Sheila A., 16

Sheila is a 16-year-old teenager who lives with her mother in a single-room semi-permanent house. She dropped out of school while in Form Two due to financial constraints and currently has no source of income. She depends entirely on her mother, who survives on casual and menial jobs to support the household. Sheila reported that she had missed her menstrual periods and began experiencing episodes of vomiting after meals. Concerned about her condition, her mother advised her to visit a nearby health facility for evaluation. At the facility, she was tested and confirmed to be pregnant. Following this, Sheila began attending antenatal care (ANC) clinics regularly, often walking for nearly an hour to access the services. Her pregnancy progressed relatively well until one morning when she developed abdominal pain. As the pain persisted, she sought medical attention later that evening at a nearby hospital, where she was admitted overnight for observation and later discharged after being informed that she was not yet in labour. However, the following day, her abdominal pain became more severe, prompting her to seek further care at a sub-county hospital. Upon evaluation, it was established that the baby was in fetal distress, and pelvimetry revealed that Sheila’s pelvis was not adequate for safe vaginal delivery. Due to the severity of her condition, she was urgently referred to Siaya County Referral Hospital for specialized management. At the referral hospital, Sheila underwent an emergency caesarean section to save the lives of both mother and baby. During her admission, a healthcare provider at the facility identified her vulnerable social situation and discomfort when told about the caesarean section when she also raised concern about the inability to pay for that, and informed her about Helpster Charity. She was guided on the process, and her case was enrolled in the program to ensure that her medical expenses would be covered, allowing her to receive the necessary care without financial strain.

Sheila was taken for an emergency caesarean surgery, the surgery was a success and she was taken to the post -op ward. While in the ward she was administered ceftriaxone,flagyl, morphine, among other drugs. Her catheter was removed after 2 days, and ambulation encouraged. The dressing on her surgical site was removed after 72 hrs. She was able to respond well to medication, and she was eventually discharged on orals. A follow up clinic was booked for her to ensure she was healing well.

Sheila presented with signs of fetal distress in the setting of cephalopelvic disproportion, a combination that made vaginal delivery unsafe. The decision to perform an emergency caesarean section was appropriate and life-saving for both mother and baby. Post-operatively, Sheila is expected to recover well with proper medical care, including pain management, wound care, and monitoring for any signs of infection or complications. Given her young age and social circumstances, additional support, including nutritional care, counseling, and postnatal follow-up, will be important for her overall recovery and well-being. The baby, having been delivered in the context of fetal distress, will require close observation to assess for any effects of reduced oxygen supply before delivery. If promptly managed and stabilized after birth, the baby’s prognosis is generally good.