Saving Lives at Birth; Maternal Health in Uganda

Harriet arrived at the Shanti Uganda Birth House in the middle of the night on a motorcycle driven by her husband. Her contractions had started around 10 o'clock that night and, this being her first baby, she felt it must be time to go because she was unable to sleep.

They were met by two midwives who welcomed them and examined Harriet. Her exam revealed that she was in labor but very early labor. Her husband, Christian, left and Harriet settled into bed for a restless night of no sleep.

When Harriet began to labour in earnest she took to heart the coaching in breathe work and body relaxation the midwife offered and was able to work with her contractions effectively. Christian returned to the Birth House and took over labor coaching. The couple spent the latter part of the afternoon walking, sitting on the birth ball, and resting as Harriet needed. As the afternoon progressed, so did her labor and by 3:30 she was 8 cm. dilated.

Christian sat behind his wife, supporting her as she leaned against him.

After about 45 minutes of struggling to get the knack of bearing down, the midwife suggested she move to the toilet and try pushing while sitting there. This turned out to be a great position for Harriet. When it was time for the baby to come the midwives helped Christian get positioned on the edge of the bed and Harriet spent the last few contractions of her labor in a squat supported by her husband.

As the baby's head crowned, Harriet, ever compliant and open to the midwives' suggestions, panted, and her baby slid out gently into the midwives hands. The little boy looked around and patiently waited to cry until his mouth and nose were suctioned. He promptly cried as soon as his back and head were dried and let us all know that he just wanted to be left in peace in his mother's arms -- which is exactly where he went!

After a short time of skin-to -skin bonding, the baby was weighed (3.6 kilos) and given to his admiring Papa. Then he was put skin-skin on his mother's chest and proved to be a champion nurser.

While this story sounds like a typical out-of-hospital birth in the USA or Canada, it was a remarkable scenario in Uganda. Few fathers attend their child's birth and even fewer act as a coach to their laboring wife. Delivering in anything other than the lithotomy position is a rare occurrence and guided pushing is the norm instead of women finding their own power in working with their bodies to bring their baby out. Harriet and Christian were thrilled with their birth experience and are proof that Shanti Uganda is changing birth in Uganda.