Ending is just another word for new beginning

This was our final week at Lewanika General hospital on the labor and delivery ward. We are together yet again, and had the most wonderful week to conclude this final practicum as student nurses. 

(Priya) I want to pursue a career in maternity in the future so, being on the labor and delivery ward was very exciting and something I really looked forward too. This week I got to experience some very beautiful moments with nurses, families and of course lots of babies!! One our first day on the ward we were able to take part in a c-section delivery for surprise triplets! When we walked on the ward the understanding was that the mother in question was pregnant with one child and was going to give birth soon. We had the pleasure of working with the Czech Doctors and upon their arrival they assessed this mom. They were able to distinguish two separate fetal heart beats. After hearing the news, the mom was not as enthused as the staff and students were and it became apparent that the mom was not ready for two let alone one child. We found out that the second baby was in a different position than the other making a natural delivery difficult/impossible. The mom required an emergency c-section to be performed when the OR room was prepared. 

Since the patient was quite young, the patients mother provided consent for the surgery and I (Priya) performed a pre-operative checklist! Very quickly the patient was in the operating room and we were watching the doctors perform the c-section. After the first baby came out I got to perform assessments and care to the baby which was amazing and very interesting. With Priya attending to the first baby I (Jackie) was able to assess and take care of the second child. At one point I was tending to both children as Priya moved to check in on the mom in surgery. While I was busy with the babes at the baby warmer I hear Priya yell, "Jackie! There is a third baby!". It was very crazy, nobody expected this and everyone was surprised. 

(Jackie) Upon hearing that there was yet another baby I was of course very excited. However, a feeling of sadness also came along side my happiness. This mother was not prepared for a single child, let alone three. I could not help but feel for her and the situation she was now in. Over this, I felt sadness and could not help but feel empathy for her. The new mother's sister at only 2 months, had just become an aunt to three new babies. It was a bitter sweet moment for me and I could not help but cry out of joy as well as out of heartache.

We had to leave soon after the birth as the room we were in could not accommodate the needs of the three new babies. We carried the children over to the Post Natal ward where there was a bed waiting for them. Everyone along the way was surprised by the triplets and asking if they were all one birth. Many families were overjoyed by the three new faces on the ward, but in some you could see the struggle. The struggle of mixed emotions that I (Jackie) felt when they were born. 

(Priya) It was bittersweet though, imagining how difficult it was going to be for this young mother and 3 children especially when she did not know of the 2nd let alone the 3rd child she gave birth to.Knowing of this and the difficulty this mother may have for resources we provided her with extra baby packs with clothing, socks, hats and blankets she could use for the babies. All in all, it was an amazing, once in a lifetime experience!

(Jackie) The following day on my birthday I was able to deliver a baby boy! Priya and I were both very excited and still on an emotional high after delivering the triplets the day before. We worked with a midwife named Regina and she was phenomenal to work alongside. We fanned the mother and held her hand as she started to push. We really wanted to tend to the mothers needs during childbirth as understandably, so much attention is put on the babe during delivery. It was her first born and she was very nervous. At times she felt she was "going to die" and could not continue. However, despite her struggle she was able to deliver a baby boy. When she was ready the midwife turned to me and asked if I wanted to deliver the baby. I got right in there and started supporting the head as it emerged. I was able to check for the chord which was thankfully not of any danger to the baby. Once I delivered the head, I was able to assist in rotating the baby to deliver the first shoulder, followed by the second until the entire baby was out! I placed the babe on mom to promote skin to skin and keep the baby warm. When that baby let out its first cry it was like music to my ears. We warmed him with a towel and took him to the warmer to put on a cute little outfit and surprise mom after she had been tended to by the midwife. My heart was very full, and it was so wonderful to see a mother who felt truly blessed by the birth of her first child.
(Priya) My next highlight of the week was helping in the delivery of a baby boy! We had come on the ward in the morning and during rounds learnt there was a patient who was quite dilated in far into her labor so we followed this case into the delivery room. There was a nurse, nursing student and Jackie and I. We waited for a while before the mother was fully dilated and pushing. During the birth I (Priya) got to catch the babe and give it to mom for immediate skin to skin, as it was crying and healthy! I was so happy I was able to promote and get the mom and babe doing skin to skin as it is not seen much here. Mom was very happy and did so well during the birth, it was such an heart warming experience; watching a new life enter this world. After the delivery we got to assess and dress the baby, we had brought some baby packs and were very excited to dress up the little boy! When mom saw the baby she was very happy and so so thankful for our help, she was very sweet. These 2 experiences were definitely highlights of mine for this entire practicum! I learnt a lot from the midwives and nurses this week and am very thankful I got to be apart of these experiences!

We were able to work with wonderful nurses and midwives on the labour and delivery ward which truly enriched our experience there. There was so much leaning that took place, and we both left with a greater understanding of both labour and delivery but also, working hands on in a limited resource setting and making due with what was available to us. Labour and delivery was such a beautiful was of ending off this practicum. It is hard to believe it is already time to leave and know that this was our final practicum of our Bachelor of Science in Nursing degree. As we step forward into our future we will carry with us all that we have learned here in Zambia, and will continue to reflect on all that we have seen and experienced throughout our careers. This is not an ending for us, it is the start of a new beginning.

To everyone who has supported us throughout this journey, thank you.

Sincerely,

Priya and Jackie