Martha B., 21

Martha is a respectful and hardworking young woman from a financially struggling rural family. Her household depends on irregular small-scale activities for survival, and raising even USD 10 for an unexpected expense can be difficult. Despite these challenges, Martha remains determined to become financially independent, acquire useful skills and build a better future for herself and her family. During her current pregnancy, Martha presented to hospital in labour. She had a history of one previous Caesarean section performed because of cephalopelvic disproportion (CPD). On assessment during the current labour, her pelvis was again found to be inadequate for safe vaginal delivery. In addition, Grade II meconium-stained liquor was noted, raising concern about the baby’s wellbeing. Considering her previous uterine scar, persistent pelvic inadequacy and meconium staining, the medical team determined that continuing labour posed significant risks to both mother and baby. An urgent Caesarean section was therefore recommended. A socioeconomic assessment also confirmed that Martha was underprivileged and unable to meet the cost of the necessary emergency care.

Martha Barasa received care during labour and delivery, including monitoring of maternal and fetal wellbeing, management of delivery in cephalic presentation, and assessment of the placenta and fetal membranes after birth. Due to the presence of meconium-stained liquor (MSL), the baby was closely monitored for possible complications. Post-delivery, Martha received routine postnatal care, including observation, health education, and support for recovery. The outcome was positive, with Martha stabilised after delivery and advised to continue with postnatal follow-up care with support given by Helpster Charity Organisation for free medical treatment at Bungoma County Referral Hospital.

Martha had a previous Caesarean section for CPD and was again found to have an inadequate pelvis during the current labour, with Grade II meconium-stained liquor. These findings increased the risk of obstructed labour, fetal compromise and complications associated with labour in a scarred uterus. An urgent repeat Caesarean section was therefore medically appropriate. With timely surgery, appropriate postoperative care and newborn monitoring, the prognosis for both Martha and her baby is favourable.