Susan A., 23

Susan is an orphan with no surviving relatives to support her. She left school in Class 8 after losing both parents and now lives with her spouse and newborn in a one-room mud-walled house. She is unemployed and depends on her spouse’s irregular casual work, which also supports his unwell mother. After experiencing persistent fatigue and illness, a neighbour bought her a pregnancy test, which confirmed she was expectant, and encouraged her to begin antenatal care. As the nearest facility was a two-hour walk away, Susan managed only two ANC visits. One Friday night, she developed abdominal pain and used money from a neighbour to seek care, only to find the nearby hospital closed because health workers were on strike. Stranded and in pain, she received help from a passerby and travelled by motorcycle to Siaya County Referral Hospital. Assessment revealed cephalopelvic disproportion, requiring an emergency Caesarean section. Unable to afford treatment, she was referred to Helpster Charity. Her spouse could not visit during her admission because he lacked transport fare, leaving Susan to recover largely without his support.

Susan presented to the hospital with complaints of abdominal pains radiating to the back, she went into labour but her birthcanal was small which warranted an emergency caesarean surgery. She successfully underwent the procedure and taken to the ward for post operation management. In the ward she was administered ceftriaxone, paracetamol, plastic, among other drugs. She was eventually discharged on orals with a follow up clinic booked for her.

Susan underwent an emergency caesarean section secondary to arrested descent caused by cephalopelvic disproportion (CPD), a condition where the baby’s head could not adequately pass through the maternal pelvis despite adequate labour efforts. Prognosis following surgery is generally good with timely intervention, appropriate postoperative care, infection prevention, pain management, and close monitoring for complications such as postpartum haemorrhage, wound infection, anaemia, or thromboembolic events. Maternal recovery is expected to progress steadily, although future pregnancies may require careful obstetric evaluation due to the history of CPD and caesarean delivery