Beauty for Ashes..

My eyelids fluttered open and I turned my head to look around but it felt like a cinder block. Everything was blurry and despite being under several covers, I was trembling like a reed in the wind. My body felt like lead even as I tried to stretch my hand to ring the bell beside my hospital bed. I was oriented. In time, place and person but something felt terribly wrong. I had just come from theatre but I couldn’t shake away the feeling — of impending doom. ‘I need to get to that bell,’ I thought to myself but no matter how much my mind willed my hand to move, it didn’t. It was only after several minutes that the door to my room suctioned open and a nurse walked in wheeling a BP machine. I could only make out her silhouette in her bleached uniform as I struggled to keep my eyes open. I heard her gasp and in a split second she was by my bedside ringing that bell. She ran into the corridor and her voice arrived before she did. She screamt — “P-P-H!”

Everything was a blur after that and if I am honest I prefer not to remember it. I later came to learn P-P-H means postpartum hemorrhage — an obstetric emergency. And they are words that I hope never to hear again. People sometimes say your pregnancy experience is inversely proportional to your experience of labour and delivery. They lied. This was my first pregnancy and it was dramatic. From 24 weeks onwards I had a long standing Urinary Tract Infection that failed to respond to antibiotics. Consequently, I had contractions throughout the pregnancy and was on management for preterm labour every other week. By God’s grace and several medical interventions, the baby somehow made it to full term and I went into labour at 39 weeks.

I was happy to be coming to the end of that period. I figured the worst was over. So it came as a surprise when during delivery of the placenta, the cord just snapped; leaving the midwife holding one end, while the other end disappeared back into my uterus. They made every attempt to get it out but couldn’t. I felt prickly, raw and over exposed. It seemed like they were trying to grasp a wet pebble inside me. First it was just hands, then arms and even elbows disappeared up there. And still nothing. It didn’t help that I was an open tap of blood gushing everywhere. A decision was made to rush me to theatre before I became a bloodless doll. In theatre they had to open me up to get hold of the placenta and extract it. With that, the bleeding was controlled — but only briefly. It was several hours later that the nurse found me half conscious in my ward bed and I was back in theatre.

All this while my beautiful baby girl was lodging in the nursery oblivious to what was happening to her mum. When I was out of the woods hours later, she was brought to me — a delayed reunion but a wonderful one nonetheless. I brought her to my breast full of anticipation. But she did not follow the script. I pressed her lips to my nipple and she just stuck there — lips sealed. She was as disinterested as a blind person at an art gallery. I didn’t understand it. Wasn’t she hungry? And despite my best efforts, she kept her mouth closed. And it went on for days until she developed fevers and later convulsions and ended up in the NICU. Misfortune travels in crowds. I was now reduced to pumping milk for my baby. A situation that sucked all the joy of motherhood from me. If I was not expressing milk, I was eating sadness or snacking on tears.

One day while sitting in the NICU holding my baby and pumping milk, a nurse approached me. She was a visiting midwife from the UK.
“Hello. Why are you not breastfeeding your baby?”
“She is not interested. I have tried several times with no success. I was told some babies are just like that.”
“Can we try together?” She pulled a chair next to me and began to teach me about different latching techniques and various ways of how to stimulate a baby to feed. She seemed to know so much about breastfeeding. I later came to learn she was a lactation consultant. Her whole career was based on teaching people how to breastfeed! I did not know such people existed. In thirty minutes, my little girl was breastfeeding. And in a few days, she was better, her fevers were gone and she was responding well. I didn’t know it then but through my experience and encounter with that lady, a seed was sown in me and it grew.

When my Mat leave was done, I did not go back to work. I traded my suits and heels for a lactation management course. I felt that no other mother should go through what I went through so I carried with me my passion and supportive husband and forged ahead. At that time I had only heard of one other lactation specialist in the country. It was an uncharted path. No one knew much about it and consequently no one understood how I could resign from my well paying, corporate job to teach women how to breastfeed!
“People have been breastfeeding from when God was a child. No one taught them how to. It comes naturally.” Some would say.
But I came to learn that, it is that same mentality that had women suffering in silence and giving up on breastfeeding their babies. For some it was an uphill task and because it is termed as ‘natural’ mothers feel ashamed when they can’t do it or fail at it. So for a long time I offered the service for free — while living on one salary — and eventually I started to get referrals who offered to pay and I have never looked back since then.

When my second pregnancy came after a year and two months I felt ready for anything. Nothing could faze me after what I had gone through right? Wrong. One morning, when I was about 14 weeks pregnant I got up from my bed and when my feet touched the ground, I fell. When I got up to walk I felt a sharp pain radiating from my right hip. Along with the pain came defiance. My leg defied me. Refused to hold me up. It became like a newborn — it wanted me to carry it; drag it along like a stubborn toddler. I was rushed to hospital and the medics didn’t seem to know what was going on. All the tests that were done were normal. There is nothing as frustrating as having a body part that is not in sync with the commands from your brain. A wayward limb. You tell it to walk it says, ‘No.’ And the pain was indescribable. My limb, had for all intents and purposes rebelled against me. I was reduced to using a crutch to move about; if not I had to be carried. I delegated all my roles including care of my first daughter. It was a nightmare and I was not about to wake up.

And so it was. I went through my second pregnancy — disabled. One day while at home, I felt a sharp, stitch like pain on my lower abdomen. It was initially on and off then it became constant. Remember that feeling of impending doom? I got it. I can’t explain why but I had a nagging feeling that something was off. That day my husband was unusually early from work so he took me to the doctor’s clinic. When she saw us, she thought I was there for my usual complaint about my leg but when I explained how I was feeling, she wasted no time in instructing us to head to the hospital ASAP. When we got to the Maternity Unit, I found her there waiting in full theatre garb.

“How did you get here so fast? I thought we left you at the clinic.”
“I am taking you to the OR.” She said.
“What! Why? I am only 31 weeks pregnant. The baby is too small.”
“We don’t have time.”
Suddenly my husband was signing consent papers as I was being helped out of my clothes into a hospital gown. I felt like my rib cage would crack from the constant flapping of my heart.
‘What was going on?’ I thought.
In no time I was on the OR bed counting from 1 to 10 and then darkness.

When I came to, seven hours had elapsed. Remember the stitch like pain? It was a uterine rupture. When they opened me up the first thing they encountered was my baby’s hand. The previous scar had opened up almost halfway. And my gynecologist had caught on it.

“How did you know?” A groggy me asked.

“When I was a young medic, I had a patient who came to me with the exact symptom you had. I prescribed painkillers for her and only found out post humous that it had been a rupture. So I just knew.” The surgery took seven hours because they had to control the bleeding and repair the uterus which was a mess. There was an option to remove it but they were not sure my preemie would make it. But she did. Born at 1.9 kgs, strong and healthy.

Not being one to let misfortune to go to waste, I went back to school again. This time to study how to be a Doula. I had had the first hand experience of going through two difficult pregnancies, deliveries and infant care. Even after delivery it took five years for me to walk without a cane. It was later discovered — through an MRI — that a nerve had coiled during the pregnancy. And even if I had delivered, it took time to heal because nerves are like a woman who has been told she added too much salt to a meal. They dont spring back spontaneously. Even after the offending agent is removed. It takes time to regain its previous state. After several physiotherapy sessions coupled with medication, I walked.

Opportunity often comes disguised in the form of misfortune. I used mine to help others. One pregnant woman at a time. I know I am living out my purpose because my corporate job — no matter how much it paid — never gave me the fulfillment this work gives me. I would do it for free. I am now a qualified Doula and Infant care specialist. Within this scope I am qualified to be a Lamaze childbirth educator, lactation specialist, infant massage instructor, infant and young child nutritionist and maternal nutrition advisor. I work with obstetrician gynecologists and paediatricians to ensure good outcomes for mothers all the way from the preconception period upto and beyond the postpartum period.

As the worm crawls up to the surface only when it rains, so does a man’s best self emerge only in misfortune.

As Narrated to me by Esther Kimani

Postpartum hemorrhage is a condition in which a woman loses a very large amount of blood after childbirth. It can occur after a vaginal birth or a ceserian delivery.

Causes can be due to: Failure of the uterus to contract ( commonest), Tears, Retained placenta, Clotting disorders.

The main symptom is bleeding and can lead to a lot of blood loss and shock.

The management of PPH uses a step wise approach from the administration of drugs to more invasive procedures.

Lactation failure is a condition where a mother is not able to breastfeed or produce milk.

Can be due to biological reasons like: Sore/Cracked nipples, engorged breasts, or mastitis

Neonatal reasons like: infant illness, disorders associated with poor reflux

psychological or social causes like: advise by relative/friend, worry stress, previous bad experience

Seek the help of a health professional in case of the above.