Ward 5C

I spent the day in Ward 5C, the "high-risk" labor ward. Essentially anything that isn't a completely normal and uncomplicated pregnancy goes here. In the morning I observed a C-section where the patient told me she was 1 of 24 brothers and sisters (I didn't realize this was physically possible). In the afternoon I went to the labor ward. It's much different from Ward 14.. there is a large room where 15-20 mothers are lying in bed.. some are screaming some are quiet.. some have to sit on mattresses on the floor because there are not enough beds. I was helping a midwife weigh a baby and standing at the weigh station. I look over to my left where a woman is screaming bloody murder. I see that she is lying on the floor with a baby already crowning. I grab the midwife next to me and tell her "Her baby is coming!". She looks unimpressed and says "I'm busy. You do it" and walks away. There is no one in my immediate vicinity and her baby is fast approaching. Trying to avoid the large puddle of amniotic fluid and blood I help her deliver her baby... which had pretty much already delivered itself by that time. I place the baby on her belly and rush to get supplies to tie and cut the cord. I ask for a midwife to help me but she is busy with another patient and walks away. I successfully tie and cut the cord and wrap up the baby. The baby is crying and moving. I'm relieved. Before you take a baby from her mother in Uganda you ask her to identify the sex. "Mwana chi?" I say. "Muwala" (girl) she says and smiles. I go up to a doctor and tell him what happened. He gets oxytocin, injects it in her thigh, is completely uninterested in doing anything further, and walks away. The whole time the woman is on the floor. A midwife instructs me to get her into bed but does not try to help. By this time I'm annoyed with all the people walking away from me. I help deliver the placenta in bed. I inspect it and it appears intact. I don't see any perineal tears and I ask a doctor to check. He says he will but goes on doing something else. I set the baby next to the mom and help her clean up. I thank God that I paid attention on my Ob/Gyn rotation third year.