Monday, March 28, 2011

9-Month Fast~

When I first saw her, I had a hard time believing she was pregnant, let alone in labor. She was rail thin and gaunt. I asked if she had ever been to our clinic before... perhaps for a prenatal. (I doubted it, since I would have definitely remembered her face!) She said she hadn’t, but was seen once at another clinic in town. When pushed a bit further, her husband added she was treated for hypoglycemia at the government hospital the week before.

She didn’t look well... but that was just half of her problem.

Strong, relentless contractions peaked and passed, every few minutes; she was definitely in labor, but I couldn’t tell if she was term.

Her belly was abysmally small-- barely measuring 27 cm. She agreed she was only 8 months along, but that wasn’t the only reason it was small. She had been constantly sick this pregnancy.

Pushing to understand why, she explained she hadn’t stopped vomiting since she conceived. It was merciless. Food and water, alike, made her sick. It wasn’t hard to believe. She was positively emaciated.

This was her 9th pregnancy. I tried to guess her age, but her withered state made that difficult. I considered it a minute, but ended up just writing ’40 years old’ in her book. Did it matter? Probably not.

I was tempted to refer her to Wau... but she was already 9 cm dilated.

Instead, I set up for the birth, and prayed. I prayed hard. I’d either have a premie on my hands, or an SGA (small for gestational age) term baby. Either way, it didn’t change the fact, she’d deliver shortly.

Sitting beside her, her husband was just as delicate and frail. Decades of slouching caused him to fold himself into a neat envelope with ease, legs drawn in. Origami in the flesh. 

But when it came time to push, he was instantly at her side. Still slouching and a bit unsteady with age, he comforted her well.              --It was very encouraging.

She pushed like a pro, but her baby didn’t handle it well. Small, limp, and blue when he was born, he looked more like a floppy porcelain doll than a baby; I worried to move him.

Rubbing his back in an effort to make him cry, I cheered him on: “Come on ‘lil guy. I know it’s cold and scary out here... but breathing’s fun! Just try it.”
He must have liked my pep-talk, because he recovered nicely.

Boney and long and weighing just 2 kg (4.4 lbs), he reminded me a lot of his dad-- all arms and legs and a bit shaky. So, I wrapped him up tight, and handed him over. The father smiled as his lanky arms, awkward and unsure of how to hold someone so small, engulfed him.

It was love at first sight!

Later on, when I did a full exam on this lean, mean, sucking machine, I could see no major signs of prematurity. His reflexes were good, his testes had dropped, and even the creases on his itsy-bitsy feet were deep. His Ballard’s score (exam done to determine how premature/term a baby might be.) was high, placing him roughly at 36 weeks gestation.

Conclusion: 9 months of vomiting makes for one tiny person, but it doesn’t make him premature!

When I discharged them, they promised to return for check-ups, but I haven’t seen them yet. I hope all is well. Pray they both thrive after this 9-month fast! Thanks.