"I felt very happy delivering the baby. The mom only had a small tear as a result," he tells the BDLife.
This is his proudest moment because in deliveries of big babies, there is always a risk of the mother bleeding excessively; and the uterus may not return to its normal shape immediately.
"You have to think very fast. I was happy because I did everything that was meant to be done and nothing went haywire," he says. Mr Koome has been a midwife for eight years now. Is he hesitant to introduce himself, 'Hey, I'm a midwife'?
"At first yes…I struggled but I came to accept it. I would be asked how I felt about working with women. I came to believe that 'females are the best people to be with, most of them have a good heart, it is how you handle them that matters," he says.
Mocked and ridiculed
Even in college, there were few men in class compared to female students.
"Back in school at Kakamega Kenya Medical Training College (KMTC), we were only four male students in a class of 50 females. We were dissed, saying we should have joined other fields like clinical nursing or lab rather than midwifery," he says.
"What kept me going was the fact that changing faculties was hard," says Mr Koome who is now pursuing a bachelor's degree in Community Health Nursing.
Crisis management is one skill he has had to learn as a midwife.
Mr Koome says a midwife has to be strong-willed and smart when making judgments; always prioritising what will be best for the mother and child, though the mother is prioritised more in dangerous crises.
Case in point, "We had a patient who came in at 6am and on admission, she was okay. The pregnancy was good, but uneventful. The estimated foetal weight of the baby was 3.9 kg. By night, the baby's heart rate was decelerating, and although the mom was fully dilated, she could not push.
We called the theatre and told them we wanted to attempt a kiwi vacuum (a delivery aid) so they needed to be ready. The baby still did not come out, and the heartbeat dropped further. We rushed in for an emergency caesarean section. The baby and mom came out okay, though he had to be resuscitated after delivery."
Does it get boring doing the same thing over and over?
"No! Labours are different. The basic things are almost similar, but as labour progresses, the differences become apparent. Also, you will find that sometimes you are delivering a baby for a first-time mom, a rainbow [a child born after a family has suffered a pregnancy loss], or a miracle baby, so you tap into their joy," he says.
Traumatic past
For Mr Koome, joining midwifery was necessitated not only by his school grades but also by the death of his first-born sibling.
"When I was a child, I wanted to be a neurosurgeon, and Ben Carson [the American retired neurosurgeon, academic, author, and politician] was my model, but I was a little bit naughty in school, so the next option was nursing. My mom told me how she lost our firstborn, and that nudged me to pursue midwifery," Mr Koome says.
While being new in a profession can be intimidating, Mr Koome says that the rule of thumb is not to panic despite the challenges.
And since experience is the best teacher, he recalls that the first time he was in a maternity ward as a first-year student, he did not know where to accurately place the foetal scopes, a funnel-shaped gadget, hence he could not feel the baby's heartbeat.
Learning moment
"The good thing is I did not panic because when you do, you make the patient panic more. Then I assured the patient that I was coming back and called my preceptor, who taught me that when a woman is almost delivering, the baby's heart rate is in the abdomen. I heard it, and we proceeded with the delivery," he says.
As professional as he is, Mr Koome reveals that there are patients who do not feel comfortable with him as their nurse. Though the decision ultimately rests on how the nurse relates to the patient from the word go, some traditions and religions that some patients hold discourage them from being treated by him.
Happy client, happy midwife
Is it a fulfilling career?
"Yes, it is very fulfilling. At the end of every successful delivery, it encourages you to move to the next patient. When you get good clients who appreciate you, you feel good,"says Mr Koome.
"I'm very happy when patients appreciate my service. Every a simple thank you means; 'This person has seen what I have done and is sincerely grateful. I resonate more with the thank-you than with gifts and tokens," he says.
