Bad Moment

I was at the high risk ward at Mulago Hospital with Jody and Angela (preceptor). The obstetricians were just doing Rounds with the Residents and medical students. There were about 6 of them grouped at the end of one bed. They finished with that mother and casually said "We can't hear the fetal heart, but it doesnt mean the baby is dead. The head is right there. She will deliver soon." I asked one of the Residents if I could try to detect the fetal heart with my fetoscope (can usually pick up sounds better than the pinard that is used here in Uganda). He said sure and I grabbed my fetoscope and went back to the bed. As I got there, I realized that the mother was silently pushing and the baby's head was already partially out. I called out "Help, somebody,the head is right there." The group of doctors at the bed right beside me didnt even turn around. I was not gloved, had no ties, no cloths to wipe baby dry, no razor, no oxytocin. I was telling the mother to "TOE SINDACA" (DONT PUSH), and managed to get my gloves on (at least one hand double gloved). Jody and Angela were trying to get on gloves - they had been putting an IV into another woman. I guided the little body out and knew right away he wasn't breathing. I was calling for help, and the group of doctors still didnt turn around. One man glanced over his shoulder as my voice got more urgent, and then turned away. "We need a resus here" I told Jody and Angela. By then, they were there, with the few very important items we needed. I cut the cord and Angela and Jody ran with the baby to the resuscitation room. Despite 10 minutes of positive pressure ventilation and chest compressions, the little boy never took a breath, never had a heartbeat. They had to come back and tell the mother, who sobbed and sobbed. The doctors never looked at her again. I was so very angry. It was said best by one of the head obstetricians at a meeting we had been at another day - Doctors here must start treating EVERY woman like their relative if there are to be changes in obstetrical care here in Uganda.

Tina