The Canadian Association of Midwives (CAM) regularly receives positive feedback from the midwife participants of the Midwives Emergency Skills Training (MEST) that is given within the Improved Service Delivery for Safe Motherhood project. Recently, CAM received these stories from the midwife participants of the emergency skills training in the Musoma and Mtwara Rural Districts explaining how their new skills are being put to good use.
Story of Conjoined Twins in Musoma Rural District
One midwife from the Kiembe Dispensary received a full-term, labouring client, who had had very little prenatal care. Upon examination, the midwife discovered that the baby was in a breech position. She began to apply her emergency skills training for breech delivery, and successfully delivered the baby’s legs.
She soon realized however, that there was a second baby, and that in fact the two were conjoined. The midwife managed to deliver the twins, and apply neonatal resuscitation, but unfortunately they only survived for two hours.
The mother had severe bleeding due to a retained placenta, which the midwife was able to remove manually because of her new learning on the management of postpartum hemorrhage (PPH). While the bleeding continued, the midwife was able to stabilize the mother for long enough to refer her, and have her transported to the regional hospital, where she recovered physically from the birth.
Story of a Breech Birth in Mtwara Rural District
Upendo Mligo, a midwife participant from the Namisangi Dispensary in Mtwara Rural District, Tanzania told us her story. She and her infant son travelled 40 kilometers to attend the MEST workshop that was co-delivered by TAMA and CAM in early 2015. She felt it was an important opportunity to enhance her skills, as till then she had had little practice in emergency situations.
Within hours of returning to her dispensary, Upendo was called to attend a woman in labour. After an examination, she quickly realized that the woman’s baby was in the breech position, and called for help. However, the woman had a strong urge to push, leaving little time for deliberation. Upendo and an assistant were able to successfully deliver the breech baby.
Upendo had never assisted a woman with a breech delivery before the MEST workshop. Cases like these are almost always referred to a district or regional hospital – requiring sometimes difficult/lengthy travel, and no guarantee that a skilled care provider will in fact be available once the woman arrives. There would have been no time to refer this woman, as delivery was imminent. Without the skills that Upendo gained from the MEST workshop the outcomes for the mother, the baby, and the eight children waiting for them at home, might have been much different.