To the baby I just met.
I didn’t know you were there. I am so sorry. I walked into the maternity ward and took a glance around at all the beds.
There was the bed in front of me, with the woman who was 7 cm dilated. All the other beds were clean and vacant. I didn’t know the young woman who was fully clothed and sitting upright had just given birth to you in the middle of the night. She was facing us. She looked like she was just waiting for the woman to deliver. I thought they were sisters.
That woman had a big baby. At least big for rural Uganda. And much bigger than you, the size of my shoe. But I didn’t know you were there. So I hadn’t seen you yet.
That big baby came out limp. I held him as he slumped across my hands. The midwife cut the cord and I brought that baby to the resuscitation area. We started giving that baby
breaths, but I quickly realized we needed oxygen.
I asked for someone to please move the gigantic mound of blankets that were near the oxygen. Blankets that I thought were meant to bundle the big baby up. Not neatly folded, like origami, the way most newborns in the warmer are.
But it didn't matter you were in the warmer. There was no electricity. It was just a convenient but not appropriate place they put you.
We needed that space for our resuscitation. I’m so sorry. I didn’t know that was you.
They carried you out and away.
We continued. 1-2-3 and breathe. 1-2-3 and breathe. There is so much we can control and so much we cannot. I watched the baby boy’s chest rise and fall with each breath. His heart rate was good. But after 5 minutes I felt the worry creep in.
The midwife and I kept going. Focused.
I thought the woman at my side was his aunt. I didn’t know it was your mother, waiting for you to come back.
The baby pinked up. The oxygen worked. We took the mask off his face to check and see if he could breathe on his own, when the doctor from the NICU came in carrying you.
She asked if we knew you had died. If we knew we had just brought you that way to the NICU.
She said you were cold.
You were a preemie.
Shit. It was all I could say. I turned my focus away from you to see if the boy was breathing on his own now. He was.
But you were not.
I said again as the two realities collided. The word came out fast and hot in my mask.
You had passed away hours ago, before we were even here, but no one knew.
How could this have happened?
When it was translated to your mother she melted into the floor, her love for you escaping her in screams and sobs.
I’m so sorry.
That night should not have ended your life.
You could have gone to the NICU. You could have been wrapped tightly against your mothers chest, both of your bare-skinned and clinging to life. You should not have passed away alone, in a mound of blankets that were inadequate to keep you warm enough.
You would have had a tough road ahead, but you would have had a chance.
Later that day I looked in the register to find out what your mothers name was. I wanted more information on you. What time you two came in, what time you made your early entrance into the world.
But your mother, whose name is Harriet, was not even in the books. No one even wrote her name down. No one recorded a thing about you either. There will be no birth certificate. No death certificate. You will not be included into any statistical analysis.
Which is why I am writing.
I am writing because you matter. So does your mother.
I am sorry you were born into a broken world, into a place where poverty is so crushing there are no repercussions for a life handled haphazardly. Dying is normal, even when it shouldn’t be. The nurses during the day reported the incident to their supervisor. And I brought it up the chain of command to have it addressed at the staff meeting on Monday, but that all feels small.
I heard your mother sobbing outside the maternity ward window for you. You were inside with us. Then a man with a cardboard box came for you. They unwrapped you, but kept you bundled in 1 tiny sheet. He gently placed you in the box, folded the flaps down, and you and your auntie and him left.
I took a picture, because the moment was sacred.
The family of the big baby came over and thanked us profusely for resuscitating him, but my thoughts were on you.
When I went home I looked up UNICEFS research on neonatal mortality in Uganda. In 2017, there were 19 deaths per every 1,000 live births. That’s almost four times as much as where I’m from. 27.9% of neonatal deaths were because of prematurity. I pictured your face. 375 mothers die for every 100,000 live births. But even with those chances, it wasn’t your mom. It was you.
I wanted to find the night nurses who wrapped you up and didn’t look at you for hours. I wanted to ask one of them why she said the “night was fair”, when I asked her what went on during her shift. She never mentioned you. I wanted them to see you, to see what had happened. But they left once the big baby was delivered. They didn’t even stick around to stitch that mother up, they gave the job to a student.
I’ve got answers I’ve made up to give them the benefit of the doubt. Lack of education, training and understanding. No staff overnight in the NICU.
But that’s just me trying to make it all make sense somehow.
What if your life slipped away because of apathy. Because of decades of poor outcomes causing hearts to harden. A survival of the fittest mentality, where it need not be. Where a little heat and some monitoring may have been the trick to get you through the night. Then another day. Then some antibiotics, some breastmilk, some oxygen if needed, some more monitoring, some maternal love. Until you were big and strong. Like so many of the premature babies I’ve seen survive in America.
But I digress. And that summary is oversimplified.
I’m too baffled to blame. So are the nurses I was working with that day. They just kept shaking their heads saying “we don’t understand”.
And because there is so much I don’t understand in this environment, I am left just wanting to say sorry.
I am sorry it all happened this way, little one.