Head and shoulders, hands & knees!

Carolyn had her first delivery on the ward today on hands and knees. This is exciting news as all women here are encouraged to birth on their backs with their legs up by the face. It is a challenge to get them out of that position and on their side. This really makes us reflect on the effect of "the gaze" on pushing positions. This lady was left alone until the head was basically showing and during that time she instinctively changed positions, none of which included her back. As soon as we would walk towards her, she would move to her back. It is my theory, and I'm sure it's not an original one, that women left alone will change positions frequently and will not birth on their back. I also think that as soon as attention is paid to them they become 'patients' which means on the bed and on their back. One of the benefits of homebirth, I believe, is that women feel less like patients.

This same birth also made us so, so thankful for rescucitation. The baby was born with no heartbeat, but within 1 minute of reses, the heart rate was good, and a few minutes later, began breathing. It's amazing!

Another woman came in today with the head already outside of the vagina still in the caul (or still being in the amniotic sac). Cathy received this baby. It needed a little help, but did fine.

Alix also had one delivery today with a women who was HIV + and symptomatic (she had fungal infections on her arms and kaposi sarcoma on her legs). Saying how sad it is to see these young HIV + women is the understatement of the year. Most seem well supported, but some women are highly stigmatized and kicked out of the family.

Every perineum this week was intact! Our greatest success was that we cleared the labour ward before we left.






We cleared the ward!



My ethics approval came through! Mbale on Saturday!

Today was another national holiday- Heroes Day. I have reflected on our local heroes. Particularly Prossy, who takes care of women so they don't die over the night shift and saves babies that are born weighing under 1kg with only shoestring supplies. Cathy and Mickey have built lasting relationships in Uganda, Nepal and Nicaragua. They train Canadian students, offer CMEs abroad, and support midwives from around the world to attend the ICM. Today's photographs feature these heroes.


Prossy proudly posing with a premature baby on discharge day- 3 weeks old. The baby weighted less than 1kg at birth and Prossy nursed it to health with only shoestring supplies.



Mickey standing outside the maternity building in Masaka



Cathy and Prossy working together on a difficult IV