A Circle of Women

At about 2:30 pm, less than 10 minutes after the ambulance has left for Ziguinchor, a taxi speeds to the front steps of the clinic. The cab driver says, “come quickly” and hands off one baby to Jessica. I open the back door of the cab to have another baby passed off to me and I passed that baby off to Jessica.  There in the back seat stretched out is a woman who appears to be semi-conscious; closer to dead than alive. The two women in the cab help me get her out and Makeda arrives to help this sick woman to stand.  Within seconds she passes out and we holler for help; women who were still gathered around from the recent ambulance departure help us carry this woman, like a huge sack of potatoes, inside the clinic to the delivery room. Makeda uses the spirits of ammonia and this woman revives enough for the four of us to lift her onto the table.

While Jessica examines the twins (both girls), we examine the mother and collect some basic information.  Mrs. S. gave birth to her third set of twins yesterday at home alone. Her neighbor came by today to check on her and found her semi-conscious, in a large pool of blood, placenta delivered, with the twins who had not been fed but their cords cut. She has had no prenatal care with these twins and has not money. Sometimes she has no food for the family. Mrs. S is a recent widow.

Soon her sister- in-law and other friends arrive to stand watch.

Mrs. S. appears to be severely dehydrated, suffering from post partum hemorrhage, with deep pitted edema radiating above her knees and her limbs are grossly swollen, very elevated blood pressure, and to have pre-eclampsia.  The placenta was delivered at her home and there are no remnants of it in her uterus.  She and the babies are filthy.

With regard to the twin girls, one girl weighs about 2300 grams and appears to doing well.  The other little girl is cold, appears to be dehydrated and weighs about 2100 grams. Neither has been fed anything. They are immediately given antibiotics, washed and wrapped securely, and passed to the arms of the waiting women.

Feeding the babies is a crucial issue now.  One of Mrs. S’s best friends, who is currently nursing her 8 month-old son (I nick name him “The Brown Bomber”) agrees to take responsibility for nursing the twins; she also brings one meal a day to feed Mrs. S.  We purchase formula and water from the pharmacy and the sister-in-law learns how to mix it and feed the babies.

With regard to Ms. S, an IV is started; pitocin (the clinic is out of methergine) and antibiotics are given. She is placed in the midwife call room, where her friends join her.

Over the next week these Sista-friends and relatives keep watch over Mrs. S and take care of her and her twins. They wash, help her to use the chamber pot, feed her; they care for and feed the babies in shifts. Her sister-in law stays awake for 2 ½ days, with her eyes and hands constantly on guard.

Mrs. S is in and out of consciousness for about 3 days. She is then moved in The Grand Salon and her friends move to the bed and floor next to her. On Friday I give each of the twins one of the special “Mommy and Infant bags” that contains baby clothes.  Yaccine arrives and takes the lead on dressing the twins in the outfits.  Thanks Sylvia Robinson and Gouda Carter for making these bags!!!!

Her friend arrives daily to visit for hours and nurse the babies.

By Tuesday Mrs. S has some milk and can supplemental nurse, with her friend still providing most of the breast milk.  She can make it to the outhouse by herself.

During the week the smaller baby loses a substantial amount of weight and gets an eye infection—we teach about the use of breast milk for treating an eye infection. The other twin loses a little weight.

Yaccine, who brings our lunch each day to the clinic, has taken the initiative of giving our extra lunch to Mrs. S and her Sista-friends.

On Thursday, Mrs. S and her twins were scheduled to be discharged. The naming ceremony with the accompanying head shaving was held in the Grand Salon.  The babies were given the white infant hats that I brought to wear after the head shaving. Awa, the larger twin now weighs 2500 grams; Amada, the smaller now weighs 2100 grams.

We slip the sister- in-law some money with which to buy some groceries and other staples.

Jessica and I are asked to carry the babies to the car.  These Sista-friends who speak no English and very little French; us who speak no Jolla, Wolof, Mandinka, or Peuhl speak words of thanks from our hearts that need no translation.

They leave and take a part of my constant prayers with them.