Who says threes a crowd?

Don't get any ideas, Mom.

 To say the labor room was "exciting" yesterday, would be a grand understatement. It had been a little over a week since I have been in the actual labor room so I was really excited to work today. I made my way through the flimsy curtain and saw 9 laboring mamas. I was with a team of 6. Outnumbered once again, but defeated...not a chance! I made my way to the back of the room and found Sakina. She wasn't screaming or crying or demanding attention, but I found myself drawn to her. Once I approached her I noticed the big tummy she carried on her petite little body. Not thinking much of it, I started a partograph and decided I would monitor her. I made my introductions and took her vitals when a doctor and a few midwives approached her bed.

"Tatu," they told me in Swahili.

Three? Three what? Three hours in labor? Three centimeters dilated? Three previous pregnancies?

They pointed to her tummy.

Triplets.

I tried to contain the fact that I wanted to jump up and down in my excitement. Three babies, in that belly, and I get to be her midwife? This is almost better than winning the lottery, twice.
As much as I would have liked to carry on by myself, I knew that I need a few extra hands. I found Steph, who was just finishing up helping out in a breech delivery down the way.

"Triplets, Steph...." I began to say...I could hardly finish my sentence before she had already agreed to take on the task with me. So we teamed up and together we began to monitor Sakina. We found three little heartbeats on her belly and marked each one with pen. We monitored more frequently than normal, knowing that this could get really risky at any moment. Our MD instructor, Sina informed us that she thought it was better Sakina goes in for a cesarean section-that's what would happen in the western would, but the doctors on duty continued to insist that she was capable of a vaginal birth. We took every precaution we could and prepared a birth plan, including finding three extra sets of hands to receive the babies once they were born. Together, the three of us labored for hours. (although, Steph and I didn't endure even of a fraction of the pain Sakina did) The doctor told us to be ready to conduct the delivery at 12pm. When 12 o'clock came and went we knew it was time to reevaluate her condition. I did a pelvic exam and found that she was only 8cm dialaetd. This could be a bit longer than we originally thought.

As we continued to monitor her and the babies, the time continued to pass and the contractions seemed to be ceasing.

After some more time passed, it was time to do another pelvic exam. Our findings indicated that she really was not progressing the way she should have. The clock was ticking and I began to be concerned about the welfare of all the lives involved. Worst of all, I knew my shift was quickly coming to an end. As much as I would have been willing to stay until I couldn't stand any longer, when my instructors say its time to go...it's time to go. I not only felt the sting of not being able to deliver her babies with Steph, but more importantly, I worried that I was abandoning her, knowing that the staff was not concerned with keeping a close eye on her case.

And what I dreaded most came to be. It was time to go. The fetal heart rates were still good but momma was not progressing and her contractions had ceased. I found a doctor before I left and begged him to take her to the operating room for a cesarean section. Maybe Sina was right after all. I pleaded my case and explained to him how I really wanted all three of these babies to live. He told me there is a back up of 8 people before her in the operating room, but he assured me he would send her.  I felt frustrated by my situation but I had to walk away.



 I got on the overcrowded bus to head home when I received a phone call, it was Maj, " I have a proposition for you..." she said, "you want to come back and watch her surgery with me. We got premission from our staff to stay as long as we don't do anything."

I grabbed Anna Elisabeth and we immediately turned around.  I was so happy to hear she was going in for her surgery sooner than expected. The babies still had a chance. When we got back to the labor room, the chaos that had been there only half an hour prior had seemed to calmed. There was only one midwife on duty and a student nurse. There were no doctors in sight.
Sakina was still lying on the bed where I had left her.

Shadrach, Meshach, and AbednegA

I protested a bit about how they needed to get her in for surgery, but to my surprise Sakina began to go into real labor. The first head was coming. Rose, the midwife made her way over to deliver the baby. I stood back, prepared for the worst but hoping to see 3 miracles.  Baby 1 came out beautifully and just then the mom two beds away began to deliver her twins.  This baby was delivered and it was time for baby 2 from Sakina to be born. From here, it became a bit chaotic. Ten babies were born in somewhere around 30 minutes. Triplets, two sets of twins, and 3 single little bubs popped there way into the world.

Baby 2 and 3 from Sakina needed stimulation, oxygen, and resuscitation- we were on it. There were some moments of doubt, but between me, Maj, Steph, Anna-Elisabeth, and Rose we rejoiced and laughed and thanked Jesus because at the end of it all every baby was okay.

One of the beautiful babies born yesterday

Maj with one on of the sets of twins

It's Saturday today, and my day off but I just had to go to the hospital and check on Sakina and her three beautiful babies. Momma's hands are full but she was looking great. We checked her health just to be sure, after  all, she did just deliver three babies and the risks of complications are pretty much through the roof. We found that she had a high bp and some protein in her urine, indicating she was at risk for preeclampsia, but after speaking with the doctor they began to treat her as necessary and I am confident she will be well taken care of by the staff and then pretty busy for the next....I don't know... 18 years.