Last night around sundown a woman in labor arrived at the clinic. She had been in for a prenatal appointment two days prior and everything had seemed fine. Heartbeat was strong. The baby was moving. It was the 23-year-old woman’s 3rd pregnancy and all signs pointed to a healthy, uncomplicated labor. All that considered, I was surprised when Rachel pulled me aside and said she couldn’t find the heartbeat.
After several hours in labor progress was minimal. Rachel and the TBAs on duty still could not locate a heartbeat and the young woman was struggling to push. I couldn’t blame her. I was sitting in the delivery room, helping to hold the woman up in a squatting position to make pushing easier and I just kept thinking to myself that I couldn’t believe this woman was knowingly and calmly going through hell to deliver what she knew would be a dead baby.
A few hours into this whole ordeal Rachel would still periodically check for a fetal heartbeat. At one point, it sounded like she had found one. Rachel was doing everything in her power to help the mother get the baby out, but he was presenting shoulder first – impossible to deliver without a c-section. Earth Birth is fortunate enough to have a car that can operate as an ambulance, so Rachel had our driver and one of the TBAs take the woman to the hospital (two hours away) for the procedure and continued with a new sense of hope for mama and baby.
Not ten minutes later the car pulled back up to the clinic. As the woman exited the car with the help of the midwives I saw her dress covered in blood and balled up, clearly carrying the baby. The horrible roads and maybe the stress of such a traumatic labor had forced the baby out. His skull bones had not developed, but he had probably been alive until the point at which heavy labor began, explaining the clear heartbeat at the prenatal appointment earlier this week. Once labor began the contracting uterus likely crushed the baby’s head. When they unwrapped the baby I didn’t even know what I was looking at, but I did know that I felt like passing out.
A few moments later the woman birthed the placenta – it was about 1/4 of the size it should have been. Much like the birth last week with respiratory distress, but far more extreme, this woman was likely unable to eat as much as any person needs in order to properly sustain themselves, let alone a pregnant woman. The small placenta and the resulting lack of nutrients caused issues in fetal development. Tests weren’t run, but it’s too easy for me to assume that the baby may have developed skull bones if the mother could have eaten properly.
It was a difficult experience for me to go through – the first time I had seen anything like it and in a part of the world far removed from my support systems in the US and London. I’m sad, of course, and I hope I never see anything like that again, but I’m also angry and struggling to process the entire ordeal. It’s easy to blame the circumstances – a poor woman in a poor community without adequate food resources gives birth to a dead child with a crushed head? I mean, really, how do I not blame the circumstances? It was also so hard to watch the mother. Her husband was nowhere in sight – he had sent his younger brother instead. Throughout the entire delivery this woman, my age, was so strong. We walked the room together to speed up labor, she pushed without complaint, she was so strong throughout the entire thing. It was when we unwrapped the baby that I almost had to leave, just to avoid bearing witness to the mother’s reaction. My heart completely melted for her and there is nothing anyone can do to make this easy for her.
I’m trying to turn the experience into a way to motivate me. Some moments it works and other moments I can’t think, but it’s been less than 24 hours so I suppose I need to give it time, experience some good, happy births and move forward.
Thanks for reading such a personal and unfortunate post and thanks to those of you who were able to support me via the crappy internet connection yesterday and today.