Over the past year and a half of being in Rwanda, my heart, emotions and understanding of God’s sovereignty have been deeply challenged. Caring for pregnant moms at the Nyabisindu outreach clinic has brought me face to face with profound suffering.
A typical mom we serve is very, very poor. She is probably unemployed, though she would jump at the opportunity to have a job. Her husband may have left her after she became pregnant. She has likely experienced violence from partners, family members or neighbors and it is possible that her pregnancy is one result. Though she may not want additional children, her partner’s control or her church’s theology leave her with little to no say in the matter. She might be HIV positive – from birth, from her husband’s infidelity or from using prostitution as a way to feed her other children. She knows little to nothing about childbirth and is reliant on the, often incorrect and sometimes harmful, advice of the abakecuru (old women) in her community. It is likely that she has already lost a child.
These are the moms I get to walk with. I see them on a monthly, biweekly or weekly basis throughout their pregnancy. They tell me their stories, shed tears with me at their sorrows and ask me their questions. I get to feel their babies’ positions, listen to their babies’ heartbeats and send them for a twenty week ultrasound to see their unborn child. I get to pray for them when they experience heartache or prepare for delivery. And I see their pain and suffering. I have measured the tummy of moms who have died in the hospital. Sometimes, the very baby I have felt arakina (playing) in their mommy’s tummy has died during pregnancy, labor or after delivery.
Low-risk moms are able to come to Iranzi clinic to deliver. Iranzi, the Kinyarwanda word for “He knows me,” is a midwife-led birth center where Nyabisindu moms have access to holistic, evidence-based labor, delivery and postpartum care. I have worked in other hospitals and clinics in Rwanda and I can safely say that Iranzi is one of a kind!
When a woman comes in to deliver, her husband or family is allowed to stay by her side. The woman has access to a bed with sheets and blankets, a birthing ball, stool, flushing toilet and warm shower. Our staff of Rwandan midwives and nurses have all been trained in Helping Babies Breath, Helping Moms Survive, CPR, and Neonatal Resuscitation, courses that few hospital nurses in Rwanda have taken. They provide labor support by assessing fetal heart tones, giving the mom food and drink, helping her with natural pain control methods and placing pressure on her back. They sing to the women and pray with and for them. If a mom or baby is transferred from Iranzi to a hospital, a nurse or midwife will visit them throughout their stay. After delivery, moms have access to postnatal care for themselves and their babies and, if they are high risk post-partum, will often receive a home visit from one of our nurses or midwives.
One of the most important and beautiful parts of Nyabisindu and Iranzi is that the women are known, not just by God, but by us. We know each woman’s history, family and income situation. We have cried and prayed with her. We have taught her about breastfeeding, skin-to-skin contact, the dangers of inducing labor with traditional medicine, warning signs in pregnancy, normal signs of labor, fetal kick counts, infant and child safety, family planning and normal newborn care. As we serve them, these women come to know and trust us.
One of the women we have been seeing regularly is Epifani (not her real name). She is close to delivery of her third pregnancy. Unfortunately, Epifani has no living children. With her first pregnancy, she arrived at the hospital full term, expecting to deliver a healthy baby. Her child was moving and had good fetal heart tones on admission, but by the time she delivered the baby was stillborn. The second time she again arrived at the hospital full term and this time delivered a live baby. However, two days later while still in the hospital, her second child died. The only explanation she had for the deaths of her babies was fetal exhaustion. Now she is full term awaiting the delivery of her third child. So far, she seems to have had a healthy pregnancy, but every time I see her, I think of the fear she must have surrounding the delivery of this child. And every time I see her, I pray for her and her child.
It may not seem like much to someone who is used to state of the art equipment, resources, doctors and training. Yet I am blessed to know that God sees this mom and her heartbreak and that my prayers make a difference. When I pray against fear and intercede for the life and health of this child, our powerful God hears me.
This is just a glimpse of what I get to do. There are many stories I could tell here – some amazing and many sad. But what a blessing to be a part of something so beautiful for God’s glory.