Amazing Energy

Sister Namaleu told me months ago about her oldest daughter's pregnancy. Chimwemwe, the first of six girls, was pregnant with the first grandchild who everyone hoped would be a boy. Namaleu asked me to attend Chimwemwe during the birth and I was excited about the prospect.

According to a hazy memory of her last period, her due date was set sometime in June, but June came and went, early July came and went, and still the baby gave no signs that it was ready to see the world. I met Chimwemwe for the first time on July 16 and by a conservative estimate she was well into the 42nd week of the pregnancy (as the pregnancy continues past 42 weeks there is a sharp increase in the risk of stillbirth as the placenta begins to deteriorate). The following day I scanned her at Bottom and could see that the baby was active and had plenty of fluid; her cervix was soft but closed - a sign that labor was still a couple days off. We decided to meet early in the following week for another scan and possibly an induction.

On the 19th I had planned a three day trip to the lake with my friend Deb who would be leaving Malawi permanently on the 27th. I very much wanted to be present for Chimwemwe's birth but both Chim and her mom knew that I would be away for a couple days. Chimwemwe seemed confident that the baby was well and would wait for my return.

Sunday Chimwemwe had mild contractions and neither she nor her mother slept but Monday the contractions stopped. Monday night and Tuesday the pattern repeated. Tuesday night at 1:30am sister Namaleu called and said they were ready to go to the hospital. Pulling myself from my warm cozy sleep, I momentarily doubted my calling as a midwife, and only with great effort escaped the magnetism of my bed. I expected that Chimwemwe was still in early labor and wanted to talk to her or examine her before we left for the hospital, but when I reached their house she and her mother were already standing out in the cold night bundled in chitengies, bags ready at their feet. I realized later that when six girls share a bedroom and when the laboring women shares a twin bed with her younger sister, the hospital is a better option than home, even in early labor. (If I hadn't had a friend sleeping in my guest room I would have brought them to my place.)

When we arrived at the Kamuzu Central Hospital the nurse agreed that Chimwemwe's labor had just begun and sent her to a room to rest if possible and to wait indefinitely. Namaleu and Chimwemwe sent me home to sleep - an invitation I happily accepted. I returned a few hours later with porridge and bread; her cervix was 4cm dilated. Chimwemwe ate a couple cups of porridge, then her mom suggested a "jolly walk." I accompanied her to the end of the outside corridor and then was shocked when she asked me to wait a minute as she ran up and down the flight of stairs three times.

The labor progressed fairly slowly throughout the day. I watched over Chimwemwe and the baby as she visited with sisters and relatives and ate and ate. I had never before seen a woman eat like her during labor. She would only stop chewing during the contractions and then resume - gesturing to hand over her food - as soon as they passed . . . oranges, samosas, bread, rice and beef, nsima and eggs, sausage and greens, juice, water, tea. I told her she would definitely have the strength to push when that moment came.

Finally, around 5pm we moved into the labor ward. Around 7 she seemed to be stuck at 8 centimeters and the baby remained high. Her contractions never came more frequently than once every five minutes. We tried walking, squatting, standing, rocking, but her contractions did not pick up and the baby, although doing well, stopped moving down. I suggested that maybe we give her a little pitocin (a synthetic version of oxytocin - the hormone which drives the pattern and strength of contractions) but she wanted to wait. Seeing the concern on my face she told me in a calm confident tone, "Don't worry, Joanne, I'm still strong." At 8 we started the pitocin, within minutes her cervix was fully dilated, and 20 minutes later I was lifting the baby on to her belly (all that food sure helped). At that exact moment her phone rang and she shouted into it, "IT'S A BOY!!" Chimwemwe was beaming and doing a little dance in the bed; I was laughing and smiled until my cheeks hurt. No more doubts about midwifery. I LOVE this job! I'd do it for bread and water.

A few days later Chimwemwe and her family asked me to give the baby a name. The father had given the first name and I gave the second. He is now forever Precious Yankho. (Yankho means answer, as he was an answer to many prayers.)