Out of the frying pan.....

I negotiated the first week successfully, thanks to a very confident colleague.  The weekend brought the arrival of two more midwives.  One who is undertaking her Masters research here and one who had a week's R&R for a friend's wedding in Hong Kong. 

 

This may be interesting - 4 women in the house as well as a very sensitive maid.

 

We get a preparation week between courses. It is also the time to do clinical and get a feel for the practice in  each of the hospitals so we can speak to the midwives with some awareness of their circumstances and of course it serves as my orientation.  Monday was spent updating lesson plans and lectures and doing running repairs on the abdomen and emergency pants. Then it was the opportunity to visit both Muhumbili where the next course is and Armana again.

 

The contrast between the hospitals is quite marked.  Muhumbili would be our equivalent of the tertiary referral hospital and Armana a regional centre.  However Muhumbili have about 20 births a day to Armana's 100 - 120!  There is little time for the niceties in life at the latter. The women labour alone (without family support) but in a communal room, and quietly accept the decisions made by the staff without much, if any, consultation.  They spend the entire labour lying down and birth flat on their backs so work extremely hard.  When we suggested that getting them upright may help shorten the labour we were laughed at and told that they didn't want to drop the babies on the floor in such positions.

 

I was the second midwife at a birth 'conducted by one of the previous week's participants. The birth went well but the baby was quite small, born in meconium and quite unresponsive. We successfully resuscitated him and were able to give him back to his mother. He did end up going to the neonatal unit but he is quite a lucky baby as many in a similar situation don't make it. 

 

I helped a woman to birth her first baby, a little girl 2.9kg. It was so lovely. There had been meconium and the little girl required a bit of vigorous stimulation, but she responded well.

 

Oliver with her baby girl

 

There were several other births around the same time and a couple of very distressed young women who had been in labour for a number of hours longer than is reasonable.  By the time my colleague and I left them they had calmed down a lot. One looked as if she may birth normally after we got her kneeling up against the bedhead but the other was heading for C/S.

 

We only observed at Muhumbili but our presence seems to have been accepted which means we have overcome a major hurdle. I am looking forward to clinical there next week.

 

Bit of a hickup this morning as no-one turned up for class.  A misunderstanding I believe they thought it was only next week. They will be there in the morning. Here's hoping.