Born Too Soon — Accessing the right care, at the right time, in the right place

A 40-year-old woman, Iveren, had waited five long years after marriage for the fruit of the womb. She and her 45-year old husband, Adamu, had prayed and fasted, yet no baby. They had spent a tidy fortune undergoing series of examinations, laboratory and other tests and both were found to be healthy in every way. The doctors could not explain why ‘they’ were unable to conceive.

Iveren woke up one morning, about a year ago, feeling unwell. At first, she thought it was an unusual upset which would go away in a day or two but when the headaches, fatigue and queasiness continued into the second week, Adamu was worried and insisted she saw their family physician.

The doctor ran some tests. A few minutes later, beaming with smiles, he gave them the wonderful news. “You’re pregnant,” he announced gleefully. Their joy was overwhelming and contagious. They could not wait to see their bundle of joy.

Iveren had antenatal care, followed all advice given and did all the things she was advised to do during pregnancy and all seemed to be going well. However, it appeared the baby too was in a hurry to come into the world and was delivered at 33 weeks.

The average length of gestation (that is from conception to birth) is 280 days, or 40 weeks, from the first day of the woman’s last menstrual period. So their baby came seven weeks earlier. Adamu did not worry much.

“This is year 2019 and we are aware that even babies born earlier than 33 weeks survive with good care and we shall provide all that’s needed for her survival,” they resolved.

Their tiny bundle of joy was kept for treatment in the neonatal intensive care unit for a few weeks  A neonatal intensive care unit, (also known as an intensive care nursery), specialises in the care of babies born prematurely or found to be ill at birth or during the neonatal period, (the first 28 days of life). The baby was named Precious, for she was indeed precious (a wait of five years no be joke!).

Precious grew by leaps and bounds. However, her mother noticed she did not maintain eye contact during breastfeeding. Her friend, Sewuese, a mother of two, told her this was not normal and advised her to take Precious to the eye doctor. The following week, the family was at the eye clinic to see what the problem could be.

The pretty lady eye medical doctor received them warmly and proceeded to listen to their concerns. She asked them several questions especially related to habits and medicines used before, during pregnancy and shortly after the birth of Precious. She proceeded to examine her.

“Precious is physically healthy and I can see you’ve taken excellent care of her. At three months, she is doing really great.” Then the doctor’s face fell. She was obviously weighing her words. It looked like ages before she pronounced the next few words. Iveren knew there was trouble. Eventually, she spoke, slowly, cautiously and in low tone.

“Precious,” she said in a barely audible tone, “regretfully has a complication in the inner recesses of her eyes (the retina) as a result of being born too soon – prematurely, a serious problem.” She called it “Retinopathy of Prematurity”. She asked if Precious had her eyes examined at birth.

It was then Iveren recalled that her baby’s neonatologist had told her the eye doctors would examine her baby’s eyes before discharge. The eye doctors had come as promised on her third week post-delivery but she had not allowed them to examine her baby. Having watched them examine other babies in her presence, she had been afraid that the bright light they used would hurt her baby’s young eyes.

“My feet almost gave way under my weight. If only I had understood the implications of my refusal. If only I had been better counselled!” Now Precious would never see her parents’ loving smiles. She was blind from Retinopathy of Prematurity (ROP). ROP affects babies born prematurely. A comprehensive eye examination of all premature and high risk babies within four weeks of birth is the only way to prevent your joy being turned to grief.

Our Guest writer, Dr. Mary Ugalahi, is a Consultant Paediatric Ophthalmologist at the University College Hospital, (UCH), Ibadan. Paediatric Ophthalmology is one of the seven subspecialties in eye care. So a consultant Paediatric Ophthalmologist is an eye medical doctor (ophthalmologist) who has a deeper knowledge and skills to tackle challenges of visual development, vision care and eye diseases in Children. Nigeria is placed third among the 10 countries with the highest number of premature births with 773,600, according to latest figures from the World Health Organisation (WHO).

  • A contribution by Dr Mary Ugalahi
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