With proper care, preterm babies survive

Parenting starts right from when a baby is conceived. The 40 weeks of gestation prepare the soon-to-be guardians of the new responsibility they are set to undertake for, ideally, the next 18 years. For some, the pregnancy is usually smooth, but for others, it is a troublesome period which might end in premature labour, a frightening and apprehensive time for the parents.

According to World Health Organization statistics, every year, an estimated 15 million babies are born preterm, while preterm birth complications are the leading cause of death among children under five years, responsible for approximately 1 million deaths in 2015. However, three-quarters of these deaths could be prevented with current, cost-effective interventions.

Tabitha Kanyungu's story

Tabitha Kanyungu is a mother of five. Her first three pregnancies were uneventful, with her first child being born in 2008 and the second in 2013.

Her third pregnancy, however, was problematic. She describes it as her most challenging one. As the pregnancy progressed, she would have difficulty sitting or lying down even for a nap. Also, though her bump was not big yet, her tummy felt heavy.

During a clinic visit, she raised this concern with the nurses, who did an ultrasound scan. She was seven months pregnant then. The test did not reveal anything alarming, and Tabitha went back home. Unknown to her, she was carrying twins. A week later, she was resting at home when she began experiencing contractions. She rushed to Mama Lucy Kibaki Hospital where she was scheduled for delivery.

“Going into the labour ward to deliver at just seven months was distressing, the worst moment of my life, because I didn’t know what to expect,” she says, and adds,

“To make matters worse, the first twin, a boy, was born legs first instead of the normal head first, and as if this was not shocking enough, the nurse attending to me informed me that there was another child. I was not expecting twins, therefore this came as a huge surprise,” continues Tabitha.

April, 2016, she says, will always be etched in her mind. She had to wait 10 minutes for the birth of the second twin, a boy as well, the longest 10 minutes of her life.

She finally had her boys, but she could not go home with them like other mothers. Her preterm babies had to remain in hospital to receive the crucial treatment they required. They were born with undeveloped lungs and therefore had to be placed in an incubator for the next 14 days.

“I almost died of worry, it was a very stressful time for me, especially because some women in the same ward lost their newborn children during this period. It was so crushing. You can imagine losing a baby that you had already named.”

Terrified, she could not bring herself to visit her twins, afraid that she would be informed they had died, such that the nurses had to keep asking her why she hadn’t gone to the nursery to breastfeed her twins. By then, she had lost a lot of weight.

The first twin was soon released from the nursery and joined Tabitha in the ward, and after two weeks, the other twin joined her. She breathed a sigh of relief.

When she was finally discharged after spending three weeks in hospital, she was hesitant to go home. She had formed a bond with the nurses that helped take care of the twins, and the thought of returning home to care for her children without expert help was daunting. The doctor, noticing her reluctance, assured her that home was the best place for her and her children.

“At the time of leaving hospital, the twins weighed 1.8kg and 2kg respectively,” she says, praising the nurses that took care of her and her children, saying that they diligently did their jobs.

Her parenting abilities were put to the test immediately she left hospital. She was aware of the huge responsibility that awaited her when she got home. Apart from the twins, there were her two older children to think about, yet she had no house help. She was required to tend to the needs of the two youngest while also ensuring the other two children, seven and three years at the time, were well taken care of.

She somehow managed to juggle all these responsibilities until the first clinic visit when the babies turned six weeks old. She breastfed them for three months and then started them on porridge.

In subsequent visits, the nurses commended her as the twins’ health was robust, their weight having risen to 3.5kgs.

“Onset of weaning is usually a challenging time for a new mother, but due to my experience with my two older children, it was manageable,” she explains.

Fast forward to 2018, the twins were doing quite well, and would be joining school in two years’ time. By then, Tabitha was settled, the challenges and apprehension that characterised her days when the twins were younger long forgotten. And then she found out that she was pregnant. She was distressed. She imagined all manner of scenarios, all devastating. Above all she was afraid that the pregnancy would be problematic and that she would not make it through, leaving her children behind without a mother. Contrary to her fears, however, her fifth child was born on the ninth month, healthy.

“All the children are doing well. They are a handful, but they are healthy. To manage, I draw up a programme to guide them from when they wake until they go to bed in the evening. I help them with their homework, make dinner and put them to sleep,” says Tabitha, who worked for a clearing and forwarding agent before the birth of the twins. Currently, she works as a motivational speaker, giving talks in schools and in forums bringing mothers together.

Her twin boys, Samuel and Richard, will be turning seven in April. They have an uncanny resemblance to each other, not only this, they also behave as if they are one person.

In the 10 years it has taken her to get five children, she says she has no regrets despite having had to resign from her job to look after her children. She also lost friends since her focus was on caring for her children, but does not regret it one bit, because, as she puts it, her children will not be young forever. To women who are where she once was, and have preterm babies to look after, she advises them to follow their doctors’ advice. Apart from this, she says that having a programme helps one to avoid getting overwhelmed.

Ben Osama’s story

Ben and his wife Linda Tunje, both medical doctors, have an almost similar story. In 2019, Ben and his wife, who was eight months pregnant at the time, had travelled to Kisumu when she started developing abdominal pains. They both shrugged off the pain as mild discomfort due to exhaustion from the travelling. The pain would, however, persist, and a doctor friend recommended they visit the nearest medical facility to get checked as it could be early labour. After assessment, Linda was diagnosed with high blood pressure, and was advised to have an emergency caesarean section.

“The need to have the procedure done at a hospital near our home prompted us to ask for a transfer to Bungoma, where the surgery was done,” he explains.

Their twins, both girls, were delivered on May 31, 2019.

“The older twin weighed 2100 grams while the other weighed 1900 grams,” he says, and adds,

“It was an exceptionally tough time because as a doctor, you witness what other parents go through in such cases, at that moment, we were the ones experiencing it,” observes Ben, adding that it was even worse for them because they were aware of how serious the situation was and the probable complications.

“At times, it is better if you don’t know what to expect and live on hope,” he says.

Ben describes the two-week period his wife and children were in hospital as the worst in his life. This was her second caesarean section, and it had taken a toll on her, such that she needed ample time to recover. As it is, he had to step in and take care of the twins in the neonatal unit as his wife recovered. Fortunately, he had his sister’s help.

For the two weeks the babies were under a paediatrician’s supervision, a scary moment presented itself. One of the twins developed fever and the other jaundice (yellowing of the body caused by caused by too much bilirubin in the blood, a yellow substance produced when red blood cells are broken down.)

“We had fears regarding the outcome, since one of the biggest contributors of death among pre-term babies is immature lungs. Since they were born when the pregnancy was eight months old, the biggest concern was their lungs failing. They needed oxygen support to survive,” he notes.

Thankfully, after 14 days, they were discharged, put on medication and follow-up by a specialist during clinic visits on a weekly basis. With time, the babies begun gaining weight, relief for the couple.

It was challenging looking after two children that needed special care, forcing them to hire two house helps to tend to their demands and those of their eldest child when they resumed work.

As a father, Ben says his role is to be available for his children, who he allows to express themselves. It never ceases to amaze him how alike his twins are, and not just physically – even their school grades are almost similar, and they take care of each other. They are four now. He advises parents who may find themselves expecting pre-term babies not to panic since there are many facilities in the country equipped to care for such babies, and also experts.

“I also urge them to support each other as the period is difficult, therefore one requires a strong support system.”

He also advises pregnant women to seek medical help should they experience any pain or discomfort, rather than brush it aside.

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