It has been quite busy on the wards, this week especially. I believe Jan has written about some of the crazy days we've had so I think I'll will write about the first stillbirth I attended.
When we came in Tuesday morning Georgia would not find a fetal heart on one women. By the way, here we use the pinard horn or and Allen fetoscope to monitor fetal hearts--no such luxury as the doppler. Anyway, so many of us listened and nobody could hear a fetal heart. The woman was sent for an ultrasound and it was confirmed that the baby had died. It was really sad for all of us to hear this news nad I image heartbreaking for this mom who had carried her baby to term and though she was coming here to birth her baby. The mama also had a fever by now. A blood smear was done to test for malaria which came back negative. Her membranes had only just ruptured the day before, but I guess the most likely cause of this baby's death was an infection (chorioamnionitis).
We put up an oxytocin drip to bring on contractions. This was in the late afternoon. She was also started on antibiotics. She evenutally started pushing spontaneously and by 5:30 she delivered a beautiful baby girl. She was perfect. There were no defects--nothing else to explain her passing away. Grace was with me and incredibly supportive as I did the catch and then brought the babe up to her mom's chest, which is what she had requested. I helped the mom hold her baby there for some time. I told her how well she had done and how strong she was and how sorry I was for her loss, and just stayed with her for some time. I then brought the baby to be weighed after which I gently placed the baby's limp arms across her chest and carefully wrapped her in a large forest green cloth and offered for the grandma to hold her but she declined, so I placed the baby on one of the tables on the ward and then went to say goodbye to the mom. Both she and her mom expressed thanks for our care.
As emotionally difficult as this birth was, both Grace and I were thankful that we were able to be there with her.
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UBC Students for Global Citizenship
The Midwifery Education Program at the University of British Columbia (UBC) has created a global midwifery placement option for students. This year, two midwifery faculty members and a family physician will accompany the students for part of their practicum and then local midwives, nurses and physicians will continue supervision.
For the past 4 years, UBC Midwifery students have participated in this 6 - 8 week global placement at the end of the 3rd year of their midwifery education. This year Midwifery is pleased to have colleagues from Medicine and Nursing join us.
In these placements students attend births and experience the ways that health care workers deal with normal and difficult births in a low-resource setting. These skills are especially relevant to student accouchers as they prepare to respond to the critical shortage of skilled maternity providers in rural and remote areas of British Columbia. In exchange, students and faculty share ways of practice taught at UBC with the global midwifery community.
Students return energized by their global experience and have a deeper understanding about women’s health issues, women’s rights and birthing practices, and with new friendships across borders.
Uganda. Maternal mortality is high in rural Uganda. Over 510 per 100,000 women die in childbirth. There are few trained attendants to assist women in childbirth, and transportation problems as well as social customs prevent many women from attending health centres and hospitals for deliveries. Those who attend hospitals for delivery often have risk factors and complications rarely seen in Canadian maternity practice.
Students and faculty take donations of gloves, delivery instruments, medication to prevent and treat hemorrhage, and academic articles and books on continuing education topics. Midwifery faculty work in collaboration with local staff to present continuing education topics on maternity subjects requested by the local nurse-midwife managers and medical directors. This year we raised funds to buy supplies for maternity wards and to bring a Ugandan Midwife to B.C. for an educational visit this past April.
For the past 4 years, UBC Midwifery students have participated in this 6 - 8 week global placement at the end of the 3rd year of their midwifery education. This year Midwifery is pleased to have colleagues from Medicine and Nursing join us.
In these placements students attend births and experience the ways that health care workers deal with normal and difficult births in a low-resource setting. These skills are especially relevant to student accouchers as they prepare to respond to the critical shortage of skilled maternity providers in rural and remote areas of British Columbia. In exchange, students and faculty share ways of practice taught at UBC with the global midwifery community.
Students return energized by their global experience and have a deeper understanding about women’s health issues, women’s rights and birthing practices, and with new friendships across borders.
Uganda. Maternal mortality is high in rural Uganda. Over 510 per 100,000 women die in childbirth. There are few trained attendants to assist women in childbirth, and transportation problems as well as social customs prevent many women from attending health centres and hospitals for deliveries. Those who attend hospitals for delivery often have risk factors and complications rarely seen in Canadian maternity practice.
Students and faculty take donations of gloves, delivery instruments, medication to prevent and treat hemorrhage, and academic articles and books on continuing education topics. Midwifery faculty work in collaboration with local staff to present continuing education topics on maternity subjects requested by the local nurse-midwife managers and medical directors. This year we raised funds to buy supplies for maternity wards and to bring a Ugandan Midwife to B.C. for an educational visit this past April.
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3 comments:
jan...and 'all' i am so enjoying hearing, as you are there, what life is like for you these days in uganda. some of what you say brings back memories of the month i spent in mazambique only 8 months after they were out of civil war. the lack of such basic things that we take for granted in our daily life can be hard to understand and certainly sounds like you are all doing a wonderful job of discerning when is the time to use the supplies you brought with you. compassion and caring - things we all need to be shown at times in our own lives and you are giving the gift of teaching that to those you are privildged to care for, work with and YES be mentoring while you are there. the conditions written of in "birth and death" are hard to imagine from here in canada but i know that what you are seeing and experiencing will affect how you care for women in childbirth when you are back home. so much to take in, learn from, teach through your actions and YES, enjoy along the way.. like the monkeys as you were walking to work. when you are home so much of it will feel like a dream but you are blessed to have each other to share this experience with and to help each other 'adjust' when you come home. bless you ladies as you give of yourselves to others and in turn will be blessed for doing so. hugs to you jan... i want to hear ALL about it when you get home and trust there will be an evening or 'event' planned for you to tell all and show pictures(that you are so good at taking) of your time in uganda. love you ~ dena joy
hey you wonderful women!!! such mixed feelings come up for me as i read through some of your blog entries here. i'm still confused a year after being in your shoes, but hope that you can find the strength and clarity to move through this experience with as much grace as you can be granted! i know that the women in your care are so blessed to have you there...keep working from your hearts!!! much love is coming to you from dawson, yukon...under the midnight sun. anne-marie
oh Lydia, that makes me cry....
I have been so busy with my little one I haven't had a chance to respond...so sorry. Yes, mattress sounds wonderful, it's so nice to know so little can help so much, wish it was more....
was wanting to ask, if you have a spare moment of head space, I am wondering how babies are put to sleep in other countries, expecially the ones that don't like to sleep! I can't imagine them crying it out, and if they all co-sleep, how in the world do they get them from not crawling away? and what time? If it comes up in conversation or observation, I would be so grateful for any info. Thanks so much...but of course don't give it a second thought if it doesn't happen...and keep up the heartfelt wonder..xx
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