big and small babies

Another day of midwifery. A few of the women hadn't gained any weight, and the odd one had managed to actually lose weight (this idea of weighing the women is a whole new one to me I must admit - beyond a body mass index calculation at the first visit we don't weigh women during their pregnancy back home. Here though I can see that it might be a more useful indicator of how things are going). A few babies growth was not what I would have expected either, given the gestation or just considering growth since the last visit. One woman fit both of these scenarios so I talked to her about the importance of eating well and how we would really like the baby to grow bigger. Lots of the women say they have no appetite or are reluctant to eat because of acid reflux and helping them to understand the importance of eating well can help. But this lady told me if she gets money during the day (presumably from selling some kind of produce or something) then she can eat, and if she doesn't then she can't. It's hard to know what to say to that really. I checked if there was anything else we should do given the lack of growth, but the other midwife said we just give diet advice and check it again in a few weeks. Still it's something to think about and to check out what the policy is or should be for such women (I couldn't find it at the time but am pretty sure they do have one already). 

After clinic I worked on our overflow ward, we have an 8 bedded antenatal/postnatal ward but had managed to have 10 extra mums and babies on one of the VVF wards as it had been so busy. When I arrived on the ward the Mums were all outside eating dinner. The babies were all wrapped in their multiple blankets lying in the middle of the Mum's beds. I wished I had a camera. One of the babies I was checking was 3.6kg, the same birthweight as Josh. He looked quite out of place amongst all the tiny little scraps on the other beds, it reminded me of when Josh was in NICU and had looked like a giant compared with all the prem babies around him. The Mum was so proud, and rightly so, that is quite an achievement here where the average birthweight is about 2.5kg.

I could write on and on about yesterday's taxi saga's, but I'll just say I have had the true African experience now and please pray I find a new, reliable one!