Thursday, September 29, 2011

Stillness.

Caution: This story is not for everyone. It’s about a stillbirth. I know that such stories are hard to read at times, however these are the realities of my work here.

It was the monotonous way in which she spoke that told me something was wrong. There was no urgency or fear in her voice. There was no hope.

“My baby is not moving,” she announced to my translator flatly.

This I’ve heard before. Most often it’s nothing but an overly anxious mother in need of a little reassurance. So I didn’t react.

“Okay... so she’s worried about her baby, right?” I asked, trying to determine if her ‘not moving baby’ qualified her to jump to the front of the line. She had arrived late; there were 25 woman ahead of her. I didn’t want to play favorites if all she needed was reassurance.

“Is there anything else wrong?” I asked again, wanting to hear her voice as much as know the answer. 

She answered in a slow cadence that unnerved me: “I was treated for malaria 4 days ago in the market. I think the medicines they gave me hurt my baby.”

She didn’t bother to look at me while she spoke. Instead she gazed off in the distance, trying to separate herself from something. What could it be?

It’s as if she was somewhere else and her words were spoken by another. Strange.
    --What wasn’t she saying?

Although nothing she’d said up to this point would have normally given her priority in line, I asked her to get up from the floor and follow me inside.

My translator thought I was being silly. He didn’t say so, but his exasperation said it all. He seemed irritated that she was jumping the line.

I was breaking my own rules, but I didn’t care. My internal alarm was blaring. Something was wrong.

Once inside, I asked her to lie down on the bed and tell me her story from the beginning. While she spoke, I measured her fundal height, then searched and searched for heart tones.

In the same monotone voice as before, she explained that 4 days earlier she had had a high fever. She’d gone to the market pharmacy and was treated for malaria. They gave her an injection and then pills and sent her home.

Her belly was small (28 cm) and as hard as a rock.
    --Was she in labor? Preterm?

She continued on with her story.
Two days later, she thought something was wrong so she went to the government hospital where she learned that her baby was dead. They gave her an IV drip and kept her for observation. But the next morning they told her she needed a cesarean and referred her to Wau.

She didn’t go.

Instead she went home, and later that night her labor started.

I interrupted her story at this point to confirm that I too believed her baby was dead. I could feel no movements and find no heartbeat.

She acknowledge my words with a slight nod as her eyes hardened with resolve. She knew it. She knew it long before she came for help. Her baby was dead.

I asked her about the contractions and was told that they were much stronger now. As I palpated them, I was surprised at their strength. But she didn’t seem to notice them at all.

Turning to my translator I whispered, “Please tell her I’d like to do a vaginal exam, then set up the room. I think she might be close.”

I quickly confirmed my suspicions. She was fully with an intact membrane bulging at a +2 station.

I explained that her baby was coming soon, and asked if she wanted anyone in the room with her. She asked for her friend, and a slender woman with a furrowed brow came in. She sat uncomfortably on a stool beside the bed and fidgeted with her nails.

Once everything was in place, she started pushing. Immediately the membranes bulged outwardly. Another push and they ruptured, spilling a burnt-brick fluid on the bed.

Two more pushes and he was born.

His tiny hands lay limp against his chest as I moved him about. His cord, swollen and red, looked very out of place. And his skin, though tanned, was starting to peel, confirming my suspicions.

He’d died several days before.

After cutting the cord, I asked if she wanted to see him. She again just nodded and I held his tiny frame up for her to inspect. She looked with interest but didn’t reach for him.

Then closing her eyes, she turned away --no longer able to look upon his stillness.

She spent the rest of the morning recovering from the birth with his tightly-wrapped body cuddled in her arms. Our pastors prayed for her and counseled her, then she slept some more.

She slept but didn’t cry. I discharged her later that day.

Please pray for them. Grief is always heavier than one expects. Pray that she would turn to Jesus and let Him lift this burden for her. Thanks.