A Mother's Pain...

I’m struggling to find the words to describe what I experienced today… My heart is absolutely broken for the woman whose baby I attempted to help deliver. The day started off pretty slow and Lindsay, T and I all took notice of a young woman who appeared to be close to giving birth. As they ran off, I decided it was my turn to dive in and I gloved up just to be ready. I was anticipating a quick delivery as that is how most of the ones we’ve witnessed so far have gone. That definitely was not the case with this woman. It was her first pregnancy and as such, it was expected that it might take longer. As the nurse came over, I let her know that I’d never done this before and I’d like to help her. The nurse first had to break the membrane to help the labor progress. Once that was done, you could see the baby’s head and we all assumed that the actually delivery would soon take place.

Initially the nurse was there to help coach her as I couldn’t communicate, but after a few pushes and no progress, she left to attend to other women. A Tanzanian medical student, Lindsay and I were left to attend to this woman. The nurse checked back a couple times but didn’t really do much. After about 20 minutes or so, Dr Ishmael appeared. We all knew something wasn’t going right and tried to solicit his help, but he just told us that she likely needed an episiotomy and then he basically disappeared. For about the next hour, I continued to stay by her side amidst the chaos that continued across the rest of the labor ward. I tried to continue to encourage her to push and help her progress as much as I could and relax when she wasn’t having contractions.

Something clearly wasn’t right when she wasn’t making any progress and was getting progressively more tired. And yet, I couldn’t communicate with her, I lacked the experience to know what to do and the nurses and doctors were nowhere to be found. Finally, one of the nurses came over and gave her the attention that she needed. She encouraged her to push and tried to loosen and expand the birth canal to get this baby out. After waiting yet another 5-10 minutes, the nurse finally performed the episiotomy and pushed on her belly to help with pushing during contractions.

As the baby’s head finally came out, I tried to clean it up as quickly as I could. Then with one more push, the entire baby was out. Blue and lifeless. The nurses worked quickly attempting to resuscitate the lifeless infant. The cord was cut and tied and the baby was carried back to the newborn room where they could attempt to expand the lungs and try to illicit a response.

As the nurses attended to the baby, I continued to stay with the mother. She still needed to deliver the placenta. A shot of oxytocin and about 15 minutes later, everything was out. The intentional tear still needed to be repaired. I knew things weren’t going well for her baby so I continued to stay with her and do what I could to comfort her. As the nurse came over with sutures, I held the mother’s hand and tried to rub her shoulders and continue to comfort her. They gave her a shot of lidocaine to numb the area, but it clearly wasn’t enough as the mother writhed in pain at every stitch. Once the procedure was finished, I put a few more of her kangas on her to keep her warm and got her phone for her. Still no news of her baby.

I decided to give her some privacy as she started to dial on her phone. I assumed she was calling her husband. I walked to the other side of the ward and when I came back, she was leaning against one of beds sobbing hysterically. Someone had finally told her that her baby didn’t make it. I went over to rub her back. “Pole sana, mama.” So sorry. Even as I said the words in my meek attempt to comfort her, I knew they were not enough. Nothing could heal her broken heart at that moment for the baby that she had nurtured inside of her for nine months. It was to be her first. I prayed a silent prayer over her asking God to bless her with many more children and uncomplicated pregnancies and deliveries with healthy babies. Although something told me that this child would never be forgotten and her heart will always carry the scar of her first.

After that, we all needed a breather. Hearing the broken-hearted sobs of this woman was more than we could bear. We stepped out and took a walk to attempt to deliver some surgical supplies to Dr Lee. When we couldn’t find him, we decided to give them to one of the doctors standing near the Ob/Gyn operating theater. They needed supplies too. Everywhere needs supplies.

We tried to talk through what had just taken place. Sadness for the mother and her baby that didn’t make it. Frustration that the nurses hadn’t paid more attention to her. Questioning whether or not there’s something we could have done. Maybe with more training, we could have done more. Maybe if one of the nurses had actually paid attention to our pleas for help, the baby would have made it. So many ifs and no answers. But what if we hadn’t been there? Would she have been worse off? What about the other mother’s? Would there have been more complications of other births?

So many questions that lay unanswered and yet we know that all we can do is continue to be present; to comfort the mothers as much as possible. One pair of hands is still one more than they have without us. Even if it’s just one mother that we get to help, comfort or console, it is enough and our presence is worthwhile.