We tell women to come to MSF for medical care for delivery. It is especially important if they have had many babies previously, if they are pregnant with twins or if they’ve had complications before, such as heavy bleeding.
And women also prefer to come to MSF for their deliveries; not only do they receive medication, but also a mosquito net and baby blanket. However, many live far away from the hospital and there is no transport. Their only option is “footing” - as they call walking here, and it can be a very difficult, perilous journey.
I remember one night when we had two babies born before they arrived at the hospital.
One woman, who was pregnant with her second baby, left her home for the MSF medical centre while she was already having contractions. Her first baby had died within a few hours after birth and she wanted to ensure she would have this baby in the MSF hospital.
But after two hours of walking, the labour continued and she ended up being forced to push the baby out on the side of the road. Once the baby was delivered, the mother still had the power to carry on her journey. Finally, she arrived at the MSF hospital where we delivered the placenta.
The very same day, another woman did the same. For her, it was her fifth baby. With her previous delivery, she had lost a lot of blood after delivery and was worried it would happen again. So she started walking toward the MSF medical centre as soon as her contractions started.
But she also had to stop – and she delivered the baby along the way.
Once again, she carried on walking....Further along, she ended up stopping to even push the placenta out. But she still carried on walking, followed by a trail of blood.
Finally, she arrived at the hospital for medical care. Reflecting back on that day, the miraculous part was that both women and both babies survived. When they left, they were fit and healthy - absolutely amazing when you consider the circumstances.
Women here are absolutely amazing. But these trips do not always end so well.
Last month, another woman was brought to MSF by her husband, brother and two other men from her village who helped to carry her on a homemade stretcher to the hospital.
It took them four hours and she was in obstructed labour. It was her fifth baby. All her other four babies were stillborn, having died during labour. In the past, she’d always had very long and difficult deliveries, but always managed to deliver them vaginally.
This time though, her life was in danger. Upon arrival at the hospital, she had been in labour for two days. The head of the baby was visible, but it was not coming out. She was completely obstructed. She had signs of a pending uterus rupture.
There was no fetal heart beat, and we feared she would have another stillbirth. I tried to deliver the baby vaginally with no success and so I called the surgeon to do a C-Section.
The baby looked like it had not long been dead. Thankfully, she survived the ordeal, but she has now given birth to five dead babies.
Nonetheless, she still wants to try again to have another one.
All her relatives have agreed that she will be staying with family living closer to the hospital, so that we have a chance of earlier interventions to avoid another fetal death.