Maître Marie Madeleine Donfack, Senior Staff Nurse in Reproductive Health, Efoulan District Hospital, Yaounde talks about medical errors that lead to babies being disfigured.

How do you explain the fact that children develop complications during birth even though results of ecography examinations have proved that they were normal during pregnancies?

There are several types of complications. If they are complications linked to the foetus, they are complications that are linked to foetal macrosomia. That is, the child is too big.  So, if during prenatal consultations, or follow up or ecographic examination and a macrosomia is diagnosed, there is no need to allow the woman give birth normally.

If it is not the case there should not be any delay. The woman should be sent directly for caesarean operation. For cases where the staff has wasted a lot of time during delivery there will be, maybe, a poor handling in the bringing out the shoulders or the orientation of some visible parts which can create some liaisons at the level of the head or fractures at the level of the shoulders. So in summary the causes are due to foetal macrosomia, foeto-maternal disproportions and the poor practice of the health personnel.

What does the hospital do as far as follow-up for such cases is concerned?

At the Efoulan District Hospital, paediatric consultations are systematic. In effect, when a child is born and whether there are complications or not the child must go through paediatric examination. If the paediatric is not available we have the duty to refer the child immediately to the Chantal Biya Foundation for a better follow-up.

That is what we are doing at the Eoulan Hospital. We are developing a system of reference and counter reference. We are in collaboration with the Yaounde Central Hospital where we have created a network for the treatment of women who have been referred from the Efoulan District Hospital. Actually, we are developing a second network with the staff of the Chantal Biya Foundation and other health districts which can help us in the management of reefed cases.

How can complications during deliveries be prevented?

As I was saying, treatment can start during prenatal consultation.  A prenatal visit should not be taken simply as a routine. We must try to evaluate the weight of the mother; always calculate the estimated weight of the baby because it is the weight of the baby that will enable us to decide. If we have, for example, a first pregnancy that at the time of prenatal consultation it is at full term and we notice that the foetal weight of the baby is estimated at 4.5kg, I don’t think we will allow the woman to give birth normally. In that case it will be caesarean operation.

Because for a first pregnancy with a baby of 4.5kg, we are all aware of the fact that if the staff is not well trained and if there is no adequate technical platform, we will have complications such as fractures and many others. So in principle we can do it with good prenatal consultation where each personnel knows his limits and to refer to the hierarchy in case of any complications. Also, at the level of the labour room when a woman comes to give birth we have the duty to carry out clinical consultations first.

If there is complication that was not diagnosed during prenatal control, the health workers in the labour room should detect the problem. It is important that they inform the gynaecologist who can take a decision for operation. Then we can avoid such complications. I think it all resides in the professional consciousness of each personnel and rapid treatment. With that we will be free from complications in new born babies and mothers.