Some observations and thoughts from this week...
Another day in Antenatal Clinic, now not so unfamiliar or strange. Sixty five women came, many of them were already sitting outside waiting before I arrived at 06:30. It was a long day, clinic went on until almost 17:30 and then there was 65 sets of notes waiting to be put into the computer.
While the other midwife was engaging the women in some lively antenatal education I was able to watch and wonder about them all. It seems to me that pregnancy is a great leveller, everyone at the clinic in the same boat - a shared, common experience. The women chat and laugh together as they respond to the midwife and then between themselves while they wait for their turn to see one of us. Some come in their Sunday best or their business attire (no mistaking the lady who is a banker!), others in holey, slightly grubby t shirts and a lappa tied around their waist, but I wonder how much that matters to them while they wait? They all want a live healthy baby at the end of the pregnancy and they wait their turn to be seen, some for hours on end (I might add unlike the women of the antenatal clinic I used to work in when I trained who used to moan to the receptionists if the midwife was running 15 minutes behind!). The outfit that made me smile the most was on a lady who looked like she was covered in hairdryers and somehow it didn't look that strange, although I did wonder if anyone here actually has a hairdryer.
We split the patients up for their checks between Ami, the other midwife and myself on the basis of whether they spoke English, (figuring I was going to be up a creek without a paddle otherwise). This worked pretty well and meant I could largely just get on with my own cases. I can do the antenatal checks no problem. I've got the hang of the worm meds, antimalarials and tetanus vaccines, giving out iron and folic acid but today I learnt some new things (as I am sure I will every week!). We also give HIV positive women nutritional build up milkshake powder, multivitamins and prophylactic treatment against opportunistic infection. These poor women must rattle from all the pills (they get HIV treatment from somewhere else too) but it is a blessing that we can improve their health and that of their baby through providing this aspect of care- free of charge.
Another noteworthy moment was when a man came into the labour ward - "belly woman" business is truly a woman's realm here. I did see one other Dad visit two weeks ago when his wife and newborn were on the ward. He was very sweet and very proud of them. But the 65 women came to clinic all alone today, will probably give birth alone (except for the midwives - most don't seem to even have a female relative with them from what I have seen) and stay on the ward without seeing their husband until they can return home! Somehow I must have accepted it as I was quite suprised to see him and was almost suspicious as to why he was there. But he held his wifes hand and they walked around together as she quietly laboured, and then he left again.
So these are a few thoughts - so much happens in 12 hours that it would be too long winded to mention it all and there are some things I don't feel I can blog about yet. One of the biggest challenges in clinic is trying to solve the puzzle of when women are actually due to have the baby, but that will have to be a post all of its own sometime and just amuse me in the meantime :-)
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