Thursday, May 28

Last Wednesday afternoon, the prenatal nurse, Lori and I sat down with a 15 yo girl who was in for a visit. She had been seen several months ago for her pregnancy and for several reasons, including her age was identified as high risk and encouraged to come back with a family member so the nurse could work with them during pregnancy. The area we are in is very rural and the closest hospital is about an hour away. They wanted this young mama to be to establish care with the hospital so when it came time to deliver she would be accepted and have a chance at a safe and healthy delivery.

The young girl disappeared for awhile and had not been coming for care. The staff here spent quite some time trying to find a neighbor or family member who might know how to find her. They finally got ahold of an aunt and the young girl came back last week for a visit, by herself. When we sat and talked with her, we stressed the importance of coming for care and wanted to know who was responsible for her and who would be supporting her during the birth and after the baby came. We told her we loved her and wanted to do what we could to help her, but that every woman needs a support system. In her immaturity, she was unable to give us much helpful information but ensured that she would come back the next week with an adult.

This Tuesday afternoon, clinic was running normally when the gatekeeper yelled to Lori that there was a pregnant woman coming in who was not good. I ran out in the yard to find a several people carrying a pregnant woman who was not responsive. The laid her on the ground and I took a quick glance between her legs to make sure there was not a baby coming. I could tell she was not well and they were yelling that they brought her in because she kept passing out. We all went into emergency mode and got her into the dressing room. I checked her and established that she was definitely in labor but not close to having a baby. As we were attempting to get a blood pressure, she started seizing. After stopping and taking a closer look, I realized that this girl looked very young. At that point the prenatal nurse came in and we realized that the patient was in fact the young girl we had seen last week. Thankfully we were able to get and IV and some oxygen while drawing up some magnesium sulfate to treat the eclampsia. Her blood pressure was severely elevated and thankfully we had some IV medication we could give for that.

After she was stabilized, we started to come up with a plan. We would need to transfer her to a hospital that is about an hour away to be delivered urgently. Everyone started mobilizing but no one could find a car in the village who could take her in. Lori called the governmental ambulance service but they informed us that the one ambulance for this area was taking someone into Port au Prince and would likely not be available for a couple hours. They asked if we could wait until then. Ha. Thankfully someone was able to take a motorcycle to the next town in and find a car to come out and get her. It was about 30 minutes before a car was able to come for her. Thankfully in that time she did not have any more seizures and I was able to get good heart tones on her baby. We worried about the car trip in, but did what we could and made an IV bag of medication that could be given while they were riding. We wrote a referral letter with her chart information hoping that the hospital would receive her and urgently get her delivered. We saw them off in the back of a truck and hoped and prayed God would protect this baby and mama until they could get care, but honestly we would be surprised if either one of them would come home alive.

What most of you don't understand is that eclampsia is a sever life threatening emergency of pregnancy for both mom and baby. If this incident took place in the US, we would have been back in an operating room and the baby would have been delivered by c-section in 5 minutes.

Yesterday, we did not hear anything from the family about what happened, and we assumed the worst.

This morning, the prenatal nurse had heard through the grapevine that mother was indeed alive and the baby was alive but in an incubator. We were shocked and thoroughly surprised. I had gone upstairs for lunch and when I came down to the office this afternoon everyone was quiet and said we have a surprise for you. I looked in Licia's arms and realized she had a baby in her arms. A big, healthy baby boy.

Here is what we know about what happened between Tuesday afternoon and today. Mom and baby made it to the hospital one hour away where they were told that she was too sick and they needed to go into the government maternity hospital in Port to be delivered. The extended family member who brought the baby said that mom had a vaginal delivery, and by the baby's bracelet we realized it's time of birth was 7:10 on Wednesday morning. Mom is still in the hospital but the "machines" for the baby broke today so he was discharged and told to go back to the clinic that helped them before.

Y'ALL. This is nothing short of a miracle that both mom and baby are alive today. The chart said the baby had meconium aspiration and antibiotics had been ordered. He looks great for us and we will keep him here until mom is discharged and we can make sure they are both safe to go home. I don't pretend to understand the broken healthcare system here in Haiti and why the delivery was so delayed. This is why maternal health matters so much in this country. It's overwhelming to think that this is just one story of thousands of mamas who will deliver in Haiti this year.

For the moment we are rejoicing in His goodness and soaking up all the snuggles with precious Samuel.