Thursday, July 16, 2009


While on call, the majority of activity occurs in the ER or in the labor ward, my last call was no exception. I had just come home from the ER when my phone rang - labor ward. A patient was referred from the Jimi with premature rupture of membranes and she concern for prematurity. The Jimi Valley is part of the graphical location that we care for, but it is far away, and for someone to be transferred from the Jimi on a Friday night, means it must be pretty serious. So I had them meet me in the ultrasound room. I got to the ultrasound room first, but shortly thereafter our staff was wheeling the patient into the room. The patient had delivered 5 babies previously at the health center in the Jimi, and this was her sixth. When she stood up, I couldn't believe how short she was and that she had previously delivered vaginally. I asked her again if she had delivered 5 babies and she said yes, I still didn't believe her, so I did a quick check of her abdomen for a scar - none. Unbelievable. We have this red line in the delivery area (see pic on R), which designates 147cm (4'8''). Moms below this line, statistically tend to have more Csections due to having a small pelvis. Our labor ward calls us when patients are below this line and wants us to do a Csection on them, often before they have even labored. Not only was Itet below the red line, she was way below the red line. I am not that tall, 5'4" on a good day, and I towered over her, she was about (4'3"). I was amazed that she had previously delivered the 5 babies in a health center, which is staffed by folks with very little ob training. So she proved that no matter how short someone is, God has still made a way for some moms can still deliver vaginally. Despite having delivered 5 babies previously, this time Itet needed a Csection because she wasn't progressing well. The baby had a lot of meconium and a really short nuchal cord, but came out crying. We also did a tubal ligation that her and her husband wanted, so the health care center won't have to worry about referring her for problems with deliveries anymore.