Wednesday, July 21, 2010

Babies, Babies, Babies!

I know, I've been bad about updating again. I just keep getting distracted by babies. Healthy babies and sick babies and preemies and chubsters and all those in between.

This past Wednesday was the busiest day I have seen in the hospital thus far. The North American group (Lauren, Harrison, Randi, Dawn, and myself) spent almost all day downstairs in the maternity ward. When we first went down in the morning, we found the hospital's lone incubator running at 200% capacity being shared by a preemie (28 weeks) that had arrived after being delivered at Group hospital and a Meconium Aspiration Syndrome baby born at Edna's in the middle of the night.


Most of Wednesday was spent monitoring this little guy and girl. Unfortunately, the little meconium boy had several seizures and needed one bought of resuscitation. The past days have seen improvements in both babies! The preemie slowly started to gain strength moving from NG tube feeding to sucking some from an NG tube. The mother's case is one of the saddest I have seen. This was her 7th and only living child. For every single pregnancy she has gone into labor around 6 or 7 months and her babies have all died shortly after birth. This little baby girl seems to be a fighter but she is still so tiny. Both mother and baby have been discharged. In the U.S., this baby would remain in the NICU for another month. Here, she is discharged because she is to a point where continued care in the hospital is expensive and the baby girl does not have to remain in the incubator with oxygen or an NG tube. Before she left, we found out her name is Ayaan. This is the first of her babies she has ever named.

The meconium baby boy has also seen improvement and was discharged yesterday. He slowly progressed from NG tube feeding to sucking from a syringe to breast feeding. There has been continuous discussion about his care and the possibility that he has brain damage. None of us much doubt that this baby does have brain damage, as he underwent a bit prolonged period of CPR and had some other hypoxic periods. The discussion has been whether doing resuscitation was beneficial to this baby. My immediate thought is that of course it was because it saved his life. However, the family of the baby told us that if Allah takes this baby that they would just try again and have another child. The perspective here is very different where some children and babies are expected to die. It can be hard to swallow this idea that it is okay to let one slip away because others will be born (undoubtedly with an average of 7 children per family) to replace those that were weak. He has been discharged home without any of us knowing what his mental capacities will be.

On Sunday, I meandered my way down to the maternity ward after teaching a morning English class to find the cutest little boy in the incubator. Normally, the incubator here means sickness or some problem. Turns out this adorable little baby (sorry I didn't get his picture before he left) had been born on the street. A multip who was at term had decided her labor pains might be starting and decided to walk to the hospital. About a block or two from Edna's, she realized the baby was coming NOW and delivered her own baby on the front steps of a random person's house. Another passerby ran on to the hospital to take a midwife back to help the woman. While the mother remained at the house of the woman's doorstep she delivered on (they didn't know each other prior to this encounter), they brought the baby back to be redressed and warmed. With not a single relative in the hospital with the baby (quite a rarity...as in I have never seen a patient without at least one relative in tow), the student midwives and staff kept claiming the baby. All morning was spent with random nurses and midwives coming in to see the cute little baby and claim him as her own. A relative finally did come a few hours later to take him home.

There has been one Cesarean section per day for the past three days. On Monday night, I stayed up (it didn't start until 11pm) to "catch the baby." One nurse or midwife always scrubs in and is responsible for taking the baby immediately after the doctor pulls him/her out of the mother's uterus and carrying the baby to the adjoining resuscitation room. In the next room over, Harrison and I did the immediate afterbirth care (suction, warming, chord ties, vitamin k, eyedrops, etc.). This little baby boy needed a little bit of positive-pressure ventilation to start breathing, but he pinked up pretty quick.

Today, a chubster was born. It was the woman's eight delivery and came out super fast. It is crazy to see these women who have had so many children who can progress in labor and deliver so rapidly. Her baby boy was 4.5kg (9 lb. 9 oz.). I always love the fat babies because I was such a chubster at birth myself. :)

Yep, so my week has been filled with babies and babies and more babies. Other things have been happening too (I just like the babies the most). The maternity ward has definitely been staying full the past week. We have a woman in congestive heart failure who is 35 weeks pregnant....not good. There is woman with eclampsia who arrived this evening semi-conscious. Dawn and Randi have now left, and several new volunteers have arrived (Blaine from Ethiopia, Fatima from Kuwait, and Michelle from Australia). And this Friday (Somaliland weekend), we are planning a trip to Berbera to see the beach! It will be nice to get away for a little bit. And a week from Friday I fly home...it is rapidly coming to an end. It is crazy how fast time can fly.

1 comment:

  1. You chubster, you! Yay for babies! And I'm sure that trip to the beach will be nice...take lots of pictures!

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