All in a days work.

Elizabeth looked 2 years pregnant when she waddled into the clinic for prenatals this morning. She was round in every place that could be round- obviously ready to have her baby any day.

Since she was the last to arrive, she was suppose to be the last seen. But she kept shifting her weight in pain and twisting her face with contractions. She was in labor. But she never mentioned it once.

I bumped her to the front of the line and checked her in to the clinic. She was already 9 cm dilated but the head was still high. I encouraged her to walk around a bit and empty her bladder. She agreed. And I returned to my preggos to click off a few more prenatals.

But half way through one of the prenatals, she stormed back in to the room and plopped herself in the corner on the floor. I had to step over her to measure the other woman’s fundal height. I asked her if she need to push but she didn’t. She just wanted to be near me.

The other woman smiled and said she didn’t mind if she stayed in the room. So I continued on with the prenatal trying not to notice the sweating, half naked woman to my right. It took everything in me.

Once the prenatal was over, I turned my attention to Elizabeth. She didn’t want to move. She didn’t want to get on the birth bed. She only wanted to sit in the corner of the room -- the sweat from her face dripping on her belly.

She stayed that way for some time with me coming and going trying to maintain the chaos of my Wednesday afternoon. (Another labor with twins was trying to decide whether or not she’d deliver with us. A woman five months pregnant struggled with an inevitable miscarriage. Meeting a young Sudanese girl who is going to help me do community outreach.)

Another hour went by before she wanted to get up. She was ready to push. Not long after, a very long and very loud baby girl was born. Woohoo!

But the drama continued.

She didn’t want me to deliver the placenta. In fact, she categorically refused to push it out and argued with me, stubbornly. She told me, “I’ve done this 4 times before. It will come out when it’s ready.” No doubt.

Once it was out, it wasn’t long before she stood up and walked out of the clinic toward the postpartum bed. Her bed was waiting for her. I expected her to be tired and ready to rest. I was wrong. She refused to sit down on it. She chose instead to sit on the hard bench next to it... bleeding through her menstrual pads and asked how long before she could go home.

She explained that she had work to do. Someone had to fetch the water for her husband. No one else would do it and she was burning daylight.

It was clear she wasn’t staying. She’d take off the minute I turned my head unless I discharged her immediately.

But there was just one thing... her baby girl had a fever. Normally, infection doesn’t start for at least 24 hours. If babies are born with fevers, it often means there was an infection in utero. Not a good sign.

I discharged her. I couldn’t NOT. But I made sure her baby had some medication for the fever and warned her of all the possible complications. She assured me she’d be back for postpartum checks. I believe her.

She does exactly what she says.  She says exactly what she means.

If I haven’t said it before, let me say it now. Women here are strong. Remarkably strong. Almost too strong for their own good. I admire them greatly.

Pray for Elizabeth and her little girl. They both had a long day and they need some rest. And especially pray that the fever goes away... miraculously. Thanks.