A month in the life of a midwife in Myanmar

The 5th of May is the International Day of the Midwife so it seems appropriate time to share this on our blog page. Mon Parker, an Australian nurse/midwife has recently spent several months working at the remote jungle clinic. Over the course of a month she chronicled the events of a rather busy time at the clinic.

Sun 17th March

We are witnessing a miracle! Yesterday afternoon our RT Clinic birthing house was busy. One lady was ready to birth after a long labour when a truck pulled up in a hurry red dust scattered thick in the air. One of our PA students went out to meet the truck and then I heard “Teacher Mon, I need you! We have a lady breech and a foot has already come out.” A young woman with a small bump was being ushered inside the clinic. Mums best guess was 7 months pregnant which could be anywhere 27 weeks to 31 weeks! Ultrasound was difficult and led us to think 27 weeks. This would be difficult - we are not ICU equipped. I was able to talk our PA Victoria through a breech birth and when baby was born he was not looking great. His APGARS were 2, 2 and 2. He had a great heartbeat with little assistance, but we could not get any respiratory effort or tone. Given it was so early we explained to his young parents he had a heartbeat but we had done as much as we were able to. We encouraged mum to hold her baby and she did. We quickly cleaned up around them and gave them space. I went back to my house thinking that the baby couldn’t last long. This morning early our PA in the birthing house contacted me and asked if I would come down as the little baby was crying and she wasn’t sure what to do for him. Apparently, mum cuddled him for 2 hours and noticed he might be breathing she shifted him and he started to cry. We now have made a homemade CPAP (continuous positive airway pressure) to help his lungs, have been dripping colostrum into his mouth and giving him IV fluids. This little champ has a long way ahead of him but his parents and our PAs are taking great care of him and giving him his very best chance!

Wed 20th Mar

Good morning from RT Clinic - Saw Moo Nay Soe is happy to say he has made it to 84 hours old and has weaned his CPAP and is tolerating lower amounts of oxygen. He is also tolerating small amounts of mums milk and likes to squawk when he feels the need! He enjoys kangaroo care with mum during the day and loves his warm heating box during the cold nights! Our PA’s and PA students are taking fabulous care of him!

Fri 22nd Mar

Saw Moo Nay Soe is doing really well all things considered! It will be a long journey but for now he is doing well! We now have another small guy 2 weeks old (Saw Lah Kee) who hasn’t been able to suck well and has lost a lot of weight. So we have two small wee guys fighting and slowly getting there! I will try to update periodically! ❤️❤️

Sun 24th Mar

This morning I went to the Mums and Bubs house and did a quick round on my own before all the students arrived. We have 6 babies in house at the moment! When I got to Saw Lah Kee I saw a little guy whose worst days are behind him. His colour has improved and his skin has improved and he has lost his scared lonely look. His mum was doting on him!

Wed 27th Mar

Ok it’s time to introduce you to our latest wee man. Saw Khay Nay Y’wa. He had a difficult arrival. He was persistently in a difficult position and his mum laboured for 3 days. 2 of those days the traditional birth attendant felt that his birth was imminent with a small amount of his rather swollen head visible. Mum was carried in a bambulance (a hammock stretched out over a bamboo pole) for two days! When she finally arrived at the clinic she had the classic signs of obstructed labour. We had to do a c section. Amazingly this wee man was still alive. It had been a brutal few days. His condition was quite stunned and needed extra support. He is back in our birthing house and we have evicted Saw Lah Kee from the infant heater and are giving IV, homemade CPAP, colostrum and antibiotics! 😍😍

Mon 8th April

It’s time for a baby update! Saw Moo Nay Soe is doing well! He is a tiny delight that we are trying to fatten up! He doesn’t require oxygen and he is able to get enough milk from mum to control his sugars, hydrate and grow! It’s remarkable! He is indeed our miracle baby!! Saw Lah Kee is doing well! He slowly continues to put on weight and is his mum’s delight! We will work out how to keep him fed once he gets home and it looks like we will need to help the family with baby formula. On a side note it’s common for parents to buy bags of milk creamer which is not even a dairy product and use that as formula. It says on the packet milk creamer but when you read the ingredients you see it’s not. People don’t realise that it’s not nutritious and they use it oblivious until their baby starts to lose weight! Infant formula is not available and is out of most families price range. Khay Nay Ywa is doing well! He suffered a lot in the birth process, our wee man was struggling with his breathing and fighting infection when he was born. He had a swollen head from where he was trying to come down the birth canal but not fit. He had/ has lacerations on his scalp due to well meaning birth attendants trying to push him out of the womb! He is now free of his oxygen, his IV line and he is able to snuggle with his mum and feed while we wait for his wounds to heal. Yesterday we introduced a new baby that looks like he is ready to start school! I was able to talk Eh Joe one of our 4th year students through a shoulder dystocia. This young man weighs in at 4280g (9lbs 4oz) this is an enormous baby by Karen standards! The other exciting thing for this birth was that Mum in her previous 2 births had severe post partum haemorrhages. Yesterday our team was able to actively manage her and she had minimal loss. This is the power of good care!

Sun 14th April

Saw Lah Kee was doing well and gaining weight and much to the delight of his mum and his uncle he was able to go home with milk formula support! Saw Moo Nay Soe is doing really well but has been slow to gain weight. We have finally settled on a strategy that is seeing him gain weight! He has been such a beautiful miracle. Our latest baby - yes another boy 🤷🏻‍♀️ arrived this afternoon and is the delight of his older sister ❤️ Our mama’s and baby’s are a special group and all mama’s deserve a safe birth and all baby’s deserve the best start we can give!

Mon 15th Apr

We welcomed another baby tonight. Mum was referred with heavy bleeding. We diagnosed a placenta praevia and were able to do a quick c section! Mum is doing well and baby is a little stunned from the events and so again we have set up our homemade CPAP to help her breathing! And yes out of 14 babies since March we have the 3rd Girl! ❤️