Friday, 25 October 2013

Mama Israel. The story of Noeline's birth- by Bethan


Noeline’s labour pains were rumbling along quietly all day (24th October) and started strongly at 10pm in the evening.  I sat with her in her room after I had put the kids to bed and tried to ramble on about all sorts of different subjects to take her mind off the growing contraction pains she was having.  She seemed most comfortable sitting or lying on the concrete floor, which made me think of all the comforts I had during labour: the bouncing ball, the pillows and hot baths… Her contractions continued every five minutes for the next few hours, getting stronger each time until, at 2.30am it was clear that Noeline couldn’t handle the pain anymore and I wasn’t able to cope with her in pain on my own either!  I gave Jonah-B a top-up feed in his sleep so he wouldn’t wake up for Gareth when I was out then took Noeline to the Alleluia clinic.   As I rumbled over the speed humps and toppled over the pot-holes in the pitch black with Noeline wincing at every bump I began to wish I had tried to find the clinic beforehand!  Noeline and I had assumed that the other one knew where it was!  To get lost and turn around at this point would be not only difficult and uncomfortable but soul-destroying for Noeline.

We found the clinic and banged on the gate for what seemed like an eternity.  I parked the car in the compound and the guard woke up the midwife on duty.  He was called Nelson and led us through a room where he turned the light on and two women with recently new-born babies looked round grumpily wondering why they had been disturbed.  We arrived in the next room that was small and had a pot-holed concrete floor, scuffed walls and a sink with no water in the taps, two clinical beds and a cupboard crammed in it.  Noeline climbed uncomfortably onto one of the beds and Nelson said to me “make her some tea with sugar” I looked for the tea machine… unlikely!  I saw that Noeline had packed a hot-water flask and a tea-bag with sugar.  I then remembered the cup that she thrust at me before leaving the house that I assumed she was returning to the house and I felt awful: I had forgotten her mug that means now she couldn’t have a drink during labour!  Nelson sighed and begrudgingly asked one of the other women for her mug and I made some sweet tea.  Noeline settled down to continue labour after being told that she had “2 cm”.  My heart sank: only 2 cm!  But then Nelson said “no, I mean 2cm remaining!  She’s at 8cm!”  Brilliant!  Not long now!  Nelson said to us “I need your rubber gloves, plastic sheet, cotton sheet and kitenge (African material) plus cord ties, razor and gauze.”  I was stunned.  You mean she was supposed to bring all of those things herself?!  Thankfully Noeline knows the system and had packed everything she needed, including a large plastic basin for washing afterwards!

When it was time to push, Nelson told Noeline to get in a supine position on the plastic sheet  ready for delivering and… everything stopped and became eerily calm!  Her contractions completely stopped and we just sat waiting.  And waiting.  And waiting.  3.30am. Nelson said the baby should be here by 4.  I won’t go into details but every time Nelson tried to do something as an intervention he didn’t tell Noeline what he was doing so I had to interrupt him and explain to a scared Noeline what he was about to do each time.  “Get me a needle from that cupboard and pass me the small vial of oxytocin” Nelson said to me so quietly that I had to ask three times what he meant for me to do!  After the injection Noeline’s contractions began again and she started to push.  There was still no sign of any pain-killers, not even gas and air!  At 4.30am she was still pushing.  At 5am she was still pushing.  The baby was stuck in the U-bend!  I said to Nelson that in the UK we sometimes change position during labour to try to let gravity help the baby down but Nelson just laughed as if we British people have our funny ways!  At 5.30 the pushing was getting harder for Noeline: she was exhausted and losing hope that she would even see her baby.  I was concerned the baby was getting too tired and weak but Nelson didn’t seem fazed as he started talking about how Jesus can be of any race or nationality he wants because he is beyond human perception and Noeline kept pushing and pushing.  “Get some clinical gloves on and hold this kitenge open ready to catch the baby” Nelson told me.  I nervously waited with my gloves on, mopping Noeline’s brow as she fought against her exhaustion.  “Now push down on Noeline’s belly when she pushes to help her since she is now so tired.” Nelson instructed.  I tried my best!  Eventually, at 6am, a baby’s head appeared and, shortly after, a baby boy was laid on Noeline’s tummy.  “Get for me a cord-tie and razor for the baby’s cord from Noeline’s mother’s kit.  Also a suture kit and another needle and syringe from that cupboard” said Nelson.  I now knew where everything was in the room and quickly set him up for tying the cord and helping Noeline.

After doing what needed to be done, Nelson told Noeline to stand up off the bench.  “Now wash your hands and breasts” said the nurse who had just come on day-shift.  “Let me find some water.”  She looked around and found nothing.  “Here, use your cup of tea” she concluded.  So she poured the sugary tea over Noeline’s hands and she washed with it!  Does tea have antiseptic qualities that I haven’t heard of before?  Am I missing something?  The nurse rooted through Noeline’s bag to find various plastic and cotton sheets and made her a bed in the next room.  We went through, I was holding the baby wrapped in three or four pieces of old bed-sheet that Noeline had brought with her for this purpose.  She sat down and we figured out together how to get little baby attached for a breast-feed.  Poor Noeline was exhausted and overwhelmed but overall in good spirits. I brought out some chocolate and cake I had for her to get her energy back.  Later that day she had so many visitors that she had hardly had time to sleep or rest, but in Ugandan culture it is rude to turn visitors away so she bore it with her usual pleasantness although behind the exterior there were tears of an overflow of emotion waiting to be released!

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