Work this week saw more new lives arrive and also reminders that life is fragile here. It was a long day supporting a young mother through her first labour - a real typical stroppy teenage mother for all those midwives who know what I mean! Her bump was tiny and her dates not really known so we were estimating a baby between 33 and 35 weeks gestation. We prepared for a premature birth - which really doesn't mean much here as there are no neonatal services, but I had a second midwife and plenty of things to keep this baby warm once it arrived. It actually was a pretty average size (for here, it would have barely stayed away from SCBU if in the UK!) once it arrived and we just dried it well and kept it with the mother, later we checked and it weighed just over 2.5kg. So all was well.
During an earlier part of this Mum's labour I offered to do the 6 week postnatal check on another lady, not realising that this was going to be someone I know. Only being at the unit once a week I don't really expect a lot in terms of continuity with the women but I had seen this lady for a couple of her antenatals and then had spent time with her again the day after her birth, the day her baby had died. This wasn't the easiest postnatal check I have ever done, 6 weeks is still so early after such a great loss, and it can't have been easy for her to have come back to the unit to see us. But I was glad to see her and chat with her and I'll certainly be praying for a better outcome next time.
Later in the day a family came to collect a baby which had died (prior to labour even starting) which had delivered in the night. It was one of twins, the other healthy and doing fine as far as I know. The poor family, presumably the husband and one of the sets of grandparents came to collect the baby. It was taken away in a cardboard box, which seemed a little harsh somehow. But maybe wrapping it nicely in a blanket would have been culturally inappropriate, especially given that most people don't have their own transport and may have been refused the taxi if anyone had known about the box's contents. I'm not really sure of the rights and wrongs of the way things like this are done. I would say though that the midwives are very nice and fairly sensitive, giving their condolances to the poor families who have to make the walk through the ward full of mums and babies to collect their cardboard box.
It is all in a days work here, seeing new lives born and sadly sharing a small part of the grief for the babies that are lost.