The journey of motherhood for Melodius Moraa has been one of pure heartache and agony. Since 2017, she has lost five children, some to miscarriages, and some immediately after birth.
Yesterday, marking six years after her first loss, she walked out of the Kenyatta National Hospital (KNH) carrying her newborn baby boy whom she has aptly named Blessing.
Blessing captured the country’s imagination on August 1, this year, when he received a blood transfusion while in his mother’s womb, marking a medical and technological milestone.
When Moraa fell pregnant with him, she had given up hope of being a mother, before deciding to try one more time, and even willing herself to relocate. Now, with a smile, she is happy she had the strength to try one more time.
“I got my first pregnancy in 2017, when we discovered that I was carrying twins. At some point, I became unwell, went to hospital, and was diagnosed with high blood pressure. I underwent a caesarean section to save the babies, but they both died - one immediately after birth, and the other in the nursery,” says Moraa.
“I got pregnant again in 2019 but miscarried at six months. On my third pregnancy, I miscarried at one month, and when I sought an explanation, I was informed that I had rhesus complications. I got pregnant again for the fourth time in 2022, but at nine months, just a week before the delivery date, I underwent an ultrasound scan, where doctors found that my baby had an infection. I underwent the second C-section, but the baby did not survive,” she says.
When she decided to try again and confirmed she was with child, she immediately relocated from Kisii to Nairobi, and presented herself to Mama Lucy Kibaki Hospital for her antenatal clinics. Upon taking her medical history, she was referred to KNH for specialised attention.
Her pregnancy, says Dr Rosa Chemwey, a maternal-foetal medicine specialist, was high-risk and she joined the high-risk clinic upon arrival. The clinic attends to mothers who have had poor outcomes in previous pregnancies. On the fifth month, the doctors realised that her baby had anaemia and needed a blood transfusion in order to survive.
On August 1, Moraa was sedated and a needle driven into her abdomen. The needle was directed at the point where the baby’s umbilical cord met the placenta. A catheter was then inserted, and O negative blood transfused into the baby. She was then about five months pregnant, and would undergo a similar procedure soon after. Following the transfusion, she and the baby were monitored intensively, until October 19, when, at 35 weeks’ gestation, she underwent her third c-section to deliver her son. According to Dr Chemwey, Moraa has rhesus negative blood, but her husband has rhesus-positive blood.
“What usually happens in such women when they are exposed to positive antigen, is that she develops antibodies against that kind of antigen. In subsequent pregnancies, the antibodies cross the placenta and start destroying the baby’s blood. That is how the baby gets anaemic over time,” she says.
Dr Christine Manyasia, a neonatologist, said that, at birth, Blessing “was a very delicate baby” and that they had to “undertake several interventions” to ensure his survival.
“We know that many don’t make it this far,” she notes.
She explains that the baby was born early because it was too hazardous to continue the pregnancy. The decision was reached by the gynaecology and neonatal team, which saw it best to deliver the baby early and then manage his conditions. Besides, ultrasounds were showing that the baby was getting anaemic again, even after the transfusions in the uterus.
“The baby was delivered with a very low haemoglobin level of about four, and a newborn should have a level of between 16 and 18. Most organs such as the heart and kidneys were failing, thereby requiring intensive care and support to breathing and other systems.
“We also had to undertake a blood exchange transfusion. Since the antibodies from the mother were destroying the blood repeatedly, the best option was to wash out most of the baby’s blood and replace it with clean healthy blood from a donor,” says Dr Manyasia.
“We are now looking at a fairly healthy baby. We expect that the baby will develop normally. We have scheduled the baby for a hearing screening just to make sure that his hearing function is good and the baby is able to achieve his milestones growing up,” added Dr Manyasia.