A 90-hour triplet delivery in Bentiu, South Sudan
The emergency call to the maternity ward at MSF’s hospital at Bentiu camp in South Sudan came suddenly during my shift. A 26-year-old expectant mother whose water had broken had arrived and an ultrasound was needed.
Arriving at the ward, I quickly identified three babies. The mother didn’t know she was having triplets and was premature. Because of the way the babies were lying, the situation was critical. We administered antibiotics and monitored the mother’s vitals. I had predicted she would go into labour and my colleagues in the maternity ward stayed close with her.
Within five hours of the mother arriving, I had another call from the ward to say she was pushing. She gave birth to the first baby, a little boy who was very vigorous and weighing a healthy 1.8kg - quite big for a triplet. Usually in multiple pregnancy, after the first baby is born, the second would arrive within an hour or two. But that was not the case with this mother. Fortunately, the position of the other triplets was good. The mother was somewhat uncomfortable but was stable.
One hour passed, two hours, three hours… we were wondering at that point what was happening, but everything seemed under control. The babies inside had normal heartbeats and the mother’s vital signs were good. We performed another ultrasound to confirm the position of the babies, and all looked well.
We made sure the mother understood exactly what was happening, and explained the situation to her husband, who was also at the hospital. We decided to let her rest, and she started breastfeeding her new born. A few hours later, I went to sleep because everything was under control. In the morning, I found the mother comfortable in the maternity ward and checked in on her every two or three hours. At that point, I started looking up the world record for length of triplet deliveries!
Some of my colleagues have been working in the community for six or seven years, and their experience is invaluable in situations like these. We all sat down, along with our obstetric advisor, to discuss outcomes and decide how to manage the case. While I personally had not seen a triplet pregnancy before, twin pregnancies were not unusual in the ward and triplets had also been delivered.
Word had travelled fast in the community that a mother was expecting triplets. Local women came to check on her and see if she needed anything.
At that point we were expecting the next two babies to arrive at any moment. And that’s how 24 and 48 and then 72 hours passed! 90 hours after the mother had arrived at the hospital, I woke to a call from the maternity ward at 4am on Thursday morning to say the mother had given birth to the second baby and that everything was fine. Twenty minutes later, they called again to tell me the third baby had been born. I could hear the new babies – both boys - crying over my walkie talkie.
Everyone was well and they told me that the second baby was 2kg and the third baby was 1.9kg. It was impressive for all three babies to have such a good weight and to be well.
I started looking up the world record for length of triplet deliveries!
It was a great experience, probably one I will never witness in my career again, especially because I was leaving the project in Bentiu just two days later.
People in South Sudan are facing many challenges.
- There is conflict in many areas of the country that results in displacement.
- Food insecurity and lack of resources that make them vulnerable to malnutrition.
- Lack of education and work opportunities prevent them from overcoming poverty and improving the poor living conditions.
- There are high morbidity and mortality rates due to outbreaks of diseases. All of these factors compound to create a situation where the needs of the people are increasing every year.
MSF’s projects in South Sudan can be challenging, but also very rewarding, as you get to see the impact of your help directly. At the hospital in Bentiu camp, MSF helps provide secondary health care services 24/7, so the work there never stops.
Due to food insecurity and poor nutrition, many people are malnourished. Some have chronic anaemia, with women and children being the most vulnerable. Obstetric emergencies like post-partum haemorrhages, traumas and malnutrition are the most demanding cases.
From conversations I had with women in the community in Bentiu, they said they considered MSF like a grandmother – someone that they would always love to go to sit and talk to, because a grandmother always listens to you. They told me that MSF does what they say, and if ever they need help, it’s MSF they will go to. This is also the impression I got from my patients.
Bentiu was my first time working with MSF. I cannot be more grateful for this opportunity; of being challenged, of meeting people, hearing stories, learning and growing, and of being part of someone else's experience.
Tina Popa is a midwife with Médecins Sans Frontières/Doctors Without Borders (MSF).
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