Anna A., 18

Anna lives with her four siblings and grandmother in a two-room semi-permanent house. Her parents, who have hearing and speech disabilities, do not live with them. The household depends mainly on her elderly grandmother, who survives through small-scale farming and occasional assistance from friends and church members to provide for the grandchildren. Anna had been well until she developed persistent nausea, poor appetite and missed menstrual periods. Pregnancy was confirmed at a nearby facility, where she enrolled for antenatal care. Despite walking more than 30 minutes each way, she attended her four scheduled ANC visits. One Friday, Anna developed abdominal pains, followed later by rupture of membranes, and was admitted in labour at a nearby facility. However, despite care, labour failed to progress for approximately two days. Further assessment showed signs of fetal distress, making continued labour unsafe. Given the increasing risk to both mother and baby, Anna was urgently referred to Siaya County Referral Hospital where she got to know about the Helpster program and where an emergency Caesarean section was performed to achieve a safer delivery.

Anna developed prolonged labour with a non-reassuring fetal heart rate, indicating that labour was failing to progress and the baby was showing possible signs of compromise. Continuing labour could have increased the risk of fetal hypoxia, birth asphyxia, infection, maternal exhaustion and other serious complications. Emergency Caesarean section was therefore medically indicated to achieve timely and safe delivery. With successful surgery, appropriate postoperative care and newborn monitoring, the prognosis for Anna and her baby is favourable.