Fieldset
Babies in Bekaa

MSF Field Administrator Nicole Bächtold spends a night in Bekaa's (Lebanon) mother and child centre. Before she knows it, the medical uniform is on, and she finds herself assisting in delivering four newborn babies!

Nicole Bachtold holds a newborn baby

Since I arrived in Bekaa (Lebanon) in May, it is always very important for me to spend time in our clinics and get to know our activities. I never liked sitting in an office all day.

At the end of the day I work for a humanitarian organisation, and I’d like to see what we do for our patients.

It was just a matter of time until I spent a night in our mother and child center in Majdal Anjar with Maëlle, our Midwife Activity Manager from France. I was really excited and hoping a baby would be delivered while I was there.

As you can imagine, you can’t plan their timings, so you just have to be lucky to be there at the right time.

We opened this new mother and child center in Majdal Anjar (which is not even 10 km away from the Syrian border) in February 2016 and the number of deliveries is increasing every month - we exceeded 100 deliveries in September, which was a new record.

We have a 16 employees working there 24 hours a day, seven days a week: midwives, nurses, hygiene agents, crowd controllers and security guards.

Photo of Nicole and her colleagues

Nicole and her colleagues. Photo: Nicole Bächtold/MSF

She looked up to me, grabbed my hand and squeezed it hard. I had to retain my emotions, thinking how much pain she must be in

As soon as we entered, I knew that my wish to be there when a baby arrived would come true.

Two men were waiting in front of the center (they are not allowed inside). Suddenly, we heard two women screaming - they were already in labour.

I faint quite easily and seeing blood is not something I handle very well. I didn’t really have time to think if it was a good idea to assist with the delivery or not.  More than 10 years ago, in Switzerland, I assisted in a c-section of a friend - but vaginal deliveries are something else.

Before I could change my mind, the medical uniform and mask were on, and I entered the delivery room.

I was so overwhelmed by emotion that I forgot to breathe for a moment and started to feel dizzy

Two women were already 6 cm dilated. For one of them, it was her eigth child already.

The birth went really quickly. She pushed a couple of times and before you know it, here she was: the first newborn of that night shift.

When she got out, she was slightly blue and not screaming

It’s an incredible moment, when you see the baby’s hair and head, and then the rest of the body come out. There was a moment in delivery where her shoulder got stuck - when she got out, she was slightly blue and not screaming. She had to be revived and manually cleared of the amniotic fluid in her respiratory system.

But after a couple of seconds, she was crying healthily and her skin colour turned a bright pink. I was so overwhelmed by emotion that I forgot to breathe for a moment and started to feel dizzy.

I had to sit down to recover (now I understand the men in Europe who faint regularly while assisting in the birth of their child!).

While this first delivery went very fast, the second woman was 25 years old and it was her first child - thus it took a bit longer. She was in a lot of pain, and I stood next to her and tried to help her breathe normally between her contractions, to help her feel calmer.

She looked up to me, grabbed my hand and squeezed it quite hard. I had to retain my emotions, thinking how much pain she must be in. 

She delivered a healthy girl and thanked me for my (psychological) support. There was really no time to digest all these emotions on the spot.

I helped dressing the newborn girl after she got cleaned and weighted by the nurse, and we handed the baby to the mother. Shortly afterwards, a third woman was dilated enough to be on the delivery bed.

Photo of Nicole with a newborn baby

Nicole with a newborn baby. Photo: Nicole Bächtold / MSF

They are so thankful for having a safe place to deliver their child, free of charge

When you see these women, giving birth without any anesthesia and all alone (no accompanying person is allowed in the delivery room) you can't help but compare them to deliveries in Europe.

There, women have access to an epidural anesthesia, a comfortable bed, all kind of machines to monitor every change in the baby’s or their own heart beat or blood pressure, and (of course) their partner stays next to them all the time - yet, all the Syrian women in our cener never complained.

They are so thankful for having a safe place to deliver their child, free of charge. We try to make it as comfortable and easy as possible, but our means are limited compared to the fancy European hospitals.

Photo of birthing chairs at MCC

Birthing chairs at MCC. Photo: Nicole Bächtold / MSF

All our patients are Syrian refugees; they had to flee from their home and are often living in bad conditions (in tents around the Bekaa valley), so having a safe place to deliver means a lot.

Another thing that struck me is that just after the delivery, and once the placenta comes out, the women get dressed and walk to our next room, where they rest for a couple of hours in bed (sometimes not even), before they ask to be discharged and go home with their newborn.

We try to keep them for 24 hours, or at least six, to monitor them and the baby - but most of them want to leave earlier to return to their families.

They all look very fresh and you wouldn’t know that they had just given birth if you hadn’t seen it with your own eyes. (I think that I looked more exhausted than them!)

After delivery, we gave them a light meal and monitored their and their baby’s vital signs every 15 minutes to ensure that there are no postnatal complications.

All the grandmothers wanted to take a picture with me and their grandchildren!

In the meanwhile I visited the mothers that were in the room with their newborn babies. All the grandmothers wanted to take a picture with me and their grandchildren! Although I don’t speak Arabic, I got the message that they were all very thankful for what we were doing.

All our patients are Syrian refugees; they had to flee from their home and are often living in bad conditions (in tents around the Bekaa valley), so having a safe place to deliver means a lot.

After the third delivery, a new patient entered the MCC, but as she’s had a c-section for her first child some years ago, we had to refer her to a hospital as the risks of complications are too high. We only do normal vaginal deliveries and when we have doubts about complications, we call one of our gynecologists, who are always on call and can come within 15 minutes if needed.

We danced to Dabké, the local music, with the midwife and nurse to get all the emotions out

With no women in the waiting room, we knew we would have a break so we sat in the kitchen. We ate some dinner, and danced to Dabké, the local music, with the midwife and nurse, to get all the emotions out.

It was getting late/early morning, and, very tired, I decided to try sleeping for a bit (on a gynecological consultation table). Just two hours later, at four a.m, Maëlle woke me up to assist in the fourth delivery of the night - and so the second boy of the shift was born. 

At 4.2 kg, and with a very small and thin mother, he had some complications getting out and got his shoulder stuck upon exit.

In those moments it’s very important to encourage the mother to continue pushing, to turn the baby by 90° and press on the mother’s belly to get the baby out very quickly to avoid a lack of oxygen.

On top of all this, this baby boy had the umbilical cord wrapped around his neck.

We managed to get him out quickly. In order to make him breathe and cry, we rubbed the back and cleared his respiratory ways with a small tube. Thankfully, he started crying and everyone was relieved that it all had gone well again.

And so, the fourth delivery of the night was done and the sun was already rising outside.

Photo of the landscape outside Bekaa

Bekaa. Photo: Nicole Bächtold / MSF

I had this very deep happy and satisfactory feeling of working in the right organisation, doing a meaningful job, and not just shuffling money from customers to a CEO who would spend it on a new car and a bigger house

We made some coffee and started getting ready to go home to get some well-deserved sleep.

The midwife and the nurse handed over to the day shift staff who arrived at seven a.m., telling them about all that happened during the night. At eight a.m. every day the pediatrician checks on the newborns.

As we left, two more women entered the MCC with broken waters - it definitely never gets boring in that place!

I am very thankful for having had this opportunity to assist in these emotional moments of those women’s lives

On our way back to Baalbek, I still couldn’t digest all those emotions of the night. It was definitely the most eventful and emotional night for me in a very long time for me and I’m sure that I’ll never forget it. I am very thankful for having had this opportunity to assist in these emotional moments of those women’s lives.

I had this very deep happy and satisfactory feeling of working in the right organisation, doing a meaningful job and not just shuffling money from customers to a CEO who would spend it on a new car and a bigger house.

I never regretted giving up my well-paid job in Switzerland and starting this adventure with MSF.

It was not easy to leave my personal comfort zone, but it brings me a lot of personal satisfaction and humility on a daily basis. I can only encourage other people to try it too.

PS: I just signed up for another nightshift before I leave the project mid-November!