I chose to tell this story to bring to light how we need more health workers equipped with the right skills and knowledge out in the rural areas. I also chose this story to bring across the importance of family planning services in the rural areas. Having 5 children is a tad bit too much in this day and age.
It was an ordinary afternoon at the labour ward, where I was working a few weeks back. We were working with mothers in labour, managing cases as usual. We usually got a number of referrals in a day, but sometimes none at all. We had a mobile phone at the ward that all the health centres in rural areas around Morobe could reach us on in case of an emergency.
That afternoon, we did not receive any calls from outlying health centres. We were not expecting any emergencies.Nevertheless, we heard loud voices outside and then a mother was pushed in on our only surviving wheelchair. Yes, the labour ward has only one wheelchair, you read that right. Her story? Well here’s bits and pieces of her story.
This mother was in her 5th pregnancy. She was brought in by boat from Salamaua, a small town that’s roughly 40km away from Lae and only accessible by boat and other watercraft. She was in a great deal of pain. She kept telling me and my boss and the nurses that she had been in labour for 4 days. I knew she wanted to get this across because she wanted us to do something to help her.
This mother still had white sand stuck on her hair and down her back, from where she must have been lying down, somewhere out near the sea in Salamaua, probably waiting for the boat to pick her up and bring her to Lae. Despite having good contractions, the baby was stuck way high up in the birth canal. She had to endure 4 days of pain, before she could reach help. Why 4 days? Well, the sea was a bit angry and it was unsafe for boats to be in the waters. I am not sure if Salamaua has a functioning health centre, and never got around to asking her.
Upon checking the mother, we discovered that her cervix was fully dilated,meaning it was 10cm in diameter and ready for the baby to pop out. However, we could feel that instead of the baby’s head being placed in the occiput anterior position, it was rotated a bit. The baby’s head was in the occiput transverse position. At that point in time, we could still pick up a very good fetal heart beat. This reassured us to go on and do an instrumental delivery with a vacuum extractor.
It was quite a difficult task as the mother was already distressed from labouring for 4 days. She was basically too exhausted to help us by pushing efficiently.
My boss set about positioning the vacuum cup and we set about pulling on the baby with contractions. It was quite a difficult task as the mother was already distressed from labouring for 4 days. She was basically too exhausted to help us by pushing efficiently.
Eventually however, we managed to get the baby out. It turned out the baby was abnormal. It had multiple congenital issues, including a mishapened head which was quite big.
The baby had a poor outlook. We explained that to the mother who took in stride. The mother recovered and the baby was taken to the special care nursery. The baby went under the care of the paediatric team.
Now you may ask, why this story? Well, I chose to tell this story to bring to light how we need more health workers equipped with the right skills and knowledge out in the rural areas. I also chose this story to bring across the importance of family planning services in the rural areas. Having 5 children is a tad bit too much in this day and age. Also I want to elaborate also on a much more advanced health care level – what if these abnormalities in the baby were diagnosed in-utero? Would the woman go through all these trouble to eventually bear an offspring that’s basically a vegetable?
So while people complain about health workers being impolite and rude and always in a rush, its good for these ‘people’ to put yourself in those worker’s shoes. Why are they always hurried? Why don’t they smile too much? And sometimes “people” need to be grateful they at least get health care, while a mother labouring for 4 days out in Salamaua has no one to even assess her cervical dilatation. She is alone, with village birth attendants whose only health training may have been baby delivery taught to them from older village birth attendants.
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