The births here have been amazing and beautiful! I really feel so good about the work I’m doing here. The quality of care we give is of equal standard to the care i give in the US with the difference that here it’s very difficult to refer a client for testing or ultrasounds so there is often a lot of unclarity around dates. We often have women come in with active labor and theyre 30 weeks by dates. We always try to stop their labor by treating for dehydration or uti. If it works, great, if not we have the baby. With the exception of one the babies have come out looking term. The one baby that was truly preterm, 33 weeks by assessment was actually born in the truck on the way in! She had signs of an infection so we transported her to the hospital where she Was Treated very well.

last night we had our first set of twins and although twin births ar usually more complicated this one was super straight forward! Both babies were head down and came out screaming! The placentas had fused together and came out soon after baby b was born with very minimal blood loss! We keep twins here until they are both gaining weight and treat the mama like a queen. There are a lot of fears about twins in Uganda because often one or both dies so we work hard to make sure the mama has the support she needs from her family and the traditional midwife in her village. I’ll talk more later about our relationship with the traditional midwives but basically it’s amazing! We work so well together as a team each acknowledgeing the others strengths and weaknesses.

Grossness warning: The birth that brought me to the hospital was actually not complicated but the mother with her first or second birth had had a fourth degree tear which extends to the rectum, that was never repaired. For over 10 years she had an opening between her vagina and rectum and was pooping out of her yoni. After the birth we transported her to the hospital where I really had to advocate hard for her to get taken seriously. Once they saw what was going on they prepped her for surgery and I didn’t leave until they were wheeling her into the or. Appaarently it wasn’t a true fistula but the docs could see right away what was going on and said that they’d be able to put everything back together again! I don’t know what would have happened if she hadnt come in to the birth center to have her baby? She had nevertoldanyone about the problem and her mother who caught some of her babies didnt notice. Anyway we’ll be able to follow up with her and make sure she’s healing well.

Anyway, most of the births have been great and beautiful and amazing. We had a really sweet first time mama who came in, labored for about an hour, squatted down, and had a beautiful baby girl. We had a mama with a stubborn cervical lip that when I was finally able to push it up over the babies head she came flying out in the same contraction with no tearing! I’m excited for more babies tonight!