Monday, December 12, 2011

Not one, not two but three-Triplets born at MHI Uganda clinic

Alice arrived in the Eleventh hour. Literally, translated from the Acholi language, 5 am is called the Eleventh hour, with 6 am being the Twelfth and 7 am being the First hour; the first hour of light and a new day. She arrived in what she believed would be her Ninth and final labor. Having walked about 6 miles to reach help, she was ready to push shortly after arrival. Her body was tired, she had barely eaten the previous day, and was encouraged to drink sweet tea to give her energy for the push.

The baby's tiny head emerged, quickly followed by the rest of her, and yet the mountain of Alice’s belly still loomed before us, undiminished. As her body called her to push again, she believed the placenta would be born, yet instead, tiny feet made their appearance, then disappeared again to be replaced by another, tinier head. Then the second little girl was born, followed immediately by those persistent, delicate little feet that had tried to cut the line. And then there were three. Three tiny, beautiful little girls, instead of the last, single child that Alice had been expecting.

Needless to say it was a bit of a shock, to all involved. Earlier in the pregnancy, Alice's husband had divorced her, after bearing him 5 live children. He maintained that because he had used condoms with Alice when they had intimate relations, he had nothing to do with this new pregnancy, and sent her back to her fathers village with all of her children. She found herself suddenly single, now with 8 children all under the age of 12.

The first days were challenging, but the babies, named in Acholi tradition: Apiyo (first born), Acen (second born) and Adoch (born breech) were strong spirits, all able to latch and nurse well. Apiyo was 2 kg/ 4.4 lbs, Acen 1.8 kg/ 3.9 lbs, and tiny Adoch was only .9 kg/ 1.9 lbs. Alice was very despondent at first, overwhelmed with the reality before her. She was reluctant to hold them or nurse them, believing that at least one or more would surely die, afraid to love them. Her tired body refused to cooperate, and two, three, four days passed and still her milk failed to come in. We fed her, gave her teas, vitamins, homeopathics and loving support... yet still her milk did not come.

By the second day, the babies were crying in hunger, so we supplemented their milk, always having them first nurse for some time on Alice to continue stimulating her milk supply. The most difficult in the beginning was Adoch. She was so weak, it would take her five minutes of dripping milk into her mouth for her to gain enough strength to suck. By the third night of sleep deprivation, Alice asked me to take Adoch at night, and I was happy to, because I could see that as the weakest, unable to express her needs, she was wasting at night while the other two grew slowly stronger. And she thrived, sleeping on my chest at night and spending the day curled up with her sisters, by a week old she was starting to gain on them.

It took 6 long days for Alice's milk to come, but thankfully it did, as we knew it must. She was able to fully nurse Apiyo, but we had to continue helping her with Acen, who developed reflux, and needed to be fed small quantities in an upright position and then burped and held upright for 10 minutes after each frequent feeding. As for Adoch, more and more Alice asked that she remain with us midwives. She expressed her belief that she might be unable to care for all of her many children, collect firewood, cook, wash, find food for so many with three small babies. Who would carry the other two while she worked with one on her back? How would she manage while they were still so small and unable to be worn on the back? Several days later, her milk supply was still not adequate for three, not even quite enough for two, no matter how much we fed and hydrated her.

One afternoon, as I sat bathing the babies with her, Alice looked me in the eye, told me about her concerns and asked if I would like to have Adoch. I asked her if she was serious. She said she knew now that she could not take care of these babies alone. Could I, or someone else take one or even two of them?

With Adoch bound to my chest, and my own one-year-old daughter on my hip, I went to my co-midwife Rachel, to cry the pain in my heart because I knew I could not take this baby, yet I knew if I did not, she would surely die. And as she often does, Rachel inspired me... what if we could find an adoptive family? And as soon as we put the word out to the universe, a miracle was provided! 

Two weeks postpartum, a grateful and stronger Alice returned to her village with Apiyo, the first and strongest of the baby girls. Acen and Adoch grew steadily with us, and just a couple of days later met their new mother. Although the legal process in Uganda is lengthy, the new parents are committed to give their daughters the very best and are sticking with it through thick and thin.

At 2 1/2 months old, all the girls are now over 4 kg/ 8 1/2 lbs , healthy, strong and beautiful.
Olivia Kimball, Traditional Midwife