We told Matron we wanted to get in the thick of things so she sent us up to the Labour Ward. Our whistlestop tour ended in the final delivery room where a woman stuck her head out from underneath the blanket and said it was time to push. After some persuasion from the Matron, the midwife who insisted she was only 6cm dilated gowned up just in time to welcome an 8lb 2oz baby boy. At this point, having not made a sound during the whole process, the new mother stuck her head back up with a disappointed face to declare she had wanted a girl. Baby boy was quickly cleaned, measured, weighed and wrapped and put under a warming unit to keep him toasty whilst his mom was seen to. The placenta appeared to be taking it's time to make an appearance but after some almighty tugging by the midwife (which caused the woman to make significantly more noise than she did during the entire birth) it finally showed. A first degree tear was anaesthetised and stitched and the woman was left to recover. During the delivery Kerrie nudged me and pointed out a tiny baby under the warming unit peeking out from a mass of blankets. Convinced that we had already missed the event and this was all a fuss over nothing we pointed this out to the midwife who didn't seem to concerned and said it probably was someone elses baby.
We followed the midwife off to the sluice where we had a good look at the placenta and were talked through the points to take note of and then wandered off to the office to make the new arrival official and put his name in the myriad of books, lists and registers. We noted with interest that if the child had received a single-dose Nevirapine prophylaxis (if they had been exposed to HIV from the mother) it was recorded as a matter of course in the register which further emphasised to us the enormity of the HIV pandemic here.
The afternoon was a little less dramatic and we joined the student nurses in the twice daily damp dusting of the ward while they quizzed us about life in the UK.
We were both struck by the conditions that the women gave birth in in comparison to what we know as the norm in England. Handwashing does not have the same emphasis that it does in the UK, in fact, we are yet to find a sink that can offer us soap, running water and paper towels all at the same time but we are told that they do not have problems we have with things like MRSA and C-Diff so that may be part of the reason that perfunctory infection control precautions are considered sufficient. Communication in this setting seemed to differ from what we knew as well. Patients in this setting were less involved in decisions made about them and seemed happy to accept whatever the professional wanted to do.
Conditions here are sparse and the people are very grateful for any help that they receive and we cannot but help draw comparisons to some of our experiences that we have had in the UK where we have so much but frequently fail to appreciate our good fortunes.
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