Today was stunning in its chaos, challenges, and joys. I will try to give a quick run-down. Thankfully I started with my therapy—a good long swim—so that when I needed it most, I had already had it!
I went in to the ward today (yes, that’s me using the word “ward” but there just isn’t another word for it here!) and walked in on a delivery of a healthy boy to a young mother. I helped settle her and the baby—babies and mothers are left alone with the baby sin-to-skin for an hour before they are moved to the postpartum area and given meds.
The board seemed quiet so I went to have a look at the Nursery babies. Twin B born two days ago had passed away during the night. Three of the respiratory distress babies seemed to be doing well and one had a note on its incubator that breastfeeding had been successful overnight. Our 1100 gram baby (just under 2lbs) was looking very unwell. The mother was sitting next to the incubator crying. Expressions of affection are different here so while in America I would have put my hand on her shoulder, here I stood close to her but did not touch her. The baby was declining fast and she got up and started to walk out and nodded to me to come with her. I followed her into the outside corridor, knowing that none of the technology we have within relatively easy reach at home would be wheeled in to save this baby. It is kind of maddening and mind-blowing to understand this and it pushes the loss beyond sad and into bitter. But for this mother, I just wanted to meet her where she was at and be with her in whatever way she needed. Her husband had left crying and I assumed he was nearby but I could not see him. The mother and I locked eyes and hers welled with tears, fear, and sadness. So much sadness. I nodded my head slightly at her and she collapsed in tears in my arms and wept very hard for about two minutes. She then took a deep breath and walked back in the corridor, past the 12 beds of new mothers with healthy babies and into the nursery, where her husband sat waiting for her. The baby died shortly thereafter—I was upset that they were not allowed to hold their baby as he died, it was awful seeing them separated by scratched and discolored plexiglass.
Within moments their families arrived and they were given one of the private birthing rooms to hold their baby and be with their family. There was a tremendous wailing and mourning not 10 feet from the postpartum area and the grandmothers and some of the mothers in there stood up and walked close without going in.
I stood quietly in the hall when suddenly a woman came running out of the bathroom calling me “sistah, sistah, she go feint!” A woman had fainted while trying to use the bathroom. I scooped her up, a puddle of blood beneath her and opened her IV so it would drip fast. She came to nicely and just like American women when they pass out, she woke up confused and oddly cheerful. Another midwife brought a wheelchair and we put her in it, brought her back to the delivery room and dealt with her boggy uterus. She looked much stronger after 20 minutes and we cleaned her up and started her back to her bed. I went to check on M, the mom who had delivered just after I walked in. There was a circle of blood on her top sheet which was odd. I lifted it to have a look and sure enough, there was a very large pool of blood under her. Must be the day for it. I had her lie flat and massaged her uterus into submission which gently calling for assistance. Her IV was out and finally a midwife came and switched it out for a new one and added some Syntocin (synthetic pitocin) and somewhere between my rubbing and the meds her uterus behaved. It was decided she should rest with her baby an additional half hour.
A fourth-time mother I had been watching labor for a few hours decided that would be the right time to push her baby out. Hers was the first husband I have seen involved in the labor—he had been with her rubbing her back and giving her water for hours. He told me he was done “OK” and patted me on the back on his way out of the ward. He was jittery and nervous. Mom delivered quite quickly. There is no fanfare or ritual like we have…waiting for the mother to discover the sex of her baby by looking herself? No way. Husband or loved one cutting the cord? Nope. I went to find the dad and told him mom was good and baby is healthy and strong, congratulations. He asked me “smol boy o smol girl?” I told him, “com see. you com look.” This quite disturbed him and he repeated his initial question. “Ok,” I said, “Smol Boy!” Well that was one proud father—he had three girls at home. He clapped me on the back hard several times while grinning from ear to ear and repeating “smol boy! smol boy!”. We walked right past the now 30 or so people gathered and mourning the loss of their baby and he came in and joyously greeted his boy. Later he came and found me and told me the boys name. I have to find out if it means something special…it is a name I have not seen here.
I went to check on a recently discharged-from-the-Nursery baby who is staying with mom at the hospital until she reaches 2 Kilos. She is so darn teeny and cute. Her mom dresses her in all hot pink and she seems to be doing very well, indeed.
I had a talk with the head midwife here about Kangaroo Care—which is the technical term for “holding a baby” that has been proven since the 90’s to severely reduce mortality rates. Babies are held skin-to-skin in an upright position on mom’s or dad’s chest for as long as possible. Ideally the parents provide this care, and it has been shown to improve the mental health of parents, but substitutes work just as well. It helps regulate baby’s heart and respiratory systems as well as their temperatures. Kangaroo care is the first best option even in developed countries, but here it would seem of paramount importance to provide this care for premies. She said this is on her list…which is decidedly long…and asked if I would put together some research to present to the baby docs so I will work on that this weekend .
I was getting used to the fact that it is hot and sticky all the time until I skyped home tonight and saw my clean, climate controlled house with couches one can just relax on without worrying about bugs…