Midnight at the Maternity

If you know me at all, you probably know that all things medical make me queasy.  Just watching someone get a shot on a medical show (even Scrubs) makes me cringe.  Blood and I are not friends.  While this is true in general, the pinnacle of all medical things that makes me nauseous is childbirth and all things related to pregnancy.  Women with distended bellys and protruding bellybuttons weird me out.  When I went to visit my sister in the maternity ward in a nice Calgary hospital, I had to close my eyes and be led by my mother from the entry of the maternity ward to my sister's private room to insure that I saw nothing that would scar me or make me vomit.  So why do you need to know this information?  Well....

Yesterday evening I was at my African family's house, my usual Monday night hang out.  Fatima, Raichatou and I were hanging out, checking on our sauce that bubbled over the fire, our usual Monday evening activities, when Fatima received a call.  Her cousin, my friend, Fatimatou, was sick, she was informed.  This, however, was code for, Fatimatou, who was nine months pregnant, had finally gone into labour.  Fatima hung up and shared the news with us.  Although I didn't really want to, I asked, "Does she have a ride to the maternity?"  I usually drive a small single cab and therefore don't normally have the space to transport a lot of people and I knew Fatimatou would have quite an entourage going with her to the maternity.  Today, however, a teammate had traded me vehicles, since she needed mine to transport a large load of mosquito nets.  This meant I had a large, spacious Prado.  I was without excuse.  Fatima phoned back and asked if Fatimatou's family had arranged a ride to the maternity.  The answer: No, Fatimatou refused to go to the clinic.  She was afraid of what they might do to her there.  This was hard for me to believe.  Who would choose a hot, thatched hut over a maternity with medical professionals and pain killers?  Not me.  Well, at least I was off the hook.

Our evening continued in peace until the phone rang again.  Fatimatou's family again.  She still refused to go to the clinic, but she really wanted Sakki (my African mom) to come over.  We were just about to eat and would come right after that, we informed them.  After all, Sakki couldn't skip meals.  She had her own two month old to think about.  However, the dad decided to head over straight away, and I would bring Sakki and the family over after we ate.  We hadn't served the rice and sauce when "our dad" phoned.  He'd arrived at Fatimatou's family's house and assessed the situation and decided that Sakki needed to come right away, forget eating first.  So we took the food off the fire, doused the flames, and piled into the Prado.

A few minutes later we arrived at the Youssouf household (Fatimatou's family).  Sakki disappeared into the hut and, when no one motioned me into the hut after her, I sat down on a bed outside with the others who had gathered.  Soon, Fatimatou's mother emerged from the hut and asked me if I would mind going to pick up another aunt, or friend, I was really sure of her relation to the group or why she was needed, but it gave me something to do and kept me from ever getting dragged into the hut where Fatimatou was...yes, I know I'm a wimp.

When I returned, they piled all the Youssouf children and the children of my family into the Prado.  Fatima and I brought them back to "our house" where we fed them, made tea and wondered and waited.  Finally, we packed up the supper leftovers, loaded the sleepy children back into the Prado, and headed back to the Youssouf household.

By this time it was 10:15pm.  I was ready to start thinking about heading to bed and had already missed our team-imposed curfew.  I turned to Raichatou, Fatimatou's younger sister and told her to go tell Fatimatou that this was her last chance to change her mind about going to the maternity, otherwise, I was headed home to bed, and once I'm asleep it takes a lot to wake up again.  Fatimatou still refused to go to the maternity.  I said my farewells and walked out of the court yard to my truck.  I was just about to pull away when they called after me, saying they'd convinced Fatimatou to change her mind.  I felt a mixture of relief and tiredness as I backed up in order to squeeze my truck through the narrow gate into the courtyard.  I pulled up as close as I could to the thatch hut and waited while they first loaded in all the supplies they'd need (since the maternity offers nothing) and then, the men appeared, carrying Fatimatou on a homemade stretcher (okay, really just a large piece of cloth).

With Fatimatou settled across the back seat, her mother squished in beside her, her husband and her cousin in the very back with all the supplies, and her aunt and brother squished into the passenger seat beside me, we headed off into the night.  It was at this point that I was informed that we weren't going to the neighbourhood maternity but rather a maternity several neighbourhoods over.  Oh well, it still wasn't far.

We drove in silence, apart from simple directions to the maternity and the occasional soft moan or whimper from Fatimatou.  Silence is rare.  It was disconcerting.

We pulled into the maternity.  The courtyard was full of mothers and aunts camped out for the night waiting for their loved one who was in labour or had just delivered.  Two nursing came bustling out a wheel chair, but Fatimatou couldn't even move enough to get herself out of the car.  Her brother, husband and cousin managed to use the "sling" again to get her out of the car, and placed her on the dirt next to the Prado.  She looked so small.  The nurses shooed us away while they examined her.  Only minutes passed before they called us back and told us we needed to get her to the Central Maternity downtown ASAP.  Something was wrong and they didn't have the capabilities to deal with it at this small maternity.

With the hazards flashing furiously, we pulled back out into traffic and sped towards downtown Niamey, ignoring red lights and honking at anyone who got in our way until they pulled over and let us through.  Downtown well pulled into an even more crowded courtyard--apparently it was the night to have babies.  Someone from our group went running in with Fatimatou's papers and got her signed in and sent orderlies out with a wheel chair. However, seeing her condition, they ditched the wheelchair and went for a bed on wheels, and she was quickly carted away into the delivery room.  I was then instructed to park the vehicle outside, and when I returned I found my group huddled in a group, looking worried and pensive.  I didn't have time to ask any questions, because the doors to the delivery room swung open again, Fatimatou still on the stretcher.  She needed to be taken to the emergency room.  Quickly picking up our pile of supplies, we rushed after her stretcher until they took her through the doors and that was the last I saw of her.

We settled ourselves on the hard cement benches outside the emergency room and waited.  Realizing that the few word the doctor had said as they rushed Fatimatou into the emergency room had been in Zarma, the cousin took a moment to fill me in.  Nigerienne's are all about indirect communication, and so apparently the doctor's words were a proverb.  Their take on the proverb's meaning was that there was a chance that the baby would be stillborn.  I had to blink away tears as I processed this possibility.  Fatimatou is on her fifth marriage and this one seems to be a happy one, where she had some say in who she married and was maybe even friends with her husband.  We've been suspicious that her inability to get pregnant before was the cause of some of her failed marriages, and now, she was finally happy married and so happy to be having a baby.  And now the possibility that the baby might be dead...

Slowly, conversation began, wandering all over the place, from one random topic to the next with frustration interjected here and there at not knowing what was going on behind the closed door of the emergency room.  No one was allowed in there with her, not even her mother or her husband (the idea that a husband would be in the delivery room seemed bizarre to them).  I wanted to express some sort of comfort to her mother who looked so worried, but the Tamasheq center of my brain had long ago shut down and even at my best, I don't think I had the words to express anything close to what I wanted.  Every time a medical professional walked through the doors we looked up expectantly, but no one seemed to have any news to share with us.

Finally, just before 1 AM, the doctor appeared and announced the birth of a little girl.  Collective sigh of relief!  While we still weren't allowed to see her, the tension was gone.  Fatimatou's mom and aunt started preparing their beds--they'd be camping out at the maternity for the night.  After making sure they had everything they needed, Fatimatou's husband, brother, cousin and I said our good-byes and piled back into the Prado.

We drove through the now empty streets of Niamey.  We dropped Fatimatou's husband off on the main road near his house.  This struck me as interesting that he would choose to return to his empty little house rather than bunk in with Fatimatou's family for the night.  Who was going to cook for him?  Did he have work the next morning?  Who was he going to talk to about the tensions and fears of the evening?  Who was he going to celebrate his new daughter with?  Did it bother him that he didn't get to see his wife and baby before he left?

I crawled into bed at 1:30am, but soon realized that my stomach was rumbling and I felt thirsty.  Returning to my room with a bottle of water and a granola bar, I contemplated the evenings events.  In Niger, a woman's lifetime risk of dying of pregnancy-related complications is 1 in 7 (WHO), the highest in the world.  I felt relieved that Fatimatou had beat the odds thus far.  That statistic had never felt so real or so harsh as it did sitting there waiting to find out how the night would turn out.  If there's one place in the world to be afraid of pregnancy, Niger is it.  My hat's off to all the women in Niger who have starred childbirth in the face, and without modern luxuries, have bravely taken what came.