A man in labour ward was a foreigner during our time of training in 2005! It was difficult for the hospitals to accept males in Maternity ward but later this became a nightmare as more males were admitted to also work in Maternity department. Working in Emergency Medical Services is something I applaud since 2008 with Global Emergency Care. Working in a pre-hospital care setting which involves calling and dispatching, triaging, transporting and caring for casualties and other patients has given me more skills to serve my country. Delivering a baby in the back of an ambulance is very risky especially for mothers with complications.
Uganda’s maternal mortality ratio is estimated to be 336 deaths per 100,000 live birth (WHO, 2023). About 1 in 5 (22%) of women died during pregnancy and about 1 in 8 (13%) died after delivery (CDC, 2022) The leading cause of death include Hemorrhage, Infections, Pre-eclampsia & Eclampsia and unsafe abortions.
The most recent one was for a pregnant mother who went to a lower health facility and as labour progressed it was found out that she had a footling breech and everyone knows its risks and it should be delivered by Caesarean section. A call came in from lower facility to evacuate the mother to a National Referral Hospital for CS. An ambulance was dispatched, and I went with the driver. Reached the facility and found that the mother had strong contractions and we took little time to put her in an ambulance. Everything was set and we were let to go by the referring facility. I had a feeling that this mother might deliver in an ambulance. Me and the driver we laughed after we set off and he asked me if she delivers in an ambulance are you able to help her out? I told him definitely I will use my skills to save the baby and the mother.
5 minutes later after leaving the facility, the mother had more strong contractions that pushed the first leg out leaving the other one trapped inside. With the skills gained in the last 15 years in Maternity as a student I maneuvered and delivered the second leg and the whole body was out leaving the head inside the pelvis. Using Lovset’s maneuver I managed to deliver the baby, tied the cord and stimulated the baby to cry. The baby scored 8 in 1minute and 10 in 5 minutes. The placenta was delivered and checked for completeness.
After the mother and baby were stable, we had to drive back to the referring facility and re admitted the mother and baby in good condition.
Conclusion:
For all the practitioners out there, no skill is useless until it is put to use by saving a life. If there is someone who has saved your life or the life of a loved one, please take a minute to appreciate them.
Kamugisha John Bosco is a Nurse, Health Educator, Emergency Care Practitioner and a Global Health Specialist. He is part of the team supporting National Call and Dispatch Center for Ministry of Health at Naguru Hospital.
He is the Program Director at Global Emergency Care in Uganda and in collaboration with Mbarara University of Science and Technology
He is a Volunteer with Uganda Redcross Society as National Disaster Response Team- Health
Article by: Kamugisha John Bosco July 23, 2023