Guerda is one of the lovely ladies in our Maternity Program. This is Guerda's second time in our program. She went through the program 2 years ago when she was pregnant with her first baby. Guerda had a relatively normal pregnancy until she reached her seventh month. In her 33rd week of pregnancy, she developed high blood pressure 
and started to pass protein in her urine. These are the classic signs of preeclampsia. Preeclampsia is still a mystery disease. There are theories about the origin of preeclampsia, but we still do not have the full picture. We know specific groups of women who are higher risk of getting it. Once a woman is diagnosed with preeclampsia we know how to help control her symptoms and we know that birth is the cure to the disease. Women can first have symptoms of preeclampsia starting in their 20th week, but most of the time symptoms start after the beginning of the third trimester or 32 weeks. This was the case with Geurda. We diagnosed her with preeclampsia when she was 33 weeks pregnant. From that point on we've seen her on a daily basis. For the past 2 1/2 weeks she has come faithfully every day to the maternity center. We'd feed her, monitor her blood pressure and urine, give her medicine, and let her rest for a couple hours. Guerda never complained, she understood how serious her situation was and made a way to come every day.
In Haiti, preeclampsia/eclampsia kills more women then any other pregnancy/birth related issue. Women in Haiti know what preeclampsia is and what it can do. When I told Geurda she had preeclampsia, I asked her if she knew what that was. She said it could kill her baby.
Prenatal care is so important for pregnant women. With routine prenatal care, a practitioner will be able to diagnose problems like preeclampsia and treat them accordingly. According to UNICEF statistics, only 54% of Haitian women get routine prenatal care(4 or more check ups) during pregnancy. That means that nearly half of pregnant women in Haiti are not getting the care they need. These women are left in a vulnerable position. If they develop a complication like preeclampsia, they may not get to help they need before their situation becomes life threatening. Help late may be too late. UNICEF reports that the maternal mortality rate in Haiti is 670 out of 100,000. Haiti has the highest maternal mortality rate in the western hemisphere. Sixty women in Haiti die to every 1 woman in the US from complications in pregnancy and childbirth. Looking at statistics like these show how important healthcare and education is here in Haiti.
When a woman develops preeclampsia, decisions for her care are based on what is best for mother and baby.
If a woman's symptoms are not severe, it's better for the baby to continue the pregnancy till 37 weeks. At 37 weeks gestation, a baby is fully developed and shouldn't have issues related to prematurity. But if preeclampsia becomes severe before 37 weeks, delivering the baby is necessary. We were hoping Geurda would make it to 37 weeks but her condition worsened in her 35th week.
Sunday evening we had to make the decision to induce. Geurda came in Monday morning calm and peaceful. She knew what was ahead of her and approached labor with a calm strength. With the help of Dr Jen and a consulting OB in the states, we were able to safely provide the care she needed for the labor and delivery. Five hours after we started her induction, she delivered a baby girl. Her baby was born healthy and a good size for her age.
We will keep Guerda at the maternity center for a few more days and monitor her closely.
We are all so thankful and blessed for such a great outcome. Beth and I have talked a few times about what might of happened to Guerda if she wasn't receiving prenatal care. Would she have known she was in danger? Most pregnant women wouldn't know there is something wrong if they weren't receiving care. Would she have seized in her home? Would she and her baby be alive? It is hard to know. We do know that there are women in Haiti who are not getting prenatal care who have preeclampsia. What happens to them? It breaks my heart to think of it.Please join us in prayer for Guerda as she continues to heal. Lets also pray for the women of Haiti who are in need prenatal care and a safe place to birth their babies.
