Emily Adhiambo J., 20

Emily is the third-born in a family of seven children. She left school in Form Three because of financial difficulties despite dreaming of becoming a lawyer. Her elder sister also did not complete school and married early, while her younger siblings are occasionally sent home over school-related levies despite attending subsidized public schools. Emily is now a mother of two and lives with her children and parents, who depend on peasant farming. She is currently training as a salonist through support from a government programme and her church, hoping to become self-reliant. Emily suspected her pregnancy after missing her periods for two months and experiencing symptoms similar to her previous pregnancy. It was confirmed at Got Kayembe Dispensary, where she subsequently attended ANC. Near term, she developed abdominal pains and sought care at Diocese Hospital before being referred to Siaya County Referral Hospital. Emily had a previous Caesarean section due to cephalopelvic disproportion (CPD). Repeat pelvic assessment confirmed persistent CPD, indicating that vaginal delivery would be unsafe. An emergency Caesarean section was therefore recommended.

Emily has a previous Caesarean scar for CPD, with repeat pelvic assessment indicating persistent disproportion. Vaginal delivery would carry significant risk of obstructed labour, fetal compromise and uterine scar complications. Repeat Caesarean delivery was therefore medically appropriate. With timely surgery, appropriate postoperative care and monitoring for haemorrhage, infection and wound complications, Emily’s prognosis is favourable, with good recovery expected.