Today is International Day of the Midwife. It’s a day to give thanks for the hundreds of thousands of midwives around the world saving lives every day. It’s a day to acknowledge the difference a midwife can make between life and death for a mother and her baby. It’s a day to celebrate the heroes in our hospitals that all too often go unseen.

At Adara we have the pleasure of working with a dedicated team of midwives at Kiwoko Hospital in Uganda, delivering the highest standards of care.

Today we share the story of Akomoloh Caroline Ojuka, one of the fantastic midwives at Kiwoko Hospital.

I am Akomoloh Caroline Ojuka. I am 30 years old and am married. I work in Kiwoko Hospital, but was born in the Eastern part of Uganda in Kumi district. I have worked as a midwife for 5 years now.

I remember when I was 12 years old, I was living in the village with my aunt who was pregnant. One night she went into labour. I was staying with her alone in the house, so when it reached time for her to push the baby, she instructed me to help her receive it. In panic, I saw the baby coming, grabbed it and gave it to her. With such a nasty experience – delivering my aunt’s baby with my bare hands – I thought if I had adequate knowledge I would be able to help many others and prevent such complications. This inspired me to become a midwife.

The most interesting thing about maternity is that I feel so great bringing babies to into the world and listening to their beautiful cry. Midwives work as small doctors. We are involved in decision making which really motivates me. The other most interesting part is that maternity is a place where you experience pain for a short time and its relieved immediately when the baby is born. Always, the mothers say “I have forgotten the pain.”

Working at a place like Kiwoko Hospital can sometimes present challenges. The mothers still visit traditional birth attendants (TBAs) who most of the time gives them a medicine – “Emumbwa” to help with uterine contractions even with unknown doses. Mothers then get hyper uterine contractions and subsequently obstructed labour, uterine rupture and foetal distress.

Despite this challenge, being a midwife is so rewarding. In 2013 while on duty, I received a 25 year old who came in after complaining of labour pains for 2 days. Her first baby was born from home by a traditional birth attendant. This time she came because the TBA had told her the baby looked big. On examination, vital observations were normal. Two hours later, the mother called that the waters had broken.

During second stage of labour the head was delivered but the shoulders got stuck in the pelvis (shoulder dystocia). I tried some manoeuvres like rotating the shoulders, applying supra pubic pressure but I did not succeed. I called the senior midwife who also tried and gave up – by then doctor was in theatre for an operation. So I stood up and tried to remember something I could do to save the baby and mother. Indeed, I remembered. I put on the gloves and gave an episiotomy. I looked for the clavicle, broke it and a severely asphyxiated baby was born.

The baby was admitted to the NICU for management of fracture and asphyxia. The birth weight was 5kg – I had never seen something like it! Amazingly, after one week in the NICU the baby was discharged in good condition with the mother. They were reviewed after 2 weeks and both were well and happy.

Every time I work and encounter difficult cases I think of going back to school to get more knowledge and skills. I even think of moving to other places to share my knowledge and learn from other people.

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