Prolonged labour: Why it is key in congenital disabilities

Prolonged labour can have serious consequences for both mothers and newborns, highlighting the importance of timely and skilled maternity care. [iStockphoto]

For 12 years now, after giving birth to her firstborn daughter, Evelyne Nyabeta has never known the real happiness most women experience as new mothers.

During her delivery, the baby was exhausted, docile and struggling to breathe, an occurrence that rang emergency bells in the entire newborn unit of the hospital.

Instead of the delivery becoming the beginning of happy motherhood, the coming of Scarlet Regina marked another start of frustrations associated with multiple disabilities that happened to the newborn child following prolonged pangs of labour.

According to Fred Ombachi, a gynaecologist based in Nakuru, prolonged labour has far-reaching impacts on both the unborn baby and mother if not attended to urgently.

According to Dr Ombachi, when labour has been prolonged, the possibility of the baby suffering multiple complications rises depending on the duration of delay.

“In extreme cases, mothers experience stillbirths, meaning that the baby dies in the womb, and in some other situations, the mother’s life may be on the line too. But usually, prolonged labour brings with it health challenges to both the newborn and the mother,” Dr Ombachi says.

For mothers, according to Dr Ombachi, postpartum bleeding, injuries to both the uterus and the birth canal, including tearing and swelling, problems with the urinary or bowel movement, as well as fistula in severely neglected cases.

To crown Nyabeta’s many worries, the baby failed to make the signature cry that is expected of any newborn child immediately after birth.

“It was a tense moment for both the medics and my family, who got even more scared of the baby’s situation.

She was first rushed to nursery, where she stayed for a week.

Nyabeta’s motherhood had been plunged into a lifelong puzzle of helping the young life to overcome cerebral palsy, dropping hands and varied club foot, speech development, as well as body support and movement.

Her club foot presented differently: the right leg is turned inward and downward, a condition called Talipes equinovarus, and she has to walk on the outer edge of the foot while the other leg is turned outward and downward; a condition called Talipes equinovalgus.

According to Nyabeta, the child was born after a long wait that was occasioned by indecisiveness of the medics who were attending to her case in the labour ward.

“I had gone to the facility early on February 3rd while experiencing labour pains. But upon arriving at the facility, the medics observed me and made a conclusion that I was not ready for the delivery,” Nyabeta explained.

The wait for the cervix to open took the new mother another whole day of waiting until an emergency delivery through caesarean section was recommended after the 24-hour wait.

For Nyabeta’s case, the delay was approximately 36 hours.

“I waited for a day and a half for an emergency C-section to be recommended after they realised that the way was not opening,” she says.

Dr Ombachi advises that expectant women should ensure that they are attended to by professional and experienced caregivers.

“A woman in labour should be assessed by a skilled healthcare professional if labour is unusually long, contractions are ineffective, there is heavy bleeding, fever, severe abdominal pain, reduced fetal movement, or abnormal fetal heart rate,” Dr Ombachi advises.

Dealing with the consequences of the prolonged labour has since translated into a huge financial burden for Nyabeta’s family. However overwhelming it is, she has had to bear it anyway.

Motivated by her regular interactions with medics who encouraged and even supported her to enrol for a diploma course in Nursing, Nyabeta is now a trained nurse, something that has enabled her to effectively manage her daughter.

In 2023, her daughter was introduced to TSF (Taylor Spatial Frame) technology, which was an intervention to enable her to walk, and so far, it has brought the family new hope.

But it was only done on one leg. The other one also requires the same procedure.

“Through this treatment, she has made progress that I once thought might never be possible. She can now stand and is trying to walk,” Nyabeta says.

All along, the little girl has used sign language, but she has started showing signs of pronouncing a few words.

“This has given me so much hope, and I believe that with the right support, speech therapy and continued rehabilitation can help her achieve even more,” she says.

Already, the young girl has endured six surgeries, and there could be more lined up for her.

But the major impediment to her progress is a lack of finances.

“I am a certified community health nurse, but I am yet to find a job that can enable me to support all the medical procedures needed for her rehabilitation and correction of her conditions,” Nyabeta says.

Currently, she is supposed to raise approximately Sh2 million for the procedures to be fully done on her daughter, money she says she can only raise from well-wishers.

The procedures she requires for her include laboratory tests, X-rays, physiotherapy and the most costly of them are the corrective surgeries required on both legs.

Her only hope is that one day, Regina will become stronger, walk and talk, regardless of how much it will cost her.

For new mothers, Dr Ombachi advises that they seek regular consultation with skilled or specialised maternal healthcare experts.