Hope for the Hopeless

Kristen here…..

I groaned as I groped in the darkness to find my ringing phone. The clock said midnight as I answered in my half-awake state.  The voice on the other end spoke in broken English that was further garbled by a bad connection.  All I could really get from that conversation was that there was a preterm pregnant mother with abdominal pain.  I hung up the phone with a sigh.  Better go investigate. 

I heaved myself out of bed and changed into my scrubs.  Our dog, Moto merely groaned at me as I walked past him sleeping in the hallway.  I was thankful it wasn’t raining as I grabbed my flashlight and set off down the dirt path to the hospital. 

I walked into the maternity ward to find a young girl sitting on the bench waiting for me.  I could tell she was uncomfortable by the look on her face.  I brought her back into the office and began my examination.  The ultrasound confirmed a live baby dating at approximately 26 weeks gestation and weighing 833 grams.  I was peppering her with questions as I tried to sort out the story.  This was her fourth pregnancy, but she had no living children.  Each pregnancy had ended much the same way this one was going tonight.  She had lost every baby to preterm labor – 2 months, 4 months, 5 months and now 6 months. She knew the pattern.  She had been here before.  Each one started with an all too familiar pain and ended with the delivery of a baby too small to survive. 

As I finished up my exam it became clear that history was trying to repeat itself. The cervix was already 4cm dilated and the amniotic sac peered back at me with an eerie blue/gray bulge as I examined her. Not good.  Exposed amniotic membranes encourage infection and preterm delivery.  My heart ached for this patient in front of me.  Her face was grim. She knew the outcome before I even said anything. We could probably count on one hand the number of babies born at 800 grams here that have survived. The odds were very, very poor and we both knew it.

With a deep breath I began explaining the situation.  She nodded, knowing all too well. I told her that we would do everything we could to keep her pregnant longer and to give her a living child, but that we must pray because it is only God that is truly going to save this little one.  I spoke with the nurses giving them orders.  I was going to throw the kitchen sink at this patient to get every hour I could out of this pregnancy. We had to try. This was the closest she had ever come to having a live child. We held hands and prayed together as the nurses gathered supplies and started IVs. 

As I walked home in the dark, I knew that if she was still pregnant by daybreak we had a fighting chance.  This baby needed to gain as much weight as possible before being introduced into this harsh and unforgiving world.  Every day mattered.  I crawled into bed and spent the next hour pouring out to God over this mother and her tiny, unborn child before falling into a fitful sleep. 

Early the next morning I called up to the hospital to check on her status.  Still pregnant! No more contractions! Praise God!  I brought this patient before the other missionaries at our morning prayer time and we again lifted the plea of this young mother before the Lord. 

I have never seen a patient with this presentation last more than a week before delivering.  Day 6 of her admission proved this to be true with an early morning phone call.  She had begun contracting and now was completely dilated.  There was nothing else to do to stop the process.  I hurried up to the hospital to check the position of the baby. Breech. We prepared the patient for surgery.  One of our family practice physicians and a visiting pediatrician came to attend the birth.  We needed a full team to care for the immediate needs of this little one.  As soon as the baby was delivered we stuffed him into a ziplock bag. Weird, I know, but in order to keep him warm enough so that he could focus his efforts on breathing this was an essential step.  The gallon size ziplock seemed to swallow him with only his head showing out of the top. The first little peep from his tiny lungs made the whole OR sigh in relief.  He was trying to breath on his own and was even making an attempt at a cry.  Quickly, he was whisked off to the NICU and we continued to pray for this little life.

After finishing up in the OR I went down to the NICU to check on this baby’s progress.  Still in the ziplock, under the warmer they were getting our bubble c-pap apparatus set up.  Bubble c-pap is a method of delivering oxygen to our premature babies that encourages breathing with positive pressure ventilation.  It is the most advanced method of oxygen delivery for our babies available in Kapsowar and it was working like a charm.  He was taking to it well and breathing as he should.  I sighed with relief.  Keeping warm and breathing are some of the biggest obstacles in these first few hours of life and so far he was doing both with flying colors.  His weight on the scale came in at 900 grams. Smaller than I was hoping for, but not out of the realm of possibility for survival.  He would need a lot of prayer. 

In the the NICU with C-pap on

C-pap apparatus made out of an old Ragu jar, plastic ruler,
tubing and tape

The next morning I hurried to the NICU to check on his progress.  Still alive!  He had survived the first night.  The bubble c-pap was still going as I watched his tiny chest rise and fall.  Thank you Lord, for this gift.  I walked by the bed of his mother who had not yet been made aware of her baby’s progress.  The day before had been one big blur for her as the drugs from the surgery slowly left her body. She had been too sleepy to hear his tiny cry in the OR that had brought relief to the rest of us.

I sat on the edge of her bed and began to explain that her child was alive.  For the first time, she had a child that was alive.  I told her that he was very small and needed help breathing and staying warm.  We talked about how the fight was not over yet and that we needed to pray for him continuously. Tears filled her eyes. She had a son – as small and tenuous as his life was, she had a son.  I encouraged her to go to the NICU to see him and the light in her face illuminated the room.  She probably never had the chance to see the faces of her other children as culturally this isn’t done if they don’t survive.

Proud mama standing next to her baby. Her smile is radiant!

This is now day 3 of life for this little baby.  He is still alive.  His weight has dropped to 700 grams, but he has begun to tolerate very small feeds.  Keeping the bubble c-pap going and functioning properly continues to be a battle. His mother is frequently by his side enjoying caring for a baby for the very first time.  Please continue to pray for this baby and his mother. The road is going to be long and there are many obstacles. It will be the Lord that will sustain this baby into childhood, but there is a glimmer of hope for this childless mother as the Lord continues to hold and guide them both.

***story and pictures posted with permission from the patient