the last week in Mbale

Well, the twins I caught in Mulago were a harbinger for the week to come! Ashley and I had a good final week in Mbale, and there were two sets of twins born. The first set started off with a cord prolapse for the first baby who was coming breech. Ashley acted quickly to hold the baby up off the cord after we literally manhandled the woman over onto elbows and knees (the language barrier was a challenge, and also the fact that local staff had no idea what we were doing). The baby seemed to be in a hurry to be born but Ashley held her ground (that is, her whole hand up inside the mom) and would not let anybody move until it was decided whether we were going to theatre or getting the mom to push like stink. The decision was made to have her push since Ashley could feel the baby making its way down. So we flipped the mom back over and she pushed like a trooper! The baby was born within a minute, thank goodness. For those non-midwives reading, cord prolapse is an emergency that can kill a baby in a very short time. We have seen at least two fetal demises due to cord prolapse in our time here.

So, the first baby was born, a little boy and I raced off with him to resuscitate. I had located one of our very few cord clamps so we did not have to fuss around with tying the cord, thank goodness. It took a few minutes of PPV but he did come around. I really feel like his was a life our presence saved!

Meanwhile the second baby was on its way out, head first luckily. A little girl was born, vigorous and healthy. The family was overjoyed, especially the dad who was actually watching the birth (an unusual thing here). He was most thrilled to have twins. And he named them Alexander (the Great) and Rhonda. Though he likely spelled it Ruanda....I get that a lot.

And then the very next day, since Ashley didn't actually end up catching the above babies, we had a replay! Another mom came in with undiagnosed twins and the first one coming breech. Ashley got to catch this one herself, and it was a little girl weighing 2.6 kg. She was vigorous so I was able to leave her on the infant warmer and get back quickly when Ashley announced that there was another baby coming! The second one was also a girl, head-first but only half the size of her sister...1.3 kg. One of these babies was also called Ruanda....a great honour for me! Ashley's name is not easily understood here so she didn't get in on this honour, unfortunately.

Today, the five remaining travellers are in Kampala and soon to leave for Entebbe. Our flight is tomorrow, and my classmates assure me they will be posting things on the blog soon! Someone will write about our safari soon!