Decorated and gratifying career as a midwife
Evelyn Makena @evemake_g
Growing up as a young girl in Tsavo, Taita Taveta county, Nerea Ojanga knew that she wanted to be a nurse.
But along the way, she stumbled upon midwifery by accident and has never looked back. Nerea has helped deliver more than 1,000 babies.
“Some people joke that I have delivered half of babies in Nairobi,” she says. Her passion for midwifery was ignited two years after she joined Kenya Medical Training College (KMTC) to train as a nurse in 1980.
She was walking to her hostel one day when she met a woman in labour. “Ordinarily all students would be dressed in blue uniforms.
Whenever people saw us they would assume we were doctors,” she remembers.
Her first instinct was to go and help the woman even though she had no experience delivering a baby.
After a successful delivery, Nerea accompanied the woman to the labour ward of Kenyatta National Hospital (KNH), she met midwives and saw how excited they were about babies.
After her training, Nerea later started working at KNH in 1984 as a nurse, but was still interested in being a midwife.
She trained as a midwife in 1989 and since then she has fully immersed herself in the job.
“To be honest, being a midwife never felt like a job. For me, it’s something I thoroughly enjoyed,” she says.
The work of midwives is often confused with that of nurses, but Nerea notes there is a huge distinction. While nurses treat the ill, midwives’ sole duty is to help women deliver.
“It involves being with women during labour and supporting them through the process. It could be a short time, but it is very critical, especially for new mothers,” she says.
While growing in the profession, Nerea noticed there was a lot more needed to succeed as a midwife.
The terrain of midwifery had changed so much over the years as compared to when she first got the training.
There was need to develop soft skills to support and care for the mother through childbirth.
“Childbirth is a very intense and intimate process. Midwives need to be personable and be able to put the mothers at ease,” she adds.
To bolster her training, she attended training in Norway in 2002 to learn how best to support women before and childbirth.
She also trained in assisting women have water births in Germany in 2012. Over the years she has expanded her skills and trained as a doula — a birth assistant, breastfeeding expert, childbirth education expert and a clinical instructor in midwifery.
The 60-year-old, who retired as a midwife in 2019, has had a career decorated with many memorable experiences.
With her entire career having been in KNH maternity, Nerea remembers one specific incident in 2009 that really stood out for her.
The hospital had put up a newborn unit in 2008 before receiving their first pre-term baby.
Baby Hope, was born to a mother who had difficulties carrying a pregnancy. For this particular pregnancy, Hope’s mother was admitted in hospital for about a month for monitoring. She ended up delivering the child at 25 weeks.
“That was by all standards a very premature baby. She weighed 400gm and was the size of bread,” remembers Nerea.
Nerea happily remembers how, Baby Hope later left the hospital at 3kg and is now grown up.
Other highlights include helping reduce rate of neonatal and maternal deaths. At some point during her career, she noticed many women were dying due to preventable causes.
“Some cases were mismanaged in local health facilities and they would be brought to KNH at critical states,” she says.
Dialogue with health workers in different facilities that were culprits, helped address the issue, provide the right training and lower the rates of maternal and neonatal deaths.
Helping HIV positive pregnant mothers reduce the rate of transmission of the virus to the babies is another area Nerea has been keen in observing.
“At KNH, we brought these women together in a group and really encouraged them to take their ARVS and provided a safe space for them to air out their hopes and fears,” she says.
This deed alone has helped in reduction of mother to child HIV transmission at a time when Nerea was in charge of the maternity unit at the hospital.
After retiring last year, Nerea still has her hands full with helping mothers through the childbirth process.
She has opened a childbirth education training centre in Kilimani where she imparts parents to be on skills on what childbirth and child care entails.
She also trains women on breastfeeding and supports women through childbirth as a doula.
After years in the profession, Nerea is happy the most about the many people she has trained in midwifery.
“For me, that is my legacy. As a clinical instructor I got to train and mentor so many students on certificate, diploma and even degree level,” she says.
She reckons that the job of a midwife is often misunderstood and often confused with that of a nurse.
Often times midwifes do not get due credit for their work, but often get overshadowed by nursing.
“I think this confusion comes because one has to become a nurse before becoming a midwife.
But still midwifery is a profession on its own. I would not trade the joy of delivering babies and seeing them grow,” she adds.
Nerea is among midwives who have stood by a profession that has faced numerous challenges over the years.
Chairpersons of Midwives Associations of Kenya, Louisa Muteti, says skilled midwives with equipment and resources required can be the difference between life and death of about 300,000 women each year and 10 times of the infants.
“Midwives are essential to achieving sustainable development goals, most of the maternal deaths are preventable and if midwives can be deployed in large numbers they can be the catalyst to avoiding these deaths,” Muteti says.
The Association has 250 certified members. Muteti notes there are about 2,500 trained midwives in the country, and expects the number to rise to about 3,000 by the end of 2020.
In 2018, the association asked the government to support training of midwives independently to reduce the shortage of nurses who do not have the capacity to be nurses and midwives on the same day.
If the government manages to train more midwives, it would reduce maternal and newborn deaths.