title: Triplets with conjoined twins. A Nigerian midwife's case report.
abstract: This article is a case report of a spontaneous vaginal delivery of live triplets, which included conjoined twins joined at the buttocks. The birth was conducted by an experienced midwife in a rural maternity in the Anambra State of Nigeria. The case illustrates the difficulties faced by rural Nigerian midwives when patients need referral to larger hospitals. There is a scarcity of diagnostic equipment, medical back-up, and the transportation that could facilitate an effective referral network. In addition, patients are reluctant to leave their home villages to give birth in a far-away hospital. For these reasons, many difficult births take place in rural maternity centers. The successful outcome of this high-risk delivery demonstrates the skill of the local Nigerian midwife, who is frequently faced with unusual complications of childbirth, ones that she must resolve herself.
authors.affiliation: Department of Nursing Sciences, University of Nigeria, Enugu Campus, Anambra State.
authors.forename: R O
authors.initials: RO
authors.lastname: Iroku
authors.forename: M
authors.initials: M
authors.lastname: Anah
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration; D009549:Nigeria; D009721:Nurse Midwives; D011247:Pregnancy; D012017:Referral and Consultation; D012424:Rural Population; D014310:Triplets; D014428:Twins, Conjoined