We didn’t know what to expect.

There are many aspects of culture you can learn and assimilate through careful observation. However, the details behind giving birth in Bomet, Kenya were not easily discernible for Clark or me who are decidedly non-obstetric in our medical practices.

So, when we found out we were pregnant while studying Swahili in Zanzibar, we knew we were entering another season of growing in our reliance on God.

This is a nice way of saying we were freaking out a little.

Blessed to have OB/GYN doc Meg Steen here to compare pregnant mom notes… She and her husband Jon  (family practice doc) were visiting Tenwek for 6 months with their two boys (and hope to return for good!)

We came to Kenya in October 2017 with hopes that we would return to Kentucky for our first furlough with a slightly larger family. However, we were not convinced that I would stay in Kenya to have the (then hypothetical) baby. The hospital did not have all the hardware or medications to care for premature infants and Clark was the only pediatrician.

Entrance to Tenwek’s Neonatal Intensive Care Unit (NICU); moms’s shoes and shukas (blankets) left outside

My husband, who has been quick to diagnose me with “ebola” at the first hint of scratchy throat or runny nose, cannot think rationally when caring for family members. He was not comfortable with the potential of providing emergency care for his own infant.

But God provided.

God provided a wonderful obstetrician in our friend Dr. Cheryl Cowles.

If you look closely, you can see Luke’s first smile (one hour old)!

As a physician, she has practiced for decades and Clark regularly says she is the best OB with whom he has ever worked. As a mom, she delivered one of her own sons at Tenwek. I knew I was in good hands.

God provided a wonderful pediatric team.

By the time I was in my second trimester, the Kenyan physicians with whom Clark works were comfortable administering surfactant (oh, and by this time our pharmacy was keeping surfactant regularly stocked!) and intubating and managing newborns on a ventilator. And while Luke’s appearance was a little too precipitous for any members of this well-trained resuscitation team to be present at his delivery, Clark had peace throughout the pregnancy knowing that Luke would be in good hands.

When this picture was taken, Clark was at a friend’s wedding in the Democratic Republic of Congo. I was seven months pregnant. We praise God for the meds, equipment, and providers at Tenwek who are able to care for babies born at this age!

God provided a safe delivery.

Luke was born “bila shida” (without issue). Breathing, crying, sucking. The resuscitation crew Clark had assembled had blessedly nothing to do when they arrived minutes after Luke’s birth.

God provided.

But things were certainly different….

Having a baby in Kenya meant:

• Knowing there was a good chance I would be laboring with some other folks—maternity ward was packed three to a bed the day Luke was born!
• Our OB Cheryl had to make-do without a standard delivery kit as no clean kits were available when Luke was born
• Planning our “nursery” was rearranging our bedroom until we could squeeze in a pak’n’play and mosquito net
• Being willing to wait three days to satisfy strawberry frozen yogurt cravings (the time it took to make yogurt, strawberry yogurt custard, and freeze the ice cream)
• No diapers, hats, clothes, or blankets would be provided by the hospital (but we did get a free mosquito net at discharge!)
• Praying my reflux would abate or my Tums supply would last until a visitor arrived with more
• Less prenatal visits and testing (per the World Health Organization recommendations)

The ultrasound closet! Cheryl would always bring freshly laundered sheets from her house for me to lie on. She does this for all patients.

• Paying out of pocket for prenatal visits set us back 100 KES ($1.00) per visit*
  

  My most expensive OB visit. That abdominal ultrasound was 800 Kenyan shillings ($8.00)!

• One of Luke’s first vaccines was BCG (to mitigate the effects of tuberculosis)

Growth chart and medical records for Luke and me! Purple book has all pre- and post-natal records for us as well as well-child and vaccine visit info for Luke.

What medical records look like in Kenya. Purple book has all pre- and post-natal records for us, as well as well-child and vaccine visit info for Luke.

• Luke was a citizen of no country for his first several weeks of life; at 6 weeks we visited the US embassy in Nairobi to apply for his citizenship; he still has no social security number…

Giving birth at Tenwek Hospital meant:

• A few necessary rounds of IV fluids during pregnancy could be received in the comfort of home

• The whole community knew when I was in labor. As we were walking “the loop” down to the river which is walked by many laboring women, we met our pastor and many neighbors and friends who somehow knew something was up. I’m not sure if it was my less-than-subtle every 5-minute pausing or the fact that Clark was not at work in the hospital at 11 AM on a weekday!
• We were home an hour after Luke was born

Luke at two hours old

• Post-birth, our OB made home visits (and brought us dinner and roses!)
• Luke received care essentially identical to what he would have received in the US, the means and setting of delivery just looked a little different

10-week vaccines

We are thankful for this healthy boy. We are thankful to be at Tenwek. We are thankful for our community.

We are thankful to continue to learn the (often hard) lesson that through life’s uncertainties and unknowns, God is faithful.

“He who keeps you will not slumber.

Behold, he who keeps Israel will neither slumber nor sleep.

The Lord is your keeper.

The Lord is your shade on your right hand.

The sun shall not strike you by day nor the moon by night.

The Lord will keep you from all evil.

He will keep your life.

The Lord will keep your going out and your coming in from this day forth and forever more.”

Psalm 121

[*The Sleeth family does have health insurance. And I may submit those $1.00 prenatal visit receipts…though until I get four contiguous hours of sleep, I will be prioritizing naps above reimbursement!]

Written by Val Sleeth