Degie is curled on her bed, her body is still. Her breathing is shallow, and her eyes can’t seem to focus. Her tattered gabby cloth swirls around her body, and one bare foot is dangling over the side of the bed. I look at her for a long time, wishing I could help her. I hear a voice, and see that the woman in the bed over in the corner is also watching her.
“She sick. Very sick,” she says in broken English. I nod silently in agreement.
Degie is tiny. Her rail thin body is listless, and her mouth gapes open as she tries to take in each breath. I try to find a midwife to ask about her, and as I start to move away, Degie screams out in agony. A midwife rushes into the room, followed by our medical team. She has been in labor for a long time, no one knows for sure exactly how many days it has been. A few family members are sitting near her bed, and as the day progresses, more brothers and sisters trickle in, having heard how sick she is. Many are openly crying.
In rural Ethiopia, family members are expected to fill in as nurses and to provide other items of support such as food and bed sheets, but it is apparent that this family is here because they love her dearly and they are deeply frightened.
This is Degie’s first pregnancy, and she is near death due to this long labor.
The midwives administer Pitocin, and wait for her contractions to come more frequently. Once they do, they ask her older brothers to carry her into the labor room, and they comply in a stoic manner. It is not hard to see the concern on their faces. Degie continues to contort her body as each contraction comes, yet she is so weak she can hardly breathe, let alone scream during her pain. The midwives ask Degie to start pushing. They try everything to get the baby out, but it will not move.
Degie is suffering from obstructed labor, which often results in death for both the mother and baby. If a woman does live through obstructed labor, she frequently develops a fistula, which has devastating physical, social and psychological effects.
After two hours of pushing and an attempt at delivering the baby with a vacuum, one midwife, Selam, asks for visiting obstetrician Dr. Philippa to return to the labor room. Once Dr. Philippa arrives, she agrees with Selam that Degie’s tiny pelvis will not accommodate the birth of this baby and the baby can only be delivered by cesarean section. When they ask for Degie’s consent, she shakes her head no. She is scared and is worried about the money: less than $100. The midwives tell her brother that both Degie and the baby will die if the baby does not come out soon. Degie’s brother assures Degie that they will sell precious cattle and do whatever it takes to find the money. He pleads with her to say yes.
Degie gives her permission, and is swiftly transported to the operating room where a team of midwives, a nurse anesthetist, Dr. Philippa and Physician’s Assistant Darlene have assembled. They are ready for her.
