My husband and I arrived in Ghana when I was 7 months pregnant with our first child. We contemplated and prayed about where to have our baby and we both came to peace about delivering at a hospital in Ghana that some of our colleagues had used for other illnesses. There was an American doctor there who met with us and we felt comfortable trying to have our baby there, allowing the midwives to deliver us unless there were complications. This is normally how things run in Ghana. We had received antenatal care in the U.S. including an ultrasound and then kept regular track of my blood pressure, ourselves, after we arrived. My husband and I are both nurses, which gave us a measure of confidence that may or may not have been helpful to us =)
The moral of our story would be that you need to be at peace about where to have your baby. We were serious about seeking God over where and who should deliver our child. There was no writing in the sky, but we both felt secure about our decision.
A week before the baby was due, we traveled to the hospital which was about 3 hours away, and settled into a little guest house nearby. I had brought my own sheets and pads and everything I could think of that we might need for a Ghanaian hospital birth. I was new to the field, and new to parenthood… there was really no way to prepare myself. I tried to think of worst-case scenarios and decided that pushing for 5 hours would definitely be one of them! (Read on...)
Our baby took its good old time and we filled the next two weeks with memorizing all the countries of Africa, going on 3 walks a day (we got to know the locals personally!) puzzles, books, naps, you name it. My maternity clothes were getting tight… and I was very tired of being pregnant. Looking back we still treasure the couple time we had before we got launched into parenthood and all the other responsibilities and adjustments of life on the field.
Our excitement was sky high when I discovered bloody show early Saturday morning (Day 8 post due date). We got up and went for a long walk which produced regular but light contractions and we became hopeful. My contractions were light all day but by 8pm we decided this was the real thing. My husband and I realized that our dream of going into labor in the morning and avoiding that extra night of no sleep was not going to be realized. I wanted to stay at our guest house for as long as I could to keep from having to be penned in a small room or be away from my nice warm shower. But at 1:30 Sunday morning hubby said he would feel better If we would just go and figure out our room and get checked awhile before things get more serious. It was about ½ km to the hospital and we kept stopping along the way to breathe through contractions.
I went to the maternity ward and found a midwife behind the desk. Since Ghanaian men are not in sight when a baby is born we had asked ahead of time if they could give us a private room to labor and deliver in. The maternity ward consisted of a large room with approximately 10 beds, and a small nurses station in the corner. Once delivery was imminent they would move the patient to a small delivery room that had two delivery tables with a partition in the middle. They graciously had said we could have one of the theater rooms to labor in, so our midwife led us down to a small hot room with a cookie sheet of an exam table that was just big enough for me to lie on. She promised to return shortly to check me. And she did.
She was a was rather rough and you can imagine my alarm when she wiped my perineum firmly and proceeded to check my progress with her entire hand inside of me. “You relax! ” she hollered. I had not been vocal with any of my discomforts up until that point. Apparently she got the info she needed and reported that I was dilated 6 cm and that she was going to go get an amnihook and break my water. She left the room and I started to bawl. She returned an hour later and we pleaded with her to please be more gentle….She smiled pleasantly, “small small eh?”. The treatment was exactly the same only this time she included an amnihook. “You relax!” I was coming off the bed in pain, forget relaxing! She decided to leave me alone and try again after a while.
It was nice and cool outside so we decided to go walking around the hospital grounds and parked ourselves by a small picnic table right outside the gatekeepers shack where I could rest my head on the table and stay clear of any midwife that might threaten to break my water. At one point we were walking down a hospital corridor, when a big rat came careering around the corner. It came to an abrupt halt at the sight of us and made a hasty retreat down the hall it came from. We rolled our sleepy eyes to the ceiling and laughed cynically. The maternity ward was busy that night and I later learned they had 8 deliveries that evening. Finally we convinced ourselves that by now if they would break my waters the baby would be born before long. So at 5:30 we let the midwife come and have another go. She was obviously trying to be considerate, but this time she decided to be quick in hopes of getting it over with in an efficient manner but she miscalculated her poking and there was some blood, more agony and no gush of water. She got the “patient look” and said that I was dealing very well with labor but was just too uptight when she tried to check me. We contemplated calling the Dr. now but, shift change was just around the corner, so we decided to wait and see how our next midwife would be.
In she came at 7’Oclock. Slim fingers, I noticed and had a very kind demeanor. She introduced herself, and I decided to believe the best about her and allowed her to check me, which she did ever so gently and reported that I was at 8 cm and she was not anxious about breaking my water. I was advised to go walk or whatever I wanted to do. Big sigh of relief! It was still cooler outside than in our little room but people were milling around and seeing a pregnant white lady with disheveled hair and squatting every so often in the hallway or on a bench drew more attention than we wanted, so we stayed in our room. The contractions were strong and coming every 2-4 minutes.
My sweet midwife finally reappeared mid forenoon and checked me. I was 9cm. Soon another Dr. came to check me. She suggested we break my water. She did it very gently and I was relieved to feel that long awaited for warm gush of water! Now things could hopefully move along and we could have this baby! They instructed me to push. I had never had a baby before but I didn’t think I felt very pushy. I had determined ahead of time not to push until I felt ready. We were both exhausted but instead I paced around the room hanging onto my husband and squatting with each contraction and pushing with the ones I felt pushy with.
2pm the nurses advised us to come into the delivery room. This time yet another midwife checked me and told us she feels a lip that’s in the way! After not pushing for a while they checked me while I pushed to see if that lip would disappear. It did….Then they checked again no, it didn’t.
I got on my hands and knees, I rocked back and forth, I panted, I blew. 4pm. They had been periodically checking the baby’s heart rate with a Doppler. The baby seemed to be tolerating the drawn out process quite well but they couldn’t be sure because the Doppler wasn’t working the greatest. The staff kept assuring me that the baby is coming and I was doing good, but I didn’t feel any different, and I was mistrusting of their encouragement.
Hello and goodbye, worst case scenario. We were now at 7+ hrs. of pushing. They started monitoring the baby more closely and soon noticed that the heart rate was dipping more often and it was decided to do an emergency C-section. The Dr. arrived shortly and checked me. The baby was too high to attempt a vacuum birth…much to my relief, and after pushing a couple more times with no progress he left to round up the surgery team. I signed the consent form gladly and suffered through a 2 minute long contraction without pushing. My husband changed into scrubs and soon they had me on the OR table surrounded by a German nurse, Ghanaian anesthetist, American surgeon, my Ghanaian nurse and a few other assistants. For a brief moment on the OR table I wondered what would happen if I would bleed profusely for some reason. There was no blood bank. And my blood type is very rare here.
Mr. Anesthesiologist had me sit up and inserted my spinal block. I am eternally grateful to him. You have no idea how comfortable an OR table can be! The Dr prayed over us. It was so beautiful! 8 people from very different walks of life all united in the operating room, coming together before our loving Father asking for his presence to fill the room. The surgery began and 10 min later Dr. announced, “Wow it’s a big baby boy!” At 6:55pm our little Noah had arrived! He started crying heartily (as well as his parents!). The nurse showed the baby to me for only a second and then whisked him off to clean him up. Everyone started to guess the weight in kilos. I was still having trouble converting kilos accurately to lbs and oz so I was little lost. 9lbs and 4oz! No wonder I was having trouble pushing him out. His head circumference was 14 in.
As they were putting the final stitches in, the electricity went off. There is generator backup but it would take several min. for it to come on. Someone quickly whipped out their phone by means of a light and thus the job was completed. The rest of the evening I was in a happy daze. Our little Noah was the sweetest baby we’d ever seen!
Many people since sympathize with me that I had to have a c –section. To me it was such a gift after laboring for nearly 24 hrs. I am so happy that I had that option and that there was a successful outcome. I look back on this “traumatizing” experience as something sacred and bonding for us as a family and not something I look back on with regret.
Being first time parents and new to the field definitely was an identity crisis for me. I went from being an independent person who held a job as a nurse and loved it. Now I was a language learner and a mom and did not have a shared history with anyone…and I did not love it. I felt like I was completely stripped from all I was comfortable in or good at. Mix in a baby who didn’t sleep great at night and some hormones…It was a low time in my life. But it got better. I have learned over the years that you are always in a season. That was the new baby, language learner, culture shock season. Now I know some language. The “baby” puts himself to bed practically (after his first night which was spent in a suitcase as the hospital weren't able to provide cots- see below) and I have adjusted to life here, to the point where I am not constantly thinking about how different it is from what I was used to.
And then I got pregnant with Zed! See Zed’s birth story next week!