My First Delivery of Twin Babies

I was not lucky throughout my undergraduate medical education and compulsory 1-year housemanship to witness or assist in the delivery of twin babies per vaginum. I only witnessed and assisted in the delivery of single babies.

Few of my colleagues were lucky to either be on duty or coincidentally walked into the labour ward complex of Lagos University Teaching Hospital, Idi-Araba when mothers were delivered of twin babies per vaginum. My legs never walked in such random manner to give me that experience that thrilled my colleagues whenever they talked about how a second baby was delivered after some minutes of the first. I longed for the experience; I did not have it. I completed my housemanship in 2009, and was certified with a full licence to practise as a medical doctor.

Before completion of housemanship, every doctor has a provisional licence to practise medicine and surgery. The provisional licence expires after two years from the date it was issued.

Fate sent me to Yobe state for my National Youths Service Corps. I sulked for a few days when I learnt in the camp in Fika LGA about the poor remuneration given by the state government to corps members. Never one to live in misery, I encouraged myself that it was a fleeting phase. I hit the ground running when I received my letter of posting to my place of primary assignment (PPA) in General Hospital, Nangere. Nangere LGA is next to Potiskum LGA, the commercial capital of the state. Damaturu is the administrative capital.

The old corps members of the Nigerian Christian Corpers Fellowship (NCCF) received us warmly in Nangere. "Second Timothy" was the slogan for anyone who wanted a second serving of the food they had prepared for us. Some of us asked for "Second Timothy."

I visited my PPA the following day in company of corps pharmacist Taiwo Lasisi, who was in the same NYSC batch with me. Both of us had a shocking encounter when we saw where we were to spend our next ten to eleven months. The General Hospital could be likened to a glorified sickbay of a secondary school due to the ineffective and inefficient use of the modest facilities available.

I knew I needed to do something to get busy if I would maintain my sanity. 

I did two things; the first, I volunteered to join the doctors who worked in General Hospital, Potiskum, a very busy place, located more than 30 kilometers from General Hospital, Nangere. I got the permissions of my Hospital Secretary and the Chief Matron to work in General Hospital, Potiskum on Tuesday and Thursday. I appealed to them that I needed to work in such busy place in order not to become an inept doctor. They encouraged my initiative and gave me all the necessary support.

The elective surgical cases were done on Tuesday and Thursday in GH Potiskum, so I used the two days to get both clinical and surgical experiences. My fellow corps member, Dr Chibueze Nwosu, was kind to me. I had met him in Fika camp. He was posted to GH Potiskum. He introduced me to the staff members in his hospital and accommodated me in his apartment on all the days I couldn't go back to my place in Nangere. Dr Muna, the Principal Medical Officer and Medical Director of the hospital was also a father figure. He was warm to the corps members. He was patient with us in learning surgical skills. 

The second decision I made that kept me busy during that one year was to do locum jobs in any Private Medical Center in Potiskum. I enquired about private hospitals, and was told of three facilities in Potiskum where I could do locum. Potiskum Medical Center (PMC) was my first choice.

I visited PMC and met the Medical Director, Dr Ben Egbo. He was an affable man, who was also willing to teach. 

About six weeks after resuming in General Hospital, Nangere, I began locum job in PMC. The wage I earned sustained me during the seven months that the state government refused to pay the state allowance. The measly 9,500 naira federal allowance was the only income most corps members earned. 

I had to learn the Hausa language in order to get accurate information from the patients who did not understand English. It became necessary when I observed that my translators were not asking the patients the right questions I said in English. Hausa is a beautiful language. It is more straightforward to learn than Yoruba. I learnt from everyone who was willing to teach me. My Hausa tutors were happy teaching an "otondo" (an NYSC lingo for an inexperienced person) their language.

Most of the Hausa and Fulani women did not register in antenatal clinics. Amongst the few who did, some refused to do the recommended pregnancy scans and other tests. Poverty, ignorance, poor orientation by the government, long distance between their homes and orthodox health centers, inadequate vehicles for transportation, and other factors influenced their poor attitude to health services generally.

So, many deliveries were taken without the doctor or nurse having adequate information of what to expect during labour. 

Before that fateful day, I had taken the deliveries of some women during my locum duty in PMC. All were single babies. While in the clinic, one of the nurse attendants in the labour room ran into the consulting room to call me urgently to assist them. Another delivery was imminent.

I got there, the baby's head had crowned (about to come out of the vagina). I immediately wore gloves and guided the delivery of the baby. I severed the baby from the mother by cutting its umbilical cord in between two clamps. I examined the woman's vagina for the placenta, which was the next thing to be delivered.

I was momentarily confused. I touched what seemed like a balloon instead of the placenta. Before then, I had not felt what seemed like a balloon after the baby had been delivered.

"Balloon ke?" I mused. Dr Egbo, the MD of the hospital, was nearby, but as a doctor who needed to justify his wage, I thought of what to do first before calling him. 

The placenta is fleshy and meat-like in texture, not a smooth and rubbery tissue like what I felt.

Like some of the previous women, the woman did not register for Antenatal Services in PMC or another hospital, neither did she do any pregnancy scan. She just arrived at the hospital when she became pressed to be delivered of her baby. So, we didn't have any information about her pregnancy.

The birth attendants looked unto me for direction. After few minutes of clueless thinking, I settled to call Dr Egbo to rescue me from the looming embarrassment. 

Fortunately, Dr Egbo walked into the labour room just in time when I wished him to be around.

"Likita Demola, yaya aiki?" he greeted me, asking how work was. I told him my concerns. He smiled professionally like someone who had seen it all. He asked for gloves and an apron. He did a vaginal examination on the woman and said another baby was there. "The 'balloon' you are feeling is the membrane protecting the second baby," he said.

"Another baby?" I replied, a little embarrassed by my naivety and also excited that, at last, I would witness the delivery of twin babies.

"Yes," Dr Egbo affirmed. He asked those not wearing apron to step aside in order not to be bathed in the baby's amniotic fluid (the water in the balloon). He burst the balloon; a gush of clear fluid egressed from the woman. Less than thirty seconds afterwards, a pink, healthy baby swam out effortlessly from the woman. It screamed as if it was flogged from inside the womb. 

"I guess this is your first experience of a twin delivery?" Dr Egbo asked me.

I nodded, now relieved that all was well.

"Every doctor has his or her first time," he told me reassuringly and left me to tidy the woman.

Since then, whenever I touch a "balloon" in the vagina after delivering a woman of a baby, I do not hesitate to burst it...

Ademola Orolu

About the Author

Ademola is a Consultant Family Physician and writer. He founded the online health magazine, The Family Doctors, and was its Editor-in-Chief from 2017 to 2020, when he wounded up the magazine to concentrate on his full-time medical practice, Nathaniel Health Consulting, Matogbun, Ogun State. 

He is an author of many books including storybooks. He regularly writes on health-promoting topics and encourages positive behavioural change in his articles.