I don't believe in the theory of evolution, but one thing is true here—the "survival of the fittest" is a fact in our NICU. Without ventilators, blood cultures, blood gases, multiple options of antibiotics, neonatal surgery teams, ultrasounds, and more—only the strongest survive here.
A new baby girl born premature at 2 lbs. and 29 weeks was at great risk of dying. We soon realized she had a lot of physical characteristics of Downs Syndrome. There’s no way to diagnose this here other than physical assessment, but we sat down with the mother and shared our observations and concerns.
When it was obvious the baby girl was going to die, I asked the mama if she wanted to hold her daughter. It’s cultural here for the mother to not want to hold her dying baby and even sometimes to not want to see the baby. This in no way means they don't love their babies; it’s just the way things are done here. I try not to push my culture on the mothers, but I always ask the question—do they want to hold their babies? Some are shocked and give an immediate no, others hesitate but say no, some reluctantly say yes, others say a grateful yes, and a few ask me before I ask them.
Most mothers will hold their babies 5-10 minutes at the most and then put them down. But this mama wanted to hold her baby the whole time she was dying. Holding her wrapped in a blanket the mama alternated between looking at her baby, joining in the daily chit chat with the other mothers in the room, then back to focusing on her baby. When I told her the baby was gone, she kept holding her a while longer. I’ve never had a Rwandan mother spend this much time with a dying baby.
Because the little one was born at 29 weeks, the mama didn't have clothes for her baby, so I gave her a preemie Onesie and a tiny hat knit by a supporter. She couldn't stop talking about the clothes, how they fit her baby, and how the baby looked dressed up with her arms crossed. I truly admire this woman for stepping out of her cultural norm and taking the time she needed with her daughter. I wish I could spend time with her in her home with the rest of her children. She must be an amazing mother.