Overwhelmed and overstretched...

It is Thursday morning and I'm quickly posting to the blog before heading to the hospital for the day. We are going in a wee bit later today, partly because Cathy has some admin work she needs to do and partly because the last two days were intense and having a later start seemed like a wise idea.

Two days ago we lost a mother - the woman's seventh pregnancy. She had taken some herbs in the village to stimulate her labour. When she came into hospital, at 9 cm dilated, her uterus was ruptured. The babe was already gone. She was taken to surgery but she had lost litres of blood and continued to lose more during the surgery. Anne-Marie observed and assisted at the surgery, so perhaps she'll want to write more about it. In the end, she had a hysterectomy but she had lost too much blood and she died shortly afterwards, leaving six children at home with no mother.

Yesterday morning, the first birth of the day for me, I caught a stillborn babe. This wee one had been dead for some time - we could tell because of the very strong smell and strange colour. The mother was infected we think, because her membranes had been ruptured for some time, but she also has a very narrow pelvis as the head was incredibly molded, far more so than would be normal for a live baby. This was the third baby she'd lost, the other two dying at one day of age. She is only 21 years old. Her cry as she realized that her baby was dead was heart-wrenching - her face keeps flashing through my mind's eye and I find myself welling up with tears at intervals as I think of her situation. She was berated by her mother-in-law for losing another baby. What will happen to her? Mickey (Cathy's husband, a family doc) had to do a D&C for her late in the afternoon as her uterus wasn't remaining contracted very well and she was shocky and feverish. I hope she isn't septic. He said there was a fair amount of retained tissue in her uterus.

I am feeling so angry at the discrepancies in care between the developed and developing world. I've always known that life isn't fair, but this just seems criminal. There just aren't the resources for women in rural areas to receive proper antenatal care, for transport to larger centres when things go wrong, for basic supplies like gloves and razor blades, antibiotics. Oh, it's just so hard. And so difficult to not speak Lugandan and thus not be able to really support women well, to speak with them in their own language, to celebrate with them and grieve with them. I am so frustrated with myself when I can't communicate a simple message to a mama.

Must go. We did have two lovely normal births yesterday - two primips, no tears, both very happy with their first-born babes. I also got to feel a breech presentation and a face presentation, both of which went to C/S, with live babes and healthy moms at the end. We visited a 97 year old Traditional Birth Attendant yesterday afternoon, who still delivers about 10 babies a month, despite having broken her leg 7 months ago. She was wonderful. I will post a picture when I next have time.