It is the nightmare of every mom-to-be. And rightfully so, because the joy of knowing that the little bundle you’ve been carrying for the last nine months will be in your arms soon, is out of this world. But alas, as some horror stories that have come from delivery wards go, babies have been kidnapped, and in some cases, switched at birth.
Such cases are rare but they do happen and the parties affected suffer several consequences.
A couple of weeks ago, local radio stations were abuzz with news of a case at Muhima hospital where a woman, Beatrice Uwamariya, a resident of Ruyenzi, gave birth to a baby boy but was instead given a baby girl.
In the nurse’s explanation, even though she had recorded the birth of the baby boy, she later attributed it to an error she made in recording the baby’s details. The couple was virtually traumatised but had to accept the situation and stay with the baby girl.
Emille Rukundo, the father of the baby, says that the truth will eventually come out; he was so upset that even now it’s difficult for him to adjust but they have now accepted the situation and have accepted the baby as their own daughter.
“When my wife gave birth, she saw that it was a boy, even the nurse who bathed the baby recognised it as a boy.
But on returning home, when the baby was undressed we saw that it was a girl. We then had to go back to the hospital but the nurse said she had mistakenly recorded the baby as a boy but that my wife had actually given birth to a girl,” he says.
“We thought of taking the case to court but my wife changed her mind and decided to stay with the baby we were given. I wasn’t happy with the decision but decided to accept things as they are.”
This is only one of the stories out there. However, most pregnant mothers are often scared about the pregnancy and birth itself and worry less about their baby’s safety in the hospital.
According to Dr Alphonse Butoyi, a gynecologist at Hopital le Croix, best known as Kwa Nyirinkwaya, switching babies is an error which is very rare and to him there could be no justifiable reason for such to happen.
“In our case, when a baby is born, it is immediately given a wristband with the name of the mother, the bay’s sex, weight and the time of birth, that’s done even before the baby is taken for a bath, so how can one mix that up?” he wondered.
What’s more strangers are not allowed in the delivery room except for immediate family of the expectant mother, he added.
For the proper care and full attention of the patients, there are some requirements an expecting mother has to fulfill. “The mother should come with the last laboratory test in antenatal care; if the test is not recent we do another one, for the materials needed in delivery the hospital provides them”.
“We mostly require a helper, like a relative, such that if anything happens we just call that person, the extra person also helps in keeping a keen eye on everything such that such cases as baby switching don’t happen. If the husband is around that’s the best because he even provides emotional support to the mother,” Dr Butoyi explained.
Dr Teckle G.Egiziabher, a gynecologist at Rwanda Military Hospital-Kanombe, explains that when an expectant mother comes to deliver, her name, marital status and all of her details are recorded.
For the case of the baby’s security, he said, the mother’s records are used; if the name of the mother is Francine, for example, it is written on a band that’s put on a baby’s arm reading ‘Baby Francine’.
“But the cases of babies getting mixed up and given to the wrong mother are very rare, though still one can’t be completely perfect, so to a very slim percentage, it does happen. The nurse could be under stress, or sometimes the number of women in labour could be more than the midwives attending to them and workload too much. This can lead to errors”.
But Dr Egiziabher insisted that baby-switching is a very rare phenomenon, noting that in most cases when the baby is born, it goes to bed with the mother. “It’s always advisable to come with someone to keep an eye on things, if possible coming with the father is the best because it even gives the woman moral support”.
While baby switching may not be commonplace in Rwanda, such cases are not rare in some countries, including in the region. According to New Vision, a Ugandan daily, on July 12 2006, a doctor was involved in a similar case; a male baby was switched with a dead female one at Mulago hospital in Kampala.
According to the Uganda Medical and Dental Practitioner’s Council, the doctor reported that he delivered Sauda Nabakiibi’s baby boy by caesarean section, but it was in poor condition because of severe asphyxia (breathing complications at birth). He further stated that he filled in two reports, the first one indicating that the baby was male and the second one indicating that the baby was female and that he was convinced to change the record by a senior nursing officer, who insisted that the baby was a girl, arguing that all other records indicated that it was a girl, except his record.
The doctor then stated that he blindly believed the nurse and accepted to re-write the theatre notes.
According to Superintendent Belina Mukamana, the director of anti-gender based violence and child protection at the Rwanda National Police, police has received cases of alleged baby switching although they are rare.
“We previously received such cases and those responsible were punished, whether it’s the midwife or someone else involved. But of recent, there have been no such cases reported to the police,” Mukamana says.
She adds: “When a baby is switched, it is a case of child theft but in case one accepts that a mistake was made, then to solve issues clearly and for confirmation towards the parents, a DNA test can be done. I have never settled a case with DNA as a solution but I think it would be a great thing to do since it would settle the dispute.”
Andre Gitembagara, the president of the Rwanda Nurses and Midwives Union, did not rule out the possibility of foul play in such circumstances although he did not confirm whether they had investigated such cases.
He said nurses can commit a mistake because they are stressed or have too much workload. “We have a committee in place (the National Council of Nursing) that handles such cases; it’s in charge of enforcing the code of conduct for professional nurses”.
“Nurses face hostility and there is always the issue related to working conditions, yes nurses commit mistakes but in some cases it’s not entirely their fault. Take an example of a midwife who is handling six to eight women who are all in labor, it would be hard to take care of them perfectly.
“Working conditions also matter, if the conditions are bad, obviously the services given by the midwife will be poor but whenever such a case comes up, an investigation is conducted,” Gitembagara says.
“When it’s found out that the mistake was a result of poor working conditions, we advocate for necessary improvements but when it’s down to the nurse’s fault then the nurse is reprimanded in line with our code of conduct,” he explained.
For now, he said, emphasis should be put on quality services by ensuring that hospitals and health centres are equipped accordingly – with both necessary manpower and equipment. “There is need to improve the ratio of patients to health care providers.”
According to research done by the Rwanda Nurses and Midwives Union this month, there is still a wide gap for the nurses in comparison to the number of patients. Research done in health centres shows that there is still a gap of 45 per cent, meaning that the number of nurses still needed is 55 per cent. For hospitals, the research shows that the gap for nurses is narrow being, only 19 per cent.
“There is still need for more midwives, especially for the health centers, because one may find that for the night shift, there is only one nurse attending to almost all patients, she could be the one to attend to maternity, consultation or emergencies. This obviously leads to provision of poor services leading to such errors,” says Nsabimana Jean Pierre, the general secretary of Rwanda Nurses and Midwives Union.
For Rukundo and his wife, the truth about what exactly happened may never come to light but what’s most certain is they will be a little more observant and probably concerned next time they are in the delivery ward.
I say: What measures can be taken to avoid baby switches?
Such situations usually happen in movies and are so rare in real life. But a child is something one has to handle with a lot of care, baby switching could be rare but you cannot afford to take such a chance, the mother should be so careful with her new born child, like memorise her face and take note of specific features so that in case of an exchange, she can she easily recognise it early enough.
While most hospitals use tight security to prevent these sorts of “disasters” from happening, they still happen; the mother should go along with her partner such that if she goes out like to the bathroom, the father can stay and look after the baby. Or even when her partner isn’t around, the woman can go along with a sister or any other relative.
Hospitals should increase security, like installing cameras to help in inspection, not in the delivery room but at least in the maternity ward and where the babies are washed from because I think that’s where most errors happen. One can even switch the baby intentionally, you never know, so with cameras it would be easier to keep track.
It is a nightmare! Giving birth to a healthy baby at the hospital, giving it a name, taking it home to nurture and care for it, only to find out later that you were sent home with the wrong child! It’s traumatising, that’s why women should be so careful in hospitals; at least they should make it a point to go with someone who will help keep an eye on things since the mother is normally in too much pain to follow up.
Stolen and switched: How to keep your newborn safe
The chances are slim, but the result can be devastating to a family. If you deliver at a hospital, how can you make sure your newborn is not stolen or switched at birth? Here are some ideas we hope will make your baby a little safer at the hospital as well as at home.
Before delivering, take a hospital a tour or attend orientation so that you are familiar with the hospital and appearance of the staff. Before birth, take the time to inquire about nursery routines as well as security procedures. If you wait until you’re in labour to become acquainted with these details, you may find it difficult to be very attentive to the finer points.
After the baby is born
Immediately after your baby is born, you, your baby and your partner/support person will receive matching identification bracelets. Personally verify that the bands have matching numbers and make sure your baby’s band (usually around the ankle, or two bands, one each around ankle and wrist) is not loose enough to slip off. If you cannot keep your baby with you at all times, double-check these numbers to ensure they are the same.
Make a note of your baby’s appearance and vital statistics: hair colour and amount, weight, length. Some hospitals take photographs of the baby shortly after birth.
If you can’t keep your baby with you at all times (“rooming in”), see if your partner or another family member can accompany the baby to the nursery (where bathing and other examinations may take place).
When baby isn’t in your arms
Never leave your baby unattended and alone if your room for even a minute. This includes while you take a nap, go to the bathroom or have a shower -- if you or a family member can’t keep a constant eye on the baby, ask to have the baby taken to the nursery. While in your room, it is preferable to keep your baby on the far side of your bed, away from the door. When you have a lot of visitors, you may get distracted.
Do not give your baby to anyone without proper identification: usually a combination of attire and a hospital photo ID badge, and usually a separate badge identifying him or her as nursery staff. If you have doubts, trust your instinct and don’t take chances -- call the nursing station and ask someone on the staff to come in and verify. Do not feel as if you are being unreasonable: this is your baby, and you have the right, and responsibility, to protect your newborn.
If anyone unfamiliar enters your room or asks about your baby, feel free to question them and satisfy yourself that they’re on the hospital staff.
The hospital staff should check your matching ID bands before you are discharged, but take it upon yourself to again check your baby’s ID bands for yourself. Look at the baby, for the features you first identified after birth: hair colour and amount and weight. Also take a quick peek into the diaper to check gender. If you have photos, also use those to compare this baby to the one you delivered.
You and your baby
Like many things in life, the buck stops with you. It’s up to you to be extra cautious, to make yourself aware of any potentially improper situations, and to listen to your intuition. It’s worth it for the peace of mind, and besides, there’s almost nothing else as wonderful bringing a new baby home.