Not-So-Complicated Obstetrics – Angola Day 6
July 9th, 2019 by INMED
“The baby delivered four hours ago, but the afterbirth is stuck!” explained our nurse midwife. She was frazzled and fatigued, being on her feet with this delivery for the entire night. At 5:00am, the new mother spiked a fever and began bleeding from her uterus.
When I arrived, a quick exam revealed her placenta was still attached to the inside of her uterus. Retained placenta is a well-known risk of pregnancy. If it continues, women develop bleeding and infection leading to sepsis. With treatment, this a not-so-complicated obstetrics. But without treatment, death is commonplace.
With a bit of anesthesia, I placed my entire hand into the vagina, and then up through the cervix into the cavity of her uterus. Unlike the rough, firm texture of the uterine muscle, a placenta feels like jelly. I encompassed the slushy placenta in my grip, and slowly extracted it with one pull. The midwife sighed with relief, and the mother gave a shout of joy.
Labor pregnancy continues to needlessly kill some 100,000 women each year, almost entirely in poor communities. One of our highest priorities at INMED and at CEML is to training healthcare personnel with basic obstetric skills such that no woman dies from not-so-complicated obstetrics.