Now I know why men run away from triplets

As she prepared to go for her first antenatal visit, Damari Rafikiyangu’s husband jokingly told her that they should expect three babies. They laughed it off.
At the scan, however, it was discovered that indeed, Fiki, as she is more commonly referred to, was carrying triplets. She received the news with anxiety wondering whether the machine was functional. “The news came as a shock,” Rafikiyangu recollects, adding, “Every time I thought about the doctor’s words; ‘you have three babies’, I got scared.”

And for a week, she had nightmares of whether the unborn babies were safe, of her responsibilities ahead and where the money to raise them was going to come from. “I thought of the bills, the food, if they got sick or if I would get a good house help. There was no answer,” she said.

When she broke the news to her husband that evening, Dicson Amanya sounded unbothered with a simple reply, “I told you.” This too left her in suspense. But Amanya, who had quietly followed the interview at their home in Namugongo, now reveals he realised he had to reassure his wife who would be doing the heavy waiting for the next six months before the babies were delivered.

“She was only three months pregnant but you would think she was eight,” he recalls. This prompted the couple to turn to each other smiling as if in affirmative. Although he admits that he wasn’t shocked at the news, what is clear is that he hadn’t expected Usher Heri, Echoe Kwanza and Alba Ayanda in one go. “I rarely get shocked. I was happy and only prayed they grow healthy,” Amanya explains, adding: “I expected a second born, but never knew it would be in numbers. I absorbed it immediately and started to arrange to receive the three guys.”

The first trimester had been occasioned with morning sickness which was different with their first born. She also felt too heavy in the early stages. Other than that, the pregnancy was generally normal although she was asked not to over work herself at three months. Rafikiyangu had about three antenatal checkups for her first son, Ray Paris Amanya. But for the triplets, she was in touch with her gynecologist almost every day to ensure the babies stayed in good position.

Unlike other pregnant women, the mother of four was advised against walking for fear that the cervix would open and cause a miscarriage so she was asked to have enough rest. After all, it wasn’t going to be a natural birth. This meant she would resign her Rubaga-based job as an administrator at Uganda Institute of Social Work and community Development and a month later, with difficulty, she threw in the towel.

“I stopped working when I was four months pregnant. At this stage, there was stitching of my cervix because the doctor thought the babies could come out. But even if the doctor hadn’t advised that I rest, I was going to stop working. I had difficulties in walking, vomited a lot and was already tired and the tummy was too heavy. I was like in labour,” she shares.

But how were they going to cope? It being the second pregnancy, they had been planning for two. But here they were going to have four children. According to Amanya, an Art curriculum specialist at National Curriculum Development Centre, they had to start preparing for them early.

“After getting the news, our preparation became instant, we started cutting costs, buying clothes one by one and I got her a special hire driver to be taking her to hospital for checkups because I would be at work and she couldn’t drive. We then looked for a gynecologist we could trust and who would accept us to call him at any time of the night,” Amanya says.

Once this was settled, they now concentrated on ensuring that she observes the doctor’s advice which included eating a balanced diet to boost her immunity. The months that followed were coupled with failure to sleep as lying on the bed had become difficult. “I used not to sleep all those months. I would get support from pillows to stay upright all night because lying on the bed had become a challenge,” she recounts. Days became months for Rafikiyangu and in October last year, the three baby boys were ushered into the world.

That night, she had felt funny yet her husband was supposed to travel to Mbarara that morning. But he had to be sure before he set off. So they called their doctor who asked them to come to hospital immediately. By 5am, they were seeing the doctor who after thorough checkup informed them that the amniotic fluids had reduced. She was only eight months pregnant.

Rafikiyangu was then put in theatre and the babies removed at eight months. Two of them weighed two kilogrammes each while the other had 1.9kgs. “`They were put on oxygen for three days and monitored in a special room,” she narrates with a sigh of relief, her husband chipping in, “they picked faster than expected and in a week, we were discharged”.

To their shock, the bills had accumulated to Shs4m from Shs2m they had initially planned for. But much more was to change. “Some of the things that were expensive were the medical bills. Our shopping has tripled, mosquito nets, clothes, cups, pampers… so if you don’t have the money what do you do? I can imagine why some of these men run away,” Amanya reminiscences.

His face lighting up, he pointed at the bedroom door. And there, there was Heri. He was the first to wake up from the afternoon nap and had crawled to the sitting room. Amanya then moved to pick him. On his way, he shares how he had jokingly asked his boss to give him four days of paternity leave for each baby when they were born but was told it was one birth.

“These boys make my day. You consider the challenges and they are replaced by seeing three young souls growing up together and you look forward to meeting them every evening and pray that God gives you many years to watch them grow,” he says.
By this time, Rafikiyangu had gone to prepare for them some porridge. “Once you see one, know that the other are on their way coming,” she shares heading to the kitchen.

While in hospital, they didn’t tell many of their relatives but immediately they were home, word spread. It was greeted with jubilation with many eager to see the boys. However, the doctor had discouraged the couple against exposing the babies to the public to avoid infections and for four months, few visitors had seen them.

Being the only boy among four girls, their mother was excited at the news. “My mother produced girls. It is like I gave her boys whom she never produced and wanted. The three have since changed the world around us. They have made my relationship with my wife stronger. Before I spend any coin, I first ask myself if they have what to eat and wear,” Amanya says.

He explains that although he doesn’t know any close relative with twins, his wife’s family has several. No wonder, Dr Peter Ssebadduka, a gynaecologist at Mulago Hospital says it is a familial gesture for some women who give birth to triplets.

The science behind multiple deliveries

Dr Peter Ssebadduka is an obstetrician and gynaecologist at Mulago National Referral Hospital. He explains some facts about multiple deliveries such as triplets. He defines triplets as a woman able to carry three fetuses in her womb at the same time. There are those who have it naturally and this runs through their family.

There are those who use drugs while others have eggs fertilized in the test tube and then these are put back in the woman’s womb. Such pregnancies are considered high risk. So the expectant mother has to be put on good diet, must attend antenatal, follow doctor’s instructions, rest enough and reduce exercises.

In most cases, the cervix of a woman pregnant with triplets is stitched in the early stages to avoid a miscarriage. This is because the cervix can become weak due to the weight and pressure forcing it to open before the nine months.

They also deliver by Caesarian section because of the complications involved. For instance, sometimes they can be sharing the same sack and the heads might be facing in different positions instead of facing down.

During delivery, we don’t charge per baby. The surgical fee is fixed irrespective of the number of babies. However, they are likely to have complications so they put under special care and each child is charged separately. That is why the medical bills go high. In a year, we can have two sets of triplets at Mulago hospital.

Amanya on family expenditure

“I breast fed them twice a day for five months but they were being supplemented with formula milk. With time, they preferred formula milk to breasts which was to my advantage because I would get dizzy every time.

It was hard to differentiate them for the first three months. While in hospital, they had labeled them. So I kept these labels on them until I could tell who was who. If it wasn’t because of that, it was going to be difficult. Kwanza is reserved and smiles a lot, Heri is very active while Ayanda is in between. They never cried so much which was a relief. At first, they would wake up at the same time to take milk. This later changed to intervals. We are lucky they have not fallen sick save for the flu and cough which is usually brought by other people.

I wake up as early as 5am to prepare breakfast for the family so that by the time the boys wake up, I have finished most of the house chores. By 7am, they start waking up one by one and before you know it, it is a lot of work. Sometimes we get our lunch at 5pm because feeding them itself is hours. If there are two people at home, I can’t leave home because one maid cant manage them. ”

Fiki on her husband;
“My husband has been very supportive. I remember when I was pregnant; he would help me to turn on the bed and he has provided what we have needed at home. But you can’t keep asking for everything. I now want to work to support my husband financially because the expenditure is too much.”