Wednesday, November 24, 2010

6 days and 6 nights.

Transporting her with our truck. Family looking on.
Nyibol came into the clinic in very active labor on Monday. I was so sure she was going to deliver, I set up the room for it while checking her in. Contraction after contraction moved across her abdomen in a lovely wave. I remembering thinking, “She’s going to deliver any minute.”

Of course... I couldn’t be sure until I did a vaginal exam. But she refused one and said she was going home to deliver. huh? I encouraged her to stay. Why come all this way, if you didn’t want my help? But she grabbed her things and rushed home.

This is fairly common here. Often, women come to ‘verify’ with me if labor has started and then go home to give birth. I don’t stop them but it breaks my heart. I figure there is something socially I’m still not clueing in on... perhaps I’ll understand better in time.

Well... this morning Nyibol came back still in labor!

She explained that she’d now been in labor 6 days. Her water broke 3 days ago (after seeing me Monday morning) and it was originally clear but then became brown. Her baby was alive (Thank God!) but she was exhausted. She hadn’t eaten in three days. Nor had she urinated.

As a result she had a painfully distended bladder which was likely one of the factors in her lack of labor progress. We removed 800-1000 cc of urine with a straight catheter and did a vaginal exam. She was fully but the baby’s head was swollen (3 cm caput). Her pelvis seemed adequate but the contractions had stopped last night.

As we started the IV fluids to induce her, she explained that her family had done fundal pressure and she had been pushing for days. But the oxytocin wasn’t working. We turned up the drip as fast as was safe but it didn’t produced even a twitch of a contraction. 

There was nothing left for us to do but transport. It was too late. I truly believe she could have delivered vaginally if she had stayed at the clinic.         Perhaps not.

The family was able to find money for a cesarean and the ministry truck was free so we took her to Wau. This afternoon she was taken into surgery.

So rejoice with me. This is a victory. A life saved -- two even. I’m just sorry it came at such a price.

Imagine, 6 days of pain... 6 nights of sleeplessness!

So I got some of my facts wrong. She got to Wau this afternoon but... when they checked her in, they discovered that her baby had died on the way. So she didn't get the cesarean right away, they have waited until this evening to do it. She is likely on her way to surgery right now. Please pray for her, her family and this precious child lost.