27th December 2011

It was all excitement at Homa health centre this morning. I was scanning a pregnant woman who had woken up with a bit of back pain this morning and was struggling to find the head as it was really low. All of a sudden she started pushing and the membranes ruptured with such a force that the entire examination couch and wall were soaked. We got a few men to come and take her to the delivery room and within 30 minutes delivered her baby girl. As you might imagine her mother and husband were convinced that it was my scanning her that had brought such a quick delivery and so they were very grateful for this.

I then got back to the queue of women waiting for their scans, only to find that the next woman was 40 weeks gestation, the baby was transverse (baby lying across rather than head down), it was her first baby, she was 140cm in height, and there was less than 2cm of liquor around the baby suggesting that at some point her membranes had ruptured (unbeknown to her). So I told her and her family that they needed to get to the hospital where she would need to have a caesarean section. They were reluctant and certainly unprepared to go to hospital as she had only come to the health centre for a scan as a message had gone around that I was scanning women today. Indeed, this was the first time that the woman had ever attended the health centre, having never had any antenatal advice and so I think she really didn’t understand what was happening when her membranes ruptured. Actually, I’m not sure that she understood that her baby was due to be born. After some persuasion, however, and convincing her that she really would not be able to deliver the baby at home or in the health centre, her family set out to catch the bus to Gimbie. I then telephoned Jeremy and told him to expect her in a couple of hours and returned to the queue of women.

When I returned to the hospital that afternoon, the woman I sent to Gimbie was just recovering from her caesarean section and both mother and the baby boy were doing well. So this is a very good example of how ultrasound scanning can actually change things. This woman would not have come to the health centre without the offer of a scan. She would not have been able to deliver the baby safely without a caesarean section and it is highly likely that both mother and baby would have not survived to tell the tale. What I am hoping is that the family will report this to the community – this is how word gets around here and so a positive story told by those involved is the best way to bring about change. The woman looked rather stunned by all that had happened to her – she is only 18 and really doesn’t seem very confident with her new role as mother. Her father, however, is staying with her and he is extremely grateful that she has come to Gimbie and I am pretty sure that he realises what could have happened to her. He held my hands in gratitude, repeating ‘galatouma, galatouma’ (thank you, thank you) and then smiles with relief that his daughter and grandchild are safe. I gave the baby some clothes and a blanket as the mother really didn’t have anything to wrap him up in.