Experiencing maternal death

Name? Age (if known)? Gravidity and parity? Cause of death? I sit on a block of sandstone outside, under the trees, with the monkeys tumbling around me, and the storm clouds gathering for the evening's coming deluge, filling in the maternal death surveillance paperwork, for the seventh time this year. It's a strange and disconcertingly beautiful setting for such a sombre task. Surely, I think to myself, surely this is it. But even as I think it, I know it is unlikely to be true. Not this year, not next year, perhaps not for many years to come. Maternal deaths will continue to happen. I baulk at the final piece of the puzzle, ‘cause of death’.

I sit and stare at nothing, trying to hold back the wave of emotion that threatens to break through the fragile facade of calm I've just about managed to keep in place since she died. Cause of death. I know why her heart stopped beating and her lungs stopped breathing. I know that. I know the pathophysiology of a catastrophic haemorrhage leading to disseminated intravascular coagulation, hypovolaemic shock and extreme hypoxia. But that's not why she died. That's how she died. And for some reason, with Tigist, I can't write it. I can't reduce the devastation in her mother's eyes, living without her eldest daughter, the fear in her husband's, living without the mother of his newborn twins, the regret in my own, living with another woman in my care dying, to a few clinical sentences. I'm too tired and angry and sad—at Tigist for not pulling through, and at us for not doing it for her. Hers was a death of circumstance.