Millicent A., 30

Millicent is a mother of four from a financially disadvantaged household. She and her husband are peasant farmers who depend on subsistence farming to provide for their children. The family lives in a modest two-room mud-walled house with an iron-sheet roof. Both Millicent and her husband lost their parents at a young age and have limited family support, making it difficult to meet household and healthcare expenses. Millicent suspected she was pregnant after missing her menstrual periods but initially delayed seeking care because the experience felt similar to her previous pregnancies. At three months, her pregnancy was confirmed at Bar-Ndege Dispensary, where she was enrolled for antenatal care and advised to obtain health insurance. However, financial difficulties affected regular ANC attendance. At term, she went into labour but failed to progress and was referred to Siaya County Referral Hospital. Assessment revealed a prolonged second stage of labour associated with fetal macrosomia. An emergency Caesarean section was performed successfully, resulting in a safe delivery.

Millicent came as a referral from Bar-Ndege dispensary in the active phase of labour. A vaginal examination revealed poor labour progression. She subsequently underwent an emergency Caesarean section due to a delayed second stage of labour secondary to fetal macrosomia. Postoperatively, she was managed with intravenous antibiotics, analgesics, and fluids. Her recovery was uneventful, and she remained clinically stable. On the third postoperative day, she was discharged on oral medications in good condition and scheduled for follow-up at the Gynaecological Outpatient Clinic (GOPC) in two weeks.If you'd like, I can also prepare a brief prognosis or outcome summary to accompany this case.

Millicent developed a prolonged second stage of labour associated with fetal macrosomia, making continued vaginal delivery difficult and potentially unsafe for both mother and baby. The emergency Caesarean section was therefore necessary to achieve timely and safe delivery and reduce the risk of complications. Her prognosis is favourable, provided recovery remains uncomplicated, with appropriate wound care, pain management, monitoring for bleeding or infection, and postnatal follow-up.