September 10th, 2017 by nitaavrith

I spent this last week covering the maternity ward. Macha delivers almost 200 babies per month. According to one of the midwives, women here have on average 8 children. As one of the initiatives to decrease infant and maternal mortality rates, the government has been pushing women to deliver at hospitals instead of at home. Women nearing their due dates who do not live in proximity of the hospital therefore camp out at the gates of the hospital waiting to deliver.

Women waiting outside hospital gate.

Delivering in Macha has been different from my experience as an intern on L&D. For one, women are asked to bring supplies for their delivery. Being in a low-resource setting, the hospital does not have enough provisions for all the deliveries therefore expecting mothers are asked to bring at the least 2 clean towels, 2 pairs of sterile gloves, disinfectant soap, and a plastic tarp. The delivery room is a large room with 4 black leather beds separated by a curtain. Women are assigned a bed only once they are in active labor. They lay down their plastic tarp over the bed and deliver on the tarp. Unlike the screams from L&D back home, the women here barely make a peep. Once baby and placenta are delivered and bleeding controlled, the tarp is cleared, the woman stands up and walks over to the post-delivery ward down the hall unassisted!

Working in the maternity ward was a test of patience. It is a waiting game. At the end of the week though I managed to perform 2 c-sections, assisted in over 10 vaginal deliveries, performed 2 vaginal deliveries on my own and resuscitated 2 neonates. We had 2 vacuum-assisted deliveries, several episiotomies (which I think are performed more frequently here than back home) and one post-partum hemorrhage that required intrauterine tamponade with a make-shift condom catheter. Back in the US, the only reason I would ever perform a delivery in the Emergency Department would be if a woman reached the hospital in active labor or if I needed to perform a peri-mortem c-section. Both situations are relatively rare and highly stressful and I am glad that I have more experience and feel more confident delivering a baby.

Maternity ward entrance