Rael C., 18

Rael comes from an extremely disadvantaged socio-economic background. Her family has no reliable source of income and survives mainly on irregular casual jobs and occasional assistance from well-wishers. They live in poor housing conditions, with limited access to clean water, proper sanitation, and adequate food. On most days, meeting basic needs such as meals, clothing, and safe shelter is a constant struggle. Access to healthcare is also very limited. Due to financial hardship and the long distance to health facilities, the family cannot afford regular medical check-ups or essential medications. Illnesses are often managed at home or addressed late, increasing the risk of serious complications. Preventive health services and health education are largely unavailable. The family is unable to consistently provide school fees and as a result, school attendance is irregular, and there is a high risk of dropping out due to financial strain and the need to assist with household responsibilities. Rael was brought to the health facility in active labour, accompanied by her mother. She complained of severe lower abdominal pain radiating to her back, with contractions increasing in both frequency and intensity and not responding to pain medication. She reported having experienced a small amount of fluid drainage the previous day, which later increased in volume and became blood-stained, accompanied by a severe headache. She had heard stories of expectant women being turned away from delivering in other hospitals since they did not have the national insurance. She decided to come to this our hospital knowing that she will be assisted first, then later explain that she does not have the money to pay for treatment. On examination and laboratory evaluation, Rael was found to have a cervical dilation of 2 cm with no signs of fetal descent for a prolonged period. She also reported a history of previous surgery with blood transfusion, after which she had not fully regained her strength. She was diagnosed with obstructed labour in a primigravida. The medical team explained to her that she had to undergo a caeserean section and it was then that she explained that she does not have any insurance, neither does she have money to pay for the caeserean section, and as she was prepared for surgery, the Helpster Charity volunteer was informed about Rael.

Rael came in the facility in labour accompanied by her mother with complains of severe abdominal pain radiating to the back increasing in frequency and intensity not responding to analgesic. A day ago she drained liquid in small amount but the next day the amount increased with blood stains noticed, she reports that previously she has undergo surgery with blood transfusion. On examination and laboratory findings, she was at 2 cm cervical dilation without any sign of descend for long time. She was diagnosed with Obstructed labour in primigravida, the medical team recommended for emergency ceaserian section to high risk and complications such as uterine rupture, infections, haemorrhage and even possible fistula, the operation was successful both mother and the baby were in good condition and discharged when stable.

With timely surgical intervention through an emergency caesarean section and appropriate supportive care, Rael’s prognosis is good. Prompt delivery will greatly reduce the risk of serious complications such as uterine rupture, severe infection, excessive bleeding, fistula formation, and fetal distress or death. With proper postoperative monitoring, pain control, infection prevention, and follow-up care, Rael is expected to recover well. Early intervention also improves the chances of a positive outcome for the baby.