If there’s one thing Nelson gynecologist Heather Gottlieb has learned during her time delivering babies in far-flung countries such as Pakistan and Nigeria, it’s this: we can do better.
Women across the globe are dying in droves from health complications that are entirely treatable and preventable, but in her experience working with Doctors Without Borders she’s seen that there are entire populations of women who have been left to fend for themselves.
During her most recent stint working in a hospital in Nigeria for six weeks from April to June earlier this year, Gottlieb worked alongside a team that delivered 800 babies a month — with about 65 per cent of those cases involving complications such as severe haemorrhaging, heart failure and untreated diseases.
It’s not an easy gig.
“In Canada we often don’t see those terrible end progressions of disease progression. What we do a lot more of in Canada is preventative medicine, counselling women about how to have healthy pregnancies and how to look out for warning signs,” she said.
“But in Nigeria it’s an entirely different story.”
Nobody had done that counselling work with the patients now walking through her hospital’s doors, and she found herself, over and over again, with these women’s lives in her hands. It was challenging, exhausting and non-stop, but it was also extremely fulfilling: she ultimately blogged about her experience under the name TravelOB — an endeavour that Doctors Without Borders published on their website.
One experience that stands out involved a 38-year-old mother of seven living children who had been delivered by home birth. She arrived at the hospital after giving birth to her eighth child, but she felt like something was wrong — the afterbirth wasn’t coming.
“She presented to our hospital, which is always a red flag when they’ve had home births in the past, and the midwife astutely noted that her belly seemed really big. She thought maybe there was another baby inside.”
That’s when Gottlieb got to work.
“I grabbed the ultrasound machine, and inside rather than one baby there were still two good-sized babies, still alive, and I was able to deliver those two remaining triplet girls. Triplets are rare in general, but to have a vaginal delivery instead of C-section is extremely rare.”
The way that makes her feel is hard to explain.
“I feel happy about the work I’ve done, but I come home from a day in Nelson feeling that same fulfilment. As physicians we’re so privileged to be involved in these intimate moments of people’s lives. It’s stressful, but it’s also extremely humbling,” she said.
“One thing I also remember is you don’t work in isolation, you’re just one person in a big team that’s part of a larger organization — Doctors Without Borders — and by doing your small part you can be part of something bigger that’s sustainable.”
In other words: “I know safe access to childbirth is achievable.”
Gottlieb originally hails from Montreal, and first started working in Nelson three years ago before permanently moving to the Kootenays last year. She works at the Kootenay Lake Hospital as an obstetrician gynecologist, but she plans to return overseas regularly.
“I’ve always been interested in women’s health and global health issues for a long time, so I always knew this was something I wanted to incorporate into my career.”
Her first mission, to a tribal area between Afghanistan and Pakistan, brought her in contact with migrant women and refugees who existed in a no man’s land in which there was virtually no access to health care of any kind. That overwhelming experience showed her that the global community has a long way to go to help prevent the deaths of millions of more women in the years to come.
“I wouldn’t say I’m angry, but it’s sad and it’s frustrating to know that so many women around the world are dying in childbirth, which is such a natural rite of passage. We can do better.”