Ashley A., 16

Ashley is a Form Two student and the first-born in a family of seven children. She lives with her parents and siblings in a two-roomed mud-walled house. Both parents are peasant farmers and depend on small-scale farming to meet the family’s basic needs. Ashley enjoys listening to music and dreams of becoming a tailor. Early in her pregnancy, Ashley developed vomiting and severe headaches but initially kept the symptoms to herself. Her mother eventually realized she was pregnant at about three months and encouraged her to attend the recommended antenatal clinic visits. On the morning of 28 July, Ashley developed severe abdominal pain and informed her mother, who accompanied her to Siaya County Referral Hospital. Following obstetric assessment, she was diagnosed to be in labour, and had cephalopelvic disproportion (CPD), mild fetal distress and Grade I meconium-stained liquor. These findings indicated that vaginal delivery could pose increasing risks to both mother and baby. She was therefore urgently prepared for theatre for a Caesarean section to achieve a safer delivery and prevent further fetal compromise.

Asheley was diagnosed with cephalopelvic disproportion (CPD), mild fetal distress and Grade I meconium-stained liquor, indicating that labour was becoming unsafe for the baby and that vaginal delivery could be difficult or obstructed. Without timely intervention, there was risk of worsening fetal distress, birth asphyxia, obstructed labour, uterine injury and other maternal or neonatal complications. Caesarean delivery was therefore medically appropriate. With timely surgery and appropriate postoperative and newborn care, the prognosis for Asheley and her baby is favourable.