In the US a baby has a chance for living after 24 weeks and as such, and at this time, interventions are done to increase the chance of survival. The mom is given steroids to help mature the baby’s lungs and antibiotics to discourage labor. Once born, the baby would have access to surfactant (a medication for the lungs), a ventilator, IV nutrition and a slew of specialist. Here we can do only the steroids, antibiotics, CPAP (some pressurized oxygen), and IV fluids (no nutrition). And in terms of specialist, what can I say, have you met Dr. Lydia, Dr. Fred and Dr. Russ the pediatrician?
In Togo we believe the age of viability is 27 weeks, not 24 due to a lack of ventilators, surfactant and specialists. But because all things are possible under God, we usually attempt treatment at 24 weeks.
She’d come all the way to see us from Lomé, she had only one living child with a history of multiple pregnancy losses, and she’d come because she heard that we could help her. We discussed with her the gravity of the situation and the very big limitations that we had at this stage in the pregnancy. We prayed with her and then put her on bed rest in the hospital, did the few medical interventions that we could do and put her and the baby in God’s hands.
If you’ve ever had to lay in bed for a long period of time, it’s not very fun and let alone when you’re pregnant and worried. This was a challenging time for her, but little did she know the real challenge was about to come. It was about a week and a half later and she went into full labor in face of anything we could do to help. The baby was born and immediately started on all treatments that we could provide at this young of an age. The physical challenge for the mom was over, but now the physical challenge for the baby and the emotional challenge for the mother was just beginning.
After 48 hours of requiring CPAP, we were able to switch her to regular oxygen and over a period of weeks was able to wean her off this. She was placed on medication to keep her from having spells of not breathing (common in premies) and she was placed on antibiotics and blood tests were done. In addition a tube was placed running from her nose to her stomach –as babies at this age do not have the ability to breast or bottle feed and with high risk of aspirating the fluid into their lungs. Despite all of the challenges of being a premie and needing to come off and on antibiotics during her stay here, she actually did remarkable well, considering all the premies we’ve delivered and worked with, helped and lost, she is one of the youngest we’ve had and one of the ones that has done so well.
During this time it was not without its emotional challenges for the mom –she spent over 6 weeks in the hospital day and night to be there for this baby. Though we have nurses –realize that the majority of care of patients falls to the family. Also, realize most of this time she was sleeping on the floor and buying just the basics of nutrition from alongside the road outside the hospital (there are no local restaurants nearby). We’d talked to her about the time she would need to stay in the hospital after the baby was born, but it is not easy to fully comprehend what that means until your there. There were several mornings when she would have tears slipping down her cheeks as she tried to keep her emotions at bay –she was tired, not fully rested, anxious to be at home with her husband and family, and to be able to get the food she was used to. It was those times, we hugged her, encouraged her, and prayed with her. I know that during these times she thanked God for the life of her baby and still does to this day! We have enjoyed watching this baby grow.
She came in to the medical clinic because of fluid in her belly –she looked like she was 9+ months pregnant. She was admitted into the hospital because of ascites (extreme fluid accumulation in her belly) that had failed initial outpatient treatment. As a part of a “normal” work-up a pregnancy test was done and surprise of all surprises she was found to be pregnant.
Further work up gave her a diagnosis of Hepatitis B and thus the cause of her ascites and a 24 week pregnancy. In the US, Hepatitis B can be treated and possibly cured. Treatment is carried out by specialist. Here we do not have the medication nor the specialist. Here we cannot treat to cure, we can only treat her symptoms. Complicating her pregnancy is the ascites and vice versa. The baby cannot grow if the uterus is restricted by the ascites and this can be a major point of concern. We did not know if we could help her, let alone if she would survive this pregnancy.
The gravity of the situation was discussed with her and treatment was started. Over the following twelve weeks, she went from 98 Kg to 55 kg and at 36 plus week, she delivered a healthy baby. But this is not the whole story.
Throughout her twelve weeks with us, she was cared for, loved, and prayed for. During her time here, she made the decision to follow Christ. After that whenever we saw her, it was always with her Bible open and her reading some portion of scripture. In this time she seemed to almost always reflect a spirit of gratitude and gentleness.
These are the tale of two ladies who we had the chance to come to know very well due to their long stay in the hospital and multiple doctor visits. We were challenged by the gravity of both of their situations. There were a lot of discussions over how to handle their care. We were blessed by how God worked not only physically in the lives of the moms and babies, but also how they were touched spiritually during this challenging time for both of them. Thank you so much again for the way that you pray for us, encourage us and give to the ministry here in Togo –these are at least four lives that you’ve had the chance to be a part of and give to.
Thank you so much and God bless.