On a cold and wet Nairobi evening, a group of mothers shuffle their feet along the New Born Unit corridor at the Kenyatta National Hospital.
Talking in low tones, they gently open the Kangaroo Mother Care Room. Cries of babies, born prematurely, fill the otherwise silent unit.
Inside, about 20 mothers are holding their babies, close to the chests. Their weary and anxious eyes beg the little angels to suck and suck.
Among them is 31-year-old Veronicah Mutindi Mweu. Her tired face however belies the endurance of a mother determined to stay at the hospital.
"Waking up every three hours to attend to my baby is painfully difficult but I am motivated if only my baby will be discharged without any infection,” she notes.
To overcome that they have set alarms and in case you wake up first, you wake the rest. Overwhelmed by sleep at times, some go back to sleep only to realise that they have missed going to the unit later on.
Immediately coming after a mother has undergone labour and birth, it can be a daunting task. These, according to Florence Ogongo, are emotionally draining exercises and experiences.
"Staying to see their babies at the incubator and their stay at the Kangaroo can be stressful and easily leave mothers mentally disturbed," observes Ogongo, the unit's head.
A mother has just delivered and her hormonal levels are adjusting and might become emotionally unstable.
"It means that within 24 hours, your sleep is interrupted eight times, and the nights are especially very cold," she says.
Some become emotional, teary and cry. "We call family members to talk to them and offer any support. In cases where the husband comes and talks to the wives, they really try."
It is equally straining owing to the small size of the babies, which further confuses the mothers. "My baby was very small and I was worried if it could survive," says Veronicah.
This was the same traumatizing experience for Juliet Wangari, who gave birth to a premature baby at the Saint Mary's Hospital, Lang'ata.
"A nurse held the baby before my eye. It looked small and out of disbelief, I asked if it was really mine,” she says.
Wangari knew that she was six months pregnant and was least prepared to be a mother that early.
“Besides, I knew that a new born weighed an average of 2.5kg and was shocked to see her weight, about 1kg. "I was dumbfounded that mine reduced to 900 grammes," she says.
Consequently, mothers and entire families are shocked as this is not a normal occurrence.
"A mother, just like her family, expects to get a big baby. But when they give birth before their term, she is shocked and very scared as the baby is very small," Ogongo observes.
Wangari's baby weighed about 1.1kg and had given birth when her pregnancy was about six months old while Veronicah’s weighed about 1.3kg after her 33-week pregnancy.
"I have been here for about two months and my baby weighs about 1.6kg now. I am almost going home,” she said, staring at her baby.
The stay is further complicated as the survival chances of the babies are compromised by their underdevelopment.
Ogongo estimates that about 300 births take place at the referral hospital where an average of 50 per cent are premature births.
About 50 per cent of those admitted at the unit pass away, which is attributable to their underdevelopment and subsequently vulnerable to various infections and other complications.
"It pains to hear about the death of a preterm baby and nobody knows if yours is next. I started praying and heeded what the nurses advise us," Veronicah explains.
During their stay, support from families and close relatives plays a significant role in ensuring the mother is well and thus able to express enough milk for the baby.
So stressful is the stay at the facility that some mothers abandon their babies. "This is a real challenge for mothers and some, who cannot make it abandon their babies," Veronicah says.
"We have cases where a mother frankly states that she cannot cope but for various reasons."
However, there those who simply state that they cannot care for the babies and take off.
There are two of those cases. “The other two had mothers died and the husbands are at a loss on what to do," Ogongo says.
But by providing them with the right information, many times they change their minds. "We tell them it is not easy but the baby needs them to breastfeed, touch, and communicate hence enhance their growth and development.”
Most importantly is to be told that premature births happen and can survive and that the baby is in safer hands.
In some families, a premature birth is condemned but advises that this is not a death sentence.
Ogongo has managed a preterm baby who went to become a medical doctor.
“It is our duty to educate them, to find where their fears are and give them the right information, to gain confidence and change their minds," she says.
At the Kangaroo, the baby can feel the mother and communicate with her too. A gentle touch is therapeutic and this helps the baby grow faster.
"It colonises with the mother's bacteria which are healthy and this improves the immune system."
A mother's milk is nutritious and helps the baby develop and grow faster, besides helping the baby bond with the mother.
"Studies have proved that babies who bond through the mother's touch and milk do develop a lot better and grow a lot better," she advises.
Besides, this lowers the infection rates and reduces the need to have the baby stay at the incubator.
Saint Mary's Hospital motivates mothers not to lose hope by posting photos of similar premature babies who went through the facility but are now big and in school.
"This way, they also believe that they will get out one day," Kimathi Henry, a nurse, says. They also encourage mothers who once spent time with their premature babies at the hospital to go back and talk to others.
However, Ogongo warns that the rising cases of preterm deliveries is worrying and urges expectant mothers to be on the lookout.
In 2014, figures released by the Ministry of Health indicated that of the 1.5 million live births in Kenya annually, 188,000 are babies born too soon, below 37 weeks.
Based on these statistics, one out of every eight children born in the country is premature.
Kenya is among the top 15 with the highest rate of premature babies worldwide. In Kenya, about 14,000 preterm babies lose their lives due to various health complications.
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Causes of premature births
There are no clear causes of premature deliveries but the contributing factors are many and varied. Maternal infections or certain maternal conditions such as cancer and diabetes which are not managed well can lead to premature birth.
Others include maternal high blood pressure, malarial infections and multiple pregnancies. "Expectant mothers who drink alcohol or smoke predispose themselves to premature births," warns Kangaroo Mother Care Room unit head Florence Ogongo.
To prevent premature labour and deliveries, one has to make a better and informed choice on what is best for her and the baby.
Environmental conditions such as accidents and falls can also lead to premature deliveries.
"If one is under medical attention or care such as high blood pressure, one must be monitored and managed well," she advises.
For those who do not have these conditions, maintaining a healthy lifestyle is significant.
Most importantly, one must eat natural food and observe good diet. Though deep fried foods are appealing, they are dangerous and must be avoided.
