed and patiently performed controlled cord traction—continuing to check the tautness of the cord. It was obvious that her placenta had not yet fully detached, and we were in no hurry to get it out –we still had time. Five or ten minutes in to the process, the female doctor came over and abruptly took over. She firmly pulled on the cord until it finally began to tear. I wasn’t sure what to do so I just sort of stood there and watched expressing my concern about how much she was pulling. The woman very quickly started losing blood from the site of the tear. The doctor then decided to reach her hand into the woman’s vagina and manually remove her placenta. A very violent procedure for something that could have been done in a more natural and gradual way. After that was over I checked her for tears –thankfully there were none. But by then, tearing was the least of our concerns. She continued to lose liter upon liter of blood for the next half hour or so. Her placenta had not been given the proper amount of time to detach and so there were many retained clots and bits of membranes still inside of her. It was horrific. I don’t think I’ve ever seen so much blood in my life. She was literally laying in it, up to her shoulders, and it began to steadily flow off the bed and on to the floor. At that point, Sarah and I were on our own in an emergency situation with a woman’s life on the line. We both took turns firmly massaging her uterus and removing many clots. The bleeding did eventually stop and the woman was ultimately okay but it was a very nerve wracking process made even more difficult because it could have been avoided if it wasn’t for the fact that someone else decided to intervene and rush the process.

fourth delivery.

After that, it proved to be an incredibly busy morning. I assisted with three more births. There were babies popping out left, right and center. I was very aware in the midst of it though how peaceful and calm the atmosphere was. I was encouraged by the fact that we seemed to be bringing the peace instead of giving way to the chaos and stress of the hospital environment. The mother I had been with at the beginning of the morning delivered a baby with no heartbeat. I stood and interceded on behalf of this child as Amy and Beck did resuscitation. We all prayed with passion and a demanding fervency. My prayers were simple, to the point and filled with desperation for God to intervene and do a miracle. They were able to get his heart going through chest compressions, but he still wasn’t breathing on his own. I felt confident that he would live and had this feeling in my spirit that God had a specific plan and purpose for this child’s life. That he had dreams and plans that he wanted to accomplish on the earth through this particular life. As we carried on with our unrelenting prayers and they continued pumping air into his tiny lungs, he finally began gasping for air on his own. We cleared his airways and he began to cough and breath more regularly. We literally saw God bring this boy back to life! So extraordinary…