Agnes Kirikumwino was caring for new mothers during a clinical placement as part of her midwifery studies when she noticed an unusual sight: a visitor to the ward, Grace*, burst into tears, of grief rather than joy.
Curious, Agnes went over to hear her story. Grace opened up to her and revealed that she had been pregnant five times but had lost every baby and she still could not understand why. No one had been able to explain to her why she could not carry her babies to full term.
As she listened to Grace, Agnes scoured her mind for reasons. She recalled a lecture about the four common blood groups and the rhesus factor. Most people are Rh-positive; normally, being Rh-negative has no risks. But during pregnancy, being Rh-negative with a Rh-positive baby can be a problem. If the mother’s and the baby's blood mixes, the mother’s body will start making antibodies that can damage the baby's red blood cells. This can cause the baby to develop anemia and other problems. Was Grace Rh-negative?
On Agnes’s advice, Grace went off to take the all-important Rh factor test which confirmed that she was indeed, Rh-negative. The next step was counselling her about taking folic acid supplements prior to conceiving and the importance of good antenatal care.
The friendship continued: the two remained in touch through Grace’s pregnancy as she took the necessary anti-D injections and medications. Agnes, recognising that the delivery could be complicated, also referred Grace to an obstetrician who recommended a c-section at the 38-week mark.
Agnes was by Grace’s side on the due date and one of the first to congratulate her as she finally delivered a healthy baby boy, Miracle Gift.
“When she gave birth, Grace could not believe it,” Agnes recalls. “She was shaking. Whenever she touched her baby, she was very careful not to hurt him to the extent that she couldn’t sleep. We had to counsel her, to take her through what to do to take care of her baby before she finally calmed down.”
“As midwives we must try as much as possible to help mothers think positively about solutions and to consistently check-up on them after discharge.”
Moments like these make a career as a midwife truly meaningful says Agnes noting that the profession brings “double happiness” by enriching the life of the mother and her family.
Agnes describes her AKU undergraduate degree in midwifery as a turning point in her career.
“My education taught me how to run a neonatal unit,” Agnes says. “Today, I’m always consulted when care plans are made and the degree has given me the confidence to pass my knowledge on to other medical students. I always tell my younger colleagues that midwifery is a profession that requires skills, knowledge and a loving heart to give care.”
Agnes is looking to do a master’s degree in nursing with a concentration in maternal health and neonatal care. “I hope to specialise in newborn care as babies are innocent and cannot express their needs. They need someone to care for them and well-trained midwives and nurses have a vital role to play in ensuring that every newborn survives and thrives.”
Agnes graduated with a bachelor’s degree in midwifery in 2018 from AKU’s School of Nursing and Midwifery in East Africa. She has worked as a nurse and midwife for over 16 years and is currently practicing at the Mulago Kawempe Hospital, one of Uganda’s large state-funded hospitals.
*The patient’s name has been changed to protect her identity.