As we neared the ward I could already tell that it was the maternity suite by the sea of women with watermelon bellies pacing the outdoor corridor. The bleak exterior masks the hustl
e and bustle that occurs inside. The building is divided into three areas. To your left is the pre-delivery room. Beds line the wall but most of the space is taken by women squatting on the floor or walking back and forth in an attempt to quell their labor pains. Every so often a nurse walks through the ward and immediately the women lie on the beds as the nurse checks to see how dilated they are. Only when a woman is fully dilated at 10cm is she permitted to waddle to the delivery room. Until that time she walks, squats, and grimaces trying to bear her labor pains in silence. In the delivery room women lie virtually side by side on metal tables. As they enter, they carry kangas, large brightly colored swaths of fabric, with them. One kanga is laid down on the metal table as a mat, the second set aside as a towel for clean up, and the third is used as the only identifying mark for the babies when they are born.
No pain medication, no water, no moral support, only the nurses voice repeating breathe, breathe. Within minutes of lying on the delivery table the baby is out and placed immediately on the mothers stomach. No APGAR score is taken, no suction is performed. Instead the nurse waits for the baby to cry to assure that it is breathing.
The baby is removed from the warmth of their mom's bare belly and the umbilical cord is cut. Carried by one arm, the new baby is weighed on the cold metal scale using the discarded packaging from sterilized gloves as the sanitary protection. The weight and approximate time of birth are noted and the baby is swaddled in the vibrant kanga, their mother brought, and left to fend for itself on the tiled counter-top.
The nurses attention turns back to the mother. She clamps the remains of the umbilical cord and extracts the placenta. Using experienced hands she massages the woman's abdomen to help reduce the flow of blood. The dirty kanga and other waste is placed into a bucket on the floor. The new mother then sits on the same bucket and is instructed to continue massaging her own swollen abdomen to push out any remaining fluid.
It is now 12:05 pm. The baby was delivered at 11:58. Mom is hustled to get up off the bucket, wrap herself in her kanga, pick up her baby and walk out of the delivery suite to post-partum recovery. Efficiency at its maximum.
Still wearing the same pair of once sterile gloves the nurse pours water on the floor and metal table. A mop sized window squeegee, squeaks across the floor, leaving muddy streaks in its path. The table is not even dry before the next woman has launched on top, ready to deliver.
After watching a day full of births I can't help but remain amazed at the strength of the women. With no pain killers or moral support they are off the delivery table minutes after their new baby arrives into the world. The nurses eyes are kind but her words and gestures are matter of fact. She delivers at least 40 babies a day so one woman's pain blends into the next. With no crash cart or resuscitation equipment, I wonder what happens in emergencies. Maternal and infant mortality are still extremely high in this area and after seeing the labor and delivery conditions in the “best” hospital, it is hard to not feel somewhat disheartened at the conditions. The uplifting part is that I can truly see how wonderful the new birthing center that International Health Partners has built will be for the women of this community. It will be revolutionary.
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