Rita N., 20

Rita is a hardworking and responsible 20-year-old woman who enjoys helping her mother with their small business and hopes to become a successful businesswoman. They live in a remote rural area and depend on the modest earnings from the business, which are often insufficient to meet basic household and healthcare needs. At 40 weeks of pregnancy, Rita presented in labour accompanied by her mother, with severe lower abdominal and back pain and leakage of fluid for about eight hours. Abdominal examination suggested that the baby’s head remained high under the ribs rather than positioned in the pelvis. Vaginal examination revealed the baby’s feet, legs and buttocks presenting first, consistent with a footling breech presentation. An abnormal fetal heart rate and Grade II meconium were also noted, raising concern that the baby was becoming distressed. Given the malpresentation and signs of fetal compromise, vaginal delivery carried significant risks. An emergency Caesarean section was therefore recommended as the safest option to achieve prompt delivery and protect both Rita and her baby.

Rita presented at term in labour with a footling breech presentation, prolonged leakage of fluid, Grade II meconium and an abnormal fetal heart rate, indicating increased risk to the baby. The malpresentation made vaginal delivery potentially unsafe due to risks including cord prolapse, fetal distress and birth injury. An emergency Caesarean section was therefore medically indicated to achieve prompt and safe delivery. With timely surgery and appropriate maternal and newborn care, the prognosis for both mother and baby is favourable.