Maternity ward

So my time on the maternity ward was cut severely short with Iris’ illness and the need to catch transport early.  In addition, I was disappointed that I did not deliver any babies but in fact none of the doctor’s deliver babies unless it is via c-section for complications, of which there are many.  Birthing is largely done without direct oversight and with a circulating nurse midwife who is very busy. Women in Malawi have a 1 in 36 chance of dying as a pregnancy complication over their childbearing years. Phenomenally high and important given the number of births per month at this hospital (between 700-800 —roughly 3x the volume at women and children’s hospital in Columbia). I have three children and never once did I fear for my wife’s life or did it even occur to me to have that concern. In fact, I feared more for my own by pointing out when her clothes weren’t fitting as well—a bonehead move that perhaps one reader will avoid in the future.

            The ward is arranged with a post-partum c-section Unit, a general medical bay for women who are pregnant and ill (with conditions both related and Unrelated to pregnancy), a small neonatal Unit with one incubator, a high-acuity room for women who have had severe complications such as a Uterine rupture, and a kangaroo care bay for children who were born prematurely and weighed less than 2000gm (for those who can’t picture this, they can fit in your two outstretched hands easily).

Didn't want to be insensitive and take pictures of laboring women. Here's some cute kids outside the hospital instead.

            The number of women in the post-surgical Unit was easily over 50 and they shared a bed with another mother and the two new infants. Many women did not have a bed and so we examined their abdomens on the floor and ensured they were not fevering post-surgery. The general medical ward was the same with no fewer than 40 pregnant women lying on a concrete floor, many traveling long distances, waiting for their problem to be ‘severe enough’ to warrant a bed. Beds were for those who were vomiting, dehydrated or had very high blood pressures or pregnancy-threatening conditions. Those not lucky enough to have a bed were seen all at once on Wednesdays to see who had gotten worse. The thought crossed my mind that it seemed women had quite an incentive to not be pregnant here and also I thought about the kind of revolt that would occur in the states if we told our women to lay on the floor or share a bed with another new mother and infant. Also, how different for a child to enter the world in a Unit that looked like a war zone-(plywood dividing the labor beds) compared to our single rooms with TV’s and foldout couches for dad.

            I don’t want to ramble on so I’ll just say that it made a huge impression on me and if I was to return, this is definitely the area of highest need. There is an entire clinic chain dedicated to reproductive health and I think working there would be eye-opening into the choices that both men and women are making (and not making) about family planning.  We are all still doing well and I am beginning to have stomach pains thinking about the flight home.