Life and Loss

I parted the curtain that separated the delivery room from the rest of the ward. An additional bed had been dragged from outside and squeezed into the delivery room in order to accommodate our newest admit, who became our fourth laboring patient. All four women, separated by dingy curtains, rested two or three apart from one another on metal tables covered in plastic – their birthing beds.

Every five minutes or so, the delivery room would echo with one of the laboring women’s cries. These were groans of pain and pressure unaccompanied by epidurals, injections, and medications that we use in the United States to ease the distress. Occasionally, two or three of the women would have contractions at the same time, filling the room with multiple cries.

As soon as I arrived in the delivery room, I found the newest patient resting from her last contraction. I introduced myself just in time to witness and assess her next contraction. Amy, one of my team members, was watching her from the end of the table. “Ladies, I see a head!” I heard her say with urgency. I grabbed a pair of gloves, quickly popped them on my hands, and ran to the bedside where the Tanzanian nurse was waiting. With only one push from the mother, a baby girl entered the world. I quickly wrapped the newborn in a Kitenge (multi-use cloth) that the mother brought from home, drying and stimulating her until we heard the first precious cry. After assessing and weighing the baby girl, I wrapped her tightly and took her to her mother.  A bright smile beamed from her sweaty face, and I saw a new surge of energy and pride overwhelm her tired body.

While I was still soaking in the emotions of assisting my first delivery in Tanzania, the second mother began to deliver. With a little more time to spare this round, I found some more gloves, gathered supplies, and prepared the table for the next birth. This time, the Tanzanian nurse gave me the look saying that said, this time it is your turn. As the nurse instructed her to push, I caught the head, pulled out the wet pink body, and laid the fresh baby on a clean Kitenge. I clamped and cut the cord, then stayed with the mother to deliver the placenta while my teammate, Kellum, took care of the baby.

For the first time in my life, I felt like the nurse. I just delivered a baby – a healthy, breathing, 3.2 kilogram baby Tanzanian girl. I patted the mother and smiled at her, and it was probably the biggest I have ever smiled in my whole life.

With two women still left in the delivery room, I turned my attention to our third patient, Luja, who was also getting ready to deliver. We went to check the fetal heart tones, only to find an eerie static sound in the spot where we had previously heard the heart beating. We wheeled Luja to the ultrasound room, my heart beating fast. Surely it was a mistake; we just couldn’t find the heart tones. But I watched the doctor find the heart and point to it on the ultrasound screen. It was still, silent. “We must do a C-section right now,” said the doctor, “or we will lose the mama, too.”

I followed Luja into the operating room. I watched the C-section, the blood pooling on the table and dripping onto the concrete floor, the stealing and wrapping of a stillborn baby. I wanted to feel something, but “psychiatric numbness” held me together…for the moment.

When our fourth mother, named Bahati, was ready for her delivery, I was right there by her side. She struggled to deliver, and it became quickly apparent that the baby was not breathing. A doctor on our team, one of my peers, and the nurses on the ward began CPR immediately. As I watched the tiny chest rise and fall with rapid compression, I held Bahati’s hand and prayed aloud for her and our team of medical professionals as they worked so intently. Even after the “amen”, I prayed constantly in my heart.  Thirty minutes later, we had tried everything we knew to do. The heart would not beat and spontaneous respirations would not begin. I watched the doctors and nurses slowly let go of the baby, and my heart broke.

The mother cradled her baby, trying to hold back the tears stoically. The nurse wrapped the baby tightly and placed her on the cold ground under a table in the corner. It took all of my being to refrain from snatching up the tiny bundle. I wanted to steal it from the cold concrete floor, from the dirt that would soon cover it,  and hold it in my arms in attempt to somehow pray life back into its lungs.  I watched Bahati and her mother walk past the curtain that divides the delivery room from the rest of the ward. Bahati was placed in a bed between two young mothers nursing their newborn babies.

With the delivery room quiet, empty, and still, I sat down on a dusty trunk and cried.

I cannot tell you what it feels like to watch a mother bleed and sweat for six hours only to hold a breathless baby in her arms. She carried that life in her womb for nine months, then labored on a metal table in a dirty hospital with no medicine whatsoever only to leave empty handed. I cannot tell you what it sounds like to hear static in the place of a beating baby’s heart. There are no words, not even understanding.

At the same time, I cannot express the relief and joy I feel at the sound of a baby’s first cry as I hold it in my hands, knowing that I helped bring this life into the world. I also cannot explain what it feels like to catch the newborn, wrap it in clothes, and then hand it to the happy mother.

These two drastically different emotions existed side by side and occurred within moments of each other. I wish I had the words to explain, words to tell.

But there is one thing that I can explain, that I can tell.  As I sat on the trunk and cried, I reminded God of Isaiah 66:9 where He says, “I will not cause pain without bringing to the point of delivery.” Lord, what about that promise?

In response, He reminded me of Job. “The Lord gives and the Lord takes away. Blessed be the name of the Lord.” He said to me, “My ways are not your ways.” I will admit that I do not understand why mothers have to labor and babies have to die, but I do know that God is the giver, sustainer, and even taker of life.

Through the intense roller-coaster of emotions I experienced, God taught me that I am not the one who gets to decide what is good and what is bad. That is where His ways are higher than my ways. We as humans tend to quickly judge our circumstances based on our perspective of what we think is good or what is bad. We decide and we label, but it is all based on our own limited perception, which is so different from the Lord’s vast perspective. What we see is not the same thing that God sees. Who am I to label my circumstances when I can only see through blurry tear-stained eyes?

I trust that as I cry on my truck and mothers cry in their beds, God is in control. He, the maker and sustainer of breath and heartbeats, is sovereign and completely trustworthy. Tonight, he holds two new babies – baby Luja and baby Bahati - in His loving arms.

Although I will never understand, I will always trust. I will always believe that God’s ways are higher than my own and that His understanding and wisdom transcend mine. Knowing that my perspective is limited to human eyesight, I choose to rise above the circumstances and my own temptation to label the situation as either good or bad.  Ultimately God knows and works for the good of those who love Him.  So my response is to be thankful in all circumstances.

Thank you, God, for allowing me to deliver two beautiful, healthy babies into your world today. And thank you for holding two new babies in heaven tonight. Thank you for giving and taking breath. Thank you for working all things together for our good. Thank you for teaching me to trust your sovereignty and surrender my perspective to you.

The day after these events, I read an entry from Jesus Calling that hit home. "I have already been working to prepare the path that will get you through this day. There are hidden treasures strategically placed along the way. Some of the treasures are trials, designed to shake you free from earth-shackles. Others are blessings that reveal my Presence: sunshine, flowers, birds, friendships, answered prayer. I have not abandoned this sin-wracked world; I am still richly present in it. 

Blessed be the name of the Lord.