Only one week left...

The baby catching continues at Villa Central Hospital - April is the busiest month being that it is nine months from Vanuatu’s Independence Day. Lately there have been a lot of very quick labors. Two babies have been born on the admission room table – now anyone who has had more then 4 children and looks even remotely in active labor gets put right into the labor room. In the last two days I have had three such women get up on to the bed and have their baby within in five minutes. Usually they are fully dilated with a bulging bag of waters – I arrange all of the things I need (cord clamp, gloves, towel for baby) draw up a vial of syntocin (the anti-hemorrhagic medication everyone gets immediately after the baby is born), break the bag of waters and baby come sliding out in one to two pushes. Usually this is woman who has had a few babies, however yesterday we had a first timer that was a total surprise. She was 4 cm when she came in, but laboring really hard, we started her CTG (a 20 minute strip that listens to the heart) and five minutes into it started to get decelerations of the heart rate down to 60 (normal is 110-160). All of a sudden the mom (strange to call a 14 year old a mom) started bearing down. We moved quickly to the labor ward, checked her and she was complete. So we started her on oxy gen, which improved the heart rate slightly and she pushed out her baby remarkably fast. She basically went from 4 cm to complete and pushed her baby out in less than ten minutes! Baby was fine with a strong cry, which was relieving in light of the decelerations. We figured baby was probably stressed with such a rapid decent and may have had a compressed cord.

On a solemn note, one of our babies that had been in the nursery for the past 16 days passed away. The baby had a heart defect that caused decreased oxygen saturation of the blood (for those that care about the details the O2 saturation was in the 70s since birth even when baby was being supplemented with O2), we aren’t sure of the specifics since the diagnosis was made clinically due to the limited amount of imaging technology that is available at the hospital. There are no options for doing surgery on neonates here, a large contrast to the vast opportunities we have to treat babies with heart defects in the states. This was a situation where potentially this child would have survived had there been access to medical resources.

The mothers of babies in the nursery live in the ward the entire time their babies are in the nursery – sometimes for months. Every four hours they all go together to squeeze their breastmilk into cups and syringe feed the babies who are too weak to feed and practice breastfeeding those that are getting stronger. The mother of the baby who died was a lovely woman who greeted us every morning with a bright smile and inquires about all the new moms in labor. The day her baby died I was sitting and watching her breastfeed and commenting on how well both she and the baby were looking (she had gotten a postpartum infection after her c-section and was pretty sick the first week we were here). She smiled and told me that she was feeling much better and was now just waiting for her baby to get healthy. Later that day I saw her looking quietly through the window into the nursery and wondered what she was thinking. A few hours later her baby had passed on. An elder woman from her village came to the nursery and they wrapped the baby up to take home for burial.

There is the sadness that always accompanies the death of someone young, the questioning, the wondering why – but also in this case a feeling of anger and injustice, had this baby been born in another hospital he might have lived have lived. Yet, mother and baby had two weeks together, uninterrupted by surgery or high tech interventions, time to bond and cherish the short time they would have together. We don’t know the extent of the defect or if the baby could have survived surgery. In this case he got to live a short, but peaceful life surrounded by those who loved him and return home to be buried in the village of his people. There is beauty in that.

As always, we are missing our friends and families. Amazing that we have only one week left – it is flying by!

Xo
Caitlin