Life and Death in the Same Breath

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8 August 2013 

I was hoping to catch a baby on my birthday. I thought it would be a wonderful gift from God if he were willing. But that morning, two of our midwives returned from outreach in Kal with a mother who was 38 weeks pregnant reporting that they could not find heart-tones. Our lead midwife, Kate, double checked. Nothing. No heart-tones. Not even the reassuring whooshing sound of the placenta remained. The death of this little baby, technically called “intra-uterine fetal demise” (IUFD), was confirmed. This was the woman’s first child. I was filled with sadness. My fellow midwives eventually decided with the woman and her husband that we would transport this woman to the hospital, two hours away in Gulu, for ultrasound confirmation and further care.

I wandered outside in a daze of sadness over this loss, and as I was walking, Korina, one of our traditional Ugandan midwives here, beckoned me to come with her. We were going to pick up a mother in labor in Okidi, 40 minutes away. I got in our “land-rover” style ambulance-truck.

As we were driving, I was thinking about the baby and the family, and I turned my attention to God and to listening-prayer. I heard the Lord say to me, “Do not be afraid” and then, “Strengthen your heart.” (Later, I would receive an email from my mother, who on my birthday had a strong impression in her spirit that a baby had died and was praying for me all day.) So I took deep, calming breaths and looked forward, out the windshield, at the landscape as we drove: the red-dirt road, the tall green grass, the mountains.

When we arrived in Okidi, the mama was in transition, nearly dancing in pain and leaning hard on a sister-friend with each contraction. Once we helped her in the truck, she was sitting beside me and leaning against me, and I could feel her pushing. I asked her if she were pushing, and she said she would stop. (Ha! Who can stop pushing when it’s time? Hardly any woman …) I had my hand on her belly, and I could feel the baby kicking the top of the fundus like babies do when they are pushing themselves out.

Then the young mama lifted her skirt, and here, the baby’s full head appeared in the caul! We quickly pulled to one side of the road, and I got my gloves on, catching the whole baby as he emerged. He cried loudly as he came, so I knew his lungs had transitioned well. I peeled back the caul so he could breathe through his nose if he wanted, turned him over on my forearm and rubbed his back to help clear his gargly lungs. He was covered in vernix! I put him skin-to-skin with his mother and waited for the placenta, which arrived in two minutes (Duncan side first): complete, healthy, with a central cord insertion. I checked to see that the fundus was firm, which it was. Korina, who was with me, tied the cord with cotton strips and then cut it after it stopped pulsing with saw grass. It was a healthy, three-vessel cord: artery-vein-artery (AVA).

On the ride back to the birth center, the sun was setting, turning the sky beautiful colors over the tall green grass and rows of cassava plantings that stretched out ahead of us. The mother was breastfeeding her child peacefully when we crossed a river. But I felt for her as we continued down that bumpy, unpaved, pot-hole filled road.

When we arrived at the birth center, she leaned on me as I carried her son for her and brought the little family to a room where they could rest together, side-by-side.

Truly, truly, I say to you,
unless a grain of wheat falls into the earth and dies,
it remains alone, but if it dies,
it bears much fruit.

~ Jesus (John 12:24)

DSC00262

the beautiful baby boy
born near Okidi

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