Life is beautiful yet complex and sometimes tragic, and sometimes all of those in one.
We had been notified that a woman was stuck in labor. She had been laboring for more than 24 hours with twins; what should they do? We requested immediate transfer. Well immediate transfer is all well and good when you have access to all the necessary requirements. For this time, it was a scramble to line all methods of travel up. There was no vehicle available and it was necessary to carry her down the mountain to the next clinic where a truck was waiting to take her as far as the river. It was dark now, and the roads are dangerous at night, so it was a slow process. On arriving to the river, it was necessary to find a boat driver who was willing to cross in the dark, with only the light of a head lamp to show the way through a maze of branches from underwater trees. It was a slow, painful and cold journey across the water, and this mama was begging for it to be over. At the other side of the river, it was a 2-hour truck ride to us. This request of “come to the clinic immediately” had amounted to 12 hours of travel.
A tiny woman with a large taut abdomen emerged from the back of the truck. She was exhausted and had fear and resignation stamped on her face. Assessment showed that she was indeed pregnant with twins, however sadly the first twin was not in a great position and the second twin had already passed away. A C- section was a likely necessity – particularly given the length of time she had been laboring and this was her 9th and 10th babies. I was feeling somewhat proud we had her assessed and ready for transfer with transport, referral letter, translator and midwife to send with her in a little more than 1 hour.
To be honest, I felt elation when we were able to get her on the road so quickly and there was a solution in sight. The hospital we had referred her to – our nearest with obstetrician cover- did not have an obstetrician available due to their day off. They said our little group needed to travel a further 2 hours to the bigger referral center where they continued to aim for a normal birth. As the hours dragged by, elation turned to a creeping fear. Final news was that the baby was unstable, and they were rushing for an emergency C-section, that delivered a live but struggling son and his stillborn brother.
The next few days was a harrowing experience for the couple. They had lost a baby and were separated from his brother. Getting updates was difficult, and it was a number of days before mama and baby were reunited. After 10 days and 2 blood transfusions following the emergency dash, they were returned to our clinic, a quick stop on their way, glad for being able to go home. Dad was so thankful as at one point during the journey he thought he had lost both babies and his wife. We sent a tiny new baby and his parents home. A month later they returned; a gorgeous fat baby and relaxed and happy parents.
Their journey continues on, and I love that the journey didn’t end with loss, but that a whole lot of living and loving continues. This points to the importance of what we are striving for, teaching and preparing our students – the future physician assistants and midwives that will play that role in locations closer to the real deal with significantly improved outcomes.
Mon Parker is an Aussie Midwife living in Kyaukkyi, Myanmar, with her husband. She is a tiny bit obsessed with how people give birth and works with EMA on this very issue.