Quit Throwing Your Placenta Around

Mangua was laying on the dirty floor, writhing, screaming and crying.  I guessed she was 8 or 9 centimeters dilated by the little grunt at the peak of each contraction.  (although I always keep in the back of my mind that some labors just don't follow the rules and can look like that at 5 cm.)  Her lips were dry and I offered her water.  I wiped her sweat beaded face with a cool cloth and started fanning her.  It is very hot and humid here and there are no fans or AC in the maternity ward. 

Her contractions were one on top of the other as I held her hand and rubbed her back.  She calmed down considerably.

Meanwhile I looked up at the wall and had to smile at the sign I read.  Translated, it said, "To all mamas: please take your placentas home with you and bury them.  We are tired of finding them tossed in the road and under the bushes.  Thank you!"

Then I witnessed what I think of as "the last hurrah."   I've seen it over and over again in births that have not been altered with medications.  It is when there is a 3-4 minute unbearable contraction and then peace.  It seems to be the last bit of dilation and then the mama experiences what midwives call the "rest and be thankful stage."  There is such a change in demeanor at the end of that last long contraction.  The contractions sometimes do continue, but they are different.  Has anyone else seen this?

After about 20 more minutes she said, "the baby is coming!" and I supported her as we wobbled down the hall to the delivery room.

Meanwhile Leali, I had been supporting, but who was coping much more quietly, passed us in the hall with her hand between her legs.  She too was on her way to the "haus bilong karim" (the room where they are supposed to push out their babies).

Mangua and Leali both got up on delivery tables with about 12 inches between them and Mangua's water broke.  It was very stained by meconium.  A very thin, and very pale baby emerged as I fanned and encouraged her.  A boy.

Leili delivered a healthy and very vocal little girl.  It soon became apparent that Mangua's baby was not okay and needed help with breathing.  About this time, Leali began to hemorrhage.  She was weak and unable to hold her baby on the narrow table.  So my job at that point was to hold and comfort the tiny and very opinionated little newborn.  I sang to her and walked the halls while I prayed for the other baby that it would breath.  And for her mama that she would stop bleeding.

My prayers were answered.  When I left both mom's and both babies were doing great.  There was another lady yesterday too, but I'll leave her story for another day. 

 

Classy Doulas and Lifeless Babies

Today I stepped in a pile of poop and then tracked it all the way around the hospital bed before I realized it.  It was really very classy.

With in minutes of arriving, my doula friend and I each stopped to talk to a couple of laboring women.  With in a few more minutes, there were 2 baby heads emerging. (from 2 different women, not the same one - in case you were worried.)  The race was on! Two first time moms yelling, "It's coming!"  The foot of their beds had only about 10 feet between them. 

Anya's baby was coming, but slowly.  She was pushing well and just wanted a hand to hold and someone to give her sips of water.  She had been completely alone for many hours.

Julie was HIV positive and her bag of waters was still intact.  Her baby was coming very quickly! Before I knew it, the baby's head, inside the water bag was completely out.  It was soon followed by the rest of the baby girl.  She splashed into this world as she slipped onto the bed and her water cushion broke simultaneously.  What a blessing that she was protected from the vaginal fluids on her way out.  I didn't get to hear if she was born HIV positive or not.

Meanwhile, Anya kept pushing.  She gently delivered a baby girl about 10 minutes later.  No tears, even thought the baby was delivered with a fist by her cheek. It was a very peaceful birth. 

The entire rest of the day was spent with Mikal.  She was also there to meet her first child.  She dilated quickly, but once she hit 10 centimeters, she grinned at us and basically fell asleep for three hours.  For awhile we encouraged her into a position that would move the second stage of labor along, but she was just not into it, so we let her sleep.  Eventually she awoke, crawled down off the bed, and squatted noisily.  The grunts became screams and I guessed that she was crowning.  Sure enough a peek proved my suspicions were true.  Within the next few minutes, a tiny,. white, lifeless little baby boy emerged.

After about 20 minutes of prayer, oxygen, and CPR, he was breathing, struggling...but breathing.  At that point we all breathed a sigh of relief.  I'm glad he wasn't one of the majority of babies in the county who are born out in the jungle and left for dead if they do not breathe immediately on their own.  The midwives did a great job on that one.

In the end, everybody was doing great...and we headed home after another awesome day of loving the women God loves.

Tribal Midwives and Jungle Waterbirths

Question: What do you get when you stick 13 laboring women, 6 tribal birth attendants receiving medical training, some hospital staff and a couple of American doulas all in the L&D room all day?

Answer: A very fun Saturday.

I learned a lot, for example....

1.  Don't try and play around with recently donated hospital beds that no one knows how to use.  (It ended up stuck in the  head down position.) Oops.

2. Leave your pants on if you think your baby might just fall out while you stand around visiting.  That way the baby is stuck in your pants instead of falling on the floor.  (This had happened to a lady the night before)

3.  One of the tribal birth attendants had a water birth.  She just got in a dammed up part of the river and sat there since the pain was better that way.  Eventually she delivered her own baby in the water.

4.  The TBAs were from many different tribes and it was so fun to hear about each of their birthing traditions.  A couple of them tied ropes around trees and let the woman hold on in a dangle/squat position while pushing.  Others mostly just squatted. 

5.  They have a lot of beliefs about unity and the baby not wanting to come until everyone is at peace. So when a woman is having a prolonged labor or birth, they bring in the father or other family to talk to the baby and tell it that it can come.

6.  The Tribal Birth Attendants had a very good understanding of birth on an emotional level...and were full of a lot of wisdom that way.

7.  Once again, I saw the squat position save the day when a woman was pushing for a long long time with out much progress.

8.  These tribal midwives open up their homes to laboring woman and help so many.  They are exposed to many diseases and are never paid.  They do it because they feel it is right to help their sisters.  It was a challenge to me to hear them talk about it.

It was a calm and beautiful day there with many babies being born gently and being cared for well.  It was different to have so many people there caring for the moms. 

Going Overseas? Read This First!

This blog gets a lot of traffic from midwives and doulas who hope to go get some practical experience overseas.  This can be a good thing...but not always.

Lets learn some things by examining the mistakes of a couple of North American nurses that came here to help in the labor and delivery ward last week.

They walked in eager for an experience, and a great story to tell.  They did not speak the language and are only here for a week. They boasted that they were so excited to be here because they were allowed to do stuff that would be unlawful for them to do in their own country.

They had never worked with laboring mothers, ever, and wanted to waltz in and deliver a "cute little brown baby."  One proceeded ..no kidding... to SLAP and SCREAM at a pushing woman I had been gently coaching for 6 hours already.  Not only was this white lady being rude and demeaning, she was screaming in English....which was not comprehended by anyone but me. This laboring mother who had been doing awesome, was terrified and scared and shut down...her contractions came to a complete stop.  This volunteer then yelled at her for "giving up."  

Next, this educated white nurse went on to try to sneak in a baby delivery by not alerting the midwife that the baby was crowning, but just getting ready to do it herself.  When I realized after a minute that this nurse had NO IDEA what she was doing, (I was having to tell her what to do...) I alerted the midwife myself, who came and delivered the baby.  This adventure seeker was willing to put a mother and baby's lives in danger simply to be able to say she had delivered a baby.  At least that is how I see it.

This nurse then kept correcting and pushing the very experienced national midwife out of the way, because "she wasn't doing it right."  These midwives are so experienced, (about 1000 births a year for 20 years or more) and could put most western midwives to shame, let alone an ER nurse who had never even seen a birth other than of her own.

You know what?  This woman probably is very proud of herself for "helping" these "poor people."  She probably feels like she is making a difference!  And she is.  Just not a good difference.

Here are some the problems I saw in these nurses:

1. Arrogance
2. A focus on the "experience" for themselves instead of serving the people
3. A failure to see these woman as intelligent and amazing people who are worthy of respect.
4. An excitement to do things "they aren't allowed to do" elsewhere.
5. A lack of respect for the culture and experiences of people different than themselves.

Instead, if you are going to volunteer in a country that is not your own:

1. Go in humility, with the heart of a learner and a willingness to lay down "your ways."
2. Do not go to "get your numbers" or to "have an awesome story to tell." Go to serve. Go to learn.
3. See these beautiful women of another land as strong and someone you can learn from.
4. Know your limits.  Do not do what you are not trained to do.
5. Study their language and culture.  Respect who they are and how they do things.
6. Be kind and treat people the way you would want to be treated.

None of us will be perfect, but let love be the focus of what you do and I'm sure things will go a lot better.

*I've changed the continent of origin of the offending parties.

Do You See What I See?

My last doula adventure was a crazy one.  I have seen a lot since I last updated you all.

1. I have seen two new doulas (that I have had the privilege of training) spread their wings and do very well. 

2. I have seen a baby born right on the dirty hospital floor.  Both mom and baby were fine. 

3. I have seen a woman punched repeatedly  while her baby was crowning. 

4. I have seen God answer my prayers over and over again when a mom is having a very hard time or when a baby is not breathing.

5. I have seen an HIV positive mom shunned and shamed. 

6. I have seen serious hemorrhages and babies that took a long time to breathe.

7. I've seen the midwives be very kind and show great skill in order to save a mom and baby.

8. I've seen the midwives share their own things and go the extra mile to be kind to a patient.

9. I've seen a movie on maternal death in childbirth put on for the laboring women to watch.

10. I've seen the squatting position spare many women from c sections and vacuum extractions.

Baby Heads and Doula Smiles

I smiled a lot yesterday while I was with all the laboring moms.

I smiled when Rosa pushed out a baby boy with ease.

I smiled when Rosa dressed him up super cute and I could tell she was in love with her new little bundle.  She had her tubes tied a few years ago, so he was quite a surprise.

I smiled when Helley gave me a skeptical look when I told her that her baby was coming soon and she was going to be okay.  It was a look that said "you are insane, I know I am going to die."

I smiled when Helley came back from the bathroom a few minutes later and lifted her skirt to show me what was going on.  I could see quite a bit of baby head.  She was holding a baby boy just a few minutes later.  Now she had a look on her face that said she was quite pleased with herself for having delivered her first child.

I smiled when Toola and I finally worked out a system to get her calmly through her contractions without going screaming and rolling around in panic and terror.  I had never seen a woman quite so active and creative with her laboring postitions. 

I smiled when Toola's baby girl finally emerged.  It took awhile and the little one arrived with a short cord 3x around her neck. I smiled because she was okay despite that.  I was so glad the midwife had arrived on that one, her head was halfway out before the midwife came.

I smiled when Toolah made it safely through a post partum hemmorage and when her baby girl finally latched on and nursed.

I smiled when Mallinah delivered her ten and a half pound baby boy (most babies here are between 5-7lb).  She was 44 weeks pregnant.  Yes, I meant to write 44.  She measured 44 weeks, and her dates said 44 weeks.  She had been completely dilated for hours, but the head was too high and not engaged.  She walked, she lunged, she sat on the toilet.  We had no birthball, that would have been helpful.  She was so drained and still the babe was high.  Her water finally broke and eventually she felt like pushing.  After 2 more hours I finally convinced her to squat and push.  She did and within 15 minutes there was a baby head.  The midwife was there just in time to see the rest of it's body slide out.

There were five births and 7 moms and it was just really fun as well as really amazing.  I'm getting more comfortable in my role as a doula and in trusting the mom's own instincts.  I am also amazed at what a woman can birth if she squats instead of laying on her back!

Is He Dead?

I thought he was dead, but I prayed and prayed that he would be okay.

 I had been attending his mother as her labor support person for many hours.  There was no sign that there would be a problem, but when he was born, he was grey, limp, and he did not start breathing or crying on his own.  There was a cord around his neck that was not removed by the student that was delivering him.  Maybe that was the problem, I don't know.

After a couple of minutes, the student realized that this baby needed more than a little stimulation.  I had run and gotten the ambu bag thingy for them just in case.  Sure enough, they started to try and resuscitate him and after what seemed like a very long time he started to cry.  Soon he was nursing. 

I thanked God for another little one that lived.  It was the 2nd close call in one day.

In the tribe I lived with for years, they do not stimulate a baby after it is born.  They just watch and wait to see if it is alive or not.  They never pick it up or touch it unless it cries.  So many of their babies were "stillborn."  In reality though I wonder if they could have lived if they were helped along a bit to take that first breathe. 

Whatever the case, I hate that 50% of children there never have the chance to grow up.  I want to help see that change.

Walk that Baby Out!!!!!!!

I volunteer in the labor and delivery ward here mostly because the laboring women are not allowed to bring even one support person with in with them.  I love it though when a brave mother in law or grandma comes marching in anyway.  I never tell on them, so sometimes they manage to hide out for a hour or so. 

Yesterday this wrinkly, ancient and very wise looking old woman came bursting in.  Policy meant nothing to her.  She had squatted on banana leaves and borne 13 babies in her lifetime.  This is what she had to say to her granddaughter who was in labor with her first child.  "Get up! Walk, walk, walk,  faster.  GO!  Do want this pain to last all day? If you do, then lay down.  If not, then get up and go!"

Amen Grandma!  I have seen many other veteran mothers here offer the same advice.  I also noticed that the women who just walk and walk have their babies so much faster than the ones who just lay on their sides.  I personally was a walker in all of my 4 labors and recommend it to anyone!

Twins and a Prolapsed Cord

This weekend at the hospital was nuts.  There were  naked women on the dirty floor yelling, "The baby is coming!"  There were not enough beds for them all, and there were more pukers than usual.

The operating theatre was not "in service" due to the air conditioner being broken.  I am not sure why the air-con is necessary to operate, but apparently it is.  The vacuum extractor was also broken. 

So into this environment, a lady named Malley (not her real name) walked in.  Her belly was HUGE (in an adorable way) and she had not had prenatal care.  She walked around until a baby started to fall out bum first. A little girl was born breech.  Then another baby started to make his way into the room head first.  Unfortunately his umbilical cord led the way.  So now the midwives were dealing with a prolapsed cord.

The midwives flipped her over to a head down/ on her knees position and tried to push the cord back up into the mom.  They also pushed the head up and then flipped her back to her back and applied suprapubic pressure in an upward direction to hold the head up off the chord while trying to fix the vacuum extractor.  They couldn't get it to work and they called the doctor.  Meanwhile there was still a heartbeat.  I was holding Malley's hand, praying with her and comforting her.  She asked me to sing a hymn while we waited.  Singing is not my gift, but we sang anyway.

The doctor arrived and without the option of C section or the vacuum, he proceeded to just have her try to deliver the baby quickly.  Two contractions later the head was in the birth canal and the chord had stopped pulsating.  Two more contractions.  We all started to anticipate a dead baby.  I prayed and prayed.  A very grey and limp 5lb baby emerged.  After some stimulation though he pinked up and cried.  I checked on him a lot throughout the rest of the day.  He was a champion nurser and very alert little guy.  I'm so thankful that he is okay.

Emergency C-Sections...tomorrow

The midwives in the hospital here are the janitors too.  They deliver the babies, mop the floors, change the sheets, train the doctors and new midwives and admit the patients.  They are often tired.  The last few times I have been there helping out, it has been one midwife running the whole ward. 

When there is a problem, it can take sometimes 24 hours to get everyone in place for a C-section.  At times, everyone just happens to be there and it goes off without a hitch.  Often though, it takes a very long time.  I witnessed this being told to a mother the other day..."Your baby is in distress, but we won't be able to even try to induce until tomorrow morning when we have a doctor on call, in case you need a C-section as a result of the induction."

It struck me the other day that most homebirths in the USA have more access to emergency help if needed than the labor and delivery ward here.  Just an interesting thought.

Speaking of C-sections, I came upon a woman the other day who was so upset when she was told they would have to cut her to get her baby out. (She was 6 centimeters and the baby was lying in a transverse position.)  It wasn't until I explained to her that she would be asleep and not awake feeling them cut her, that she calmed down at all.

Imagine thinking they were going to just cut you open while you watched, feeling everything!

Fishing in the Toilet and Interrogations.

Yesterday I witnessed a one hour interrogation of laboring and post partum women.  The nurse wanted to know which of them had tried to flush a pad down the toilet.  It ended in a very weak mother, who had delivered only an hour earlier, being forced to fish the pad out of the toilet.
 (These women have rarely seen flush toilets or used disposable pads...so it is a hard thing to get used too)

I see things in the hospital here that are very hard to see.  Interesting though, the women are NOT complaining.  They are thankful.  At the end of an awful delivery (one that would surely bring a lawsuit in the USA) she is saying..."I'm so glad I was here!  Who knows what would have happened if I had been in my hut alone."   She isn't saying this because she has been brainwashed by the medical community.  She has seen firsthand friends and relatives who died in childbirth.

It costs them one month's wages to spend the night on the floor in the hospital filled with rats and cockroaches.  They stand barefoot in a shower (if there is water) where 30 other ladies stood and bled...in a country where HIV is rampant.

The hospital situation here can be gross and sometimes even abusive.  Oh, and did I mention that you have to bring your own toilet paper?  There is often no running water for days at a time...I would like to see it changed.  I  am glad though that less women and babies are dying here in the hospital than they are in the jungles....although last weekend 3 newborns died in the hospital in a 24 hour period....so I wonder about that too sometimes.

The funny thing is that I believe the hospital staff is really trying hard to do a good job. (Except for the Nurse Interrogator)

I personally have some horrible stories about American hospitals....but I never had a nurse make me fish things out of a community toilet.

Dangerous Doula-ing Strikes Again

(Warning, don't read this while eating)

The Facilities...

As a doula here, I get to haul water, a lot. I also get to try not to mix up the babies.  Not something you learn at a doula training.

A lot of women here hemorrage, even though they are all hooked up to pitocin as soon as the baby arrives.  Out of the last twenty births I have seen, six hemmoraged...I'm not sure how that compares to other places.

Many of the women are very weak after giving birth, and within an hour they are usually asked to get up, pack up, and bathe.  Bathing includes filling a five gallon bucket with cold water and carrying it 15 feet to the shower stall.  That is where I come in, the water bucket carrier.
Once to the shower, the woman then squats and washes.  This one shower is rarely cleaned and women file through there all day and all night.  As you can imagine, it is GROSS.  (Think blood clots)

There is also only one toilet, which is rarely cleaned.  But I will spare you the description on that one.

Did I Give Her the Right One?

During one post partum hemorrage, the midwife was getting pretty worried and asked me to grab the woman's baby so that she could nurse it and cause the uterus to contract.  I walked to the little table where three babies were wrapped like little burritos side by side.  Hmmm....no identification....how was I supposed to know which baby was hers?  I ran back to the midwife and explained my dilemma.  She replied, "the big one is hers."  So, this being an emergency situation...I grabbed the biggest looking burrito baby there and brought it back to the woman.

She stopped bleeding and fell in love with her baby....at least I hope it was hers...she seemed to think it was.

A Breech Nightmare

This story is one I've hesitated to write about. 

It has been a couple of weeks and the images are still haunting me...beware.  If you are pregnant, please don't read this.

My heart in sharing this is to open your eyes to state maternal care around the world.

I walked into the labor and delivery ward one morning to find a teenage mom surrounded by midwives and nurses.  Something was dangling between her legs.  I attended to some ladies who were asking for tea.

After a few minutes a midwife stopped yelling at the girl and explained to me: "Her baby was breech, and she was not fully dilated when she pushed the baby out. We kept telling her not to push, but she did anyway and the baby got stuck at the head.  Now the baby is dead and it is all her fault.  It's dead and stuck there."

That is when my brain made sense of the baby's grey body that hung there.  I asked if  I could talk to the girl.  They said sure.

I held her hand. I prayed with her. She asked me if it was a boy or a girl.  I had to lift the dead baby's leg to check. No one had told her that it was a baby girl.  At this point the medical staff were mad at her and just leaving her alone with her baby half born.  She asked me to get the baby out.  I explained that I could not do that.

Finally they hooked her up to pitocin and started yanking on the baby...and yanking and yanking and yelling at the poor girl.  All the while I stroked her head, trying to be the presence of kindness in a horrific situation.

After about ten minutes of this, another midwife walked over and showed them how to hook the babies mouth with her finger and tilt the chin down while putting the other hand on the mom's belly.  The dead baby popped right out.

This poor girl was terribly damaged "down there."  While they stitched her up they gave her a lecture. It went something like..."This happened to you because you got pregnant out of wedlock, you deserve it and this is all your fault."

I came behind and tried to undo the damage.  It was just awful.  She wrapped up her dead baby, got dressed, and hobbled home a few hours later.

This has not been the "norm" here, sometimes I see a lot of kindness and skill.  But this was downright awful and disturbing  I wish that all women could be treated kindly and that all births ended happily.  But, they don't. 

Four Fun Births

It seems like death and life are so closely intertwined here.  Three times yesterday, I saw babies enter the world to the eerie tune of the "death wail" just outside the window where these women were giving birth..  As people left this earth in one room, new ones entered in the labor and delivery ward.

I spent all day at the local hospital as a volunteer doula.  I walked in on the birth of twin baby girls.  They were about 6lbs each and born vaginally.  It was awesome.  After the babies, the mom hemorrhaged and was quite weak afterwards.   I got to be her extra hands for the first couple of hours, cleaning little meconium bottoms and holding the babies while mom washed up.

Another little baby was named after me. I spent a lot of time with this mom, from the time she was 2 centimetres until after her baby was born.  At one point, she had not made much progress for a few hours and the baby was very high up and posterior.  We worked on movements and positions she could do to help with this and it was so exciting seeing that within a few hours her baby had turned over and was engaged.  Little Kimberly was born up to her chest before I could get anyone to come help.

Then there was the girl who walked in just a half hour before I left.  She came in with a friend, who promptly got kicked out (hospital rules).  After a few minutes everyone suspected that this first time mom just might be pretty close to delivering.  Sure enough, ten minutes after she arrived she was completely dilated and ready to push.  I got to hold her hand and talk her through what was happening and then watch her as she giggled in delight over her precious new baby boy on her chest.  

It is such an blessing to be able to be with these bright smiling, beautiful, and strong ladies as they become mothers.  I love being able to be kindness and love to them.  It is just plain old fun.

A Little Girl in Labor

She was twelve years old.  She had been in labor for two days and was HIV positive.  As I held her and rubbed her back through the contractons, it was hard for me to wrap my mind around the fact that this girl was only two years older than my son.

A smaller clinic 3 hours away had sent her to this larger hospital because they felt her labor was taking too long.  None of her family came with her.  She was so scared, and very much alone.  She kept calling out for her mom.

I encouraged her to walk if she could, and she did. She walked and walked and walked.  Eventually she had a baby boy.  When he started to nurse for the first time, the look on her face made me want to cry.  Her expression was that of  joy and amazement and love for this new little miracle that had been inside her only moments ago. 

I don't know her whole story, and I don't know what life will look like for her as she heads home. I doubt it is pretty.  All I can do is pray for her.



Left: you can see a woman walking away with a bag of firewood.  Right: the next generation of little women

What do I take to the hospital?

What do I bring when I go to the hospital here as a doula?

1. Pads to share with ladies who did not bring any.

2. Soap so that I can wash my hands.

3. Toilet paper because well, it's nice to have in the bathroom.

4. Last time I brought and donated 15 cups, because all the women in labor were sharing one cup for water and there was no dish washing going on.  I have lived in the jungle long enough that it didn't bother me too much at first...but then I thought about TB.

I have my kids make me a paper fan and I bring wash cloths to cool foreheads.

That is about it.  The contents of my "doula bag."

Kindness and an Answered Prayer

It was a Saturday, and I was at the hospital helping the women who were in labor.  They said I was the “watch mama” to all of them, since their own mothers are not allowed there. 

I was running back and forth between two ladies when I noticed Hati.  The midwives were yelling at her. “You aren’t trying hard enough! What is wrong with you! Your baby is going to die if you don’t listen to us!”  She looked so tired, barely even conscious.   

I asked what was going on with her. They told me that she had labored at her house and had been trying to push out her baby for close to two days.  Her family was concerned that the baby had not been born, and brought her to the hospital.  When she arrived, she was fully dilated and they hooked her up to Pitocin.

She had been there 2 hours and nothing had happened.  She was too tired, and she seemed to have given up.

I asked if I could talk to her.  They said yes.  I held her hand and spoke kindly to her.  I told her that she was a good mother, and that I knew she loved her baby.  I talked to her about how to push, and I asked if I could pray with her.  She opened her eyes briefly and nodded. 

I began to pray that God would give new strength to Hati so that she could push this baby out and that it would be born safely.  About ten seconds after I started to pray, she sat up and started pushing with all of her might….and the tiniest bit of the head appeared!

I called out to the midwife.  Within ten minutes, a healthy baby girl was born.  It was an answer to prayer.

 

 

Dangerous Doula-ing

I have only been to 6 births as a doula in the United States.  So I wasn't exactly a seasoned veteran when I started volunteering here.

Although labor is the same everywhere, what is accepted culturally is quite different.  I have safety concerns in this country, so carrying a big "doula bag" full of goodies for supporting women is not an option here.  I carry as little as possible so as to not look like a easy and worthwhile target.

A few of the only "dangers" I have really faced while doula-ing (not quite sure how to write or say that) over here are these:

1. Danger of having too many babies named after me...Kimberly (my name) has been bestowed on far too many baby girls whose mothers I have helped.  Ten years from now, people will be wondering why that has become such a popular name.  I have considered using my middle name sometimes...

2. Slipping in amniotic fluid...yes, I have done the, "just about slip while waving my arms wildly and trying not to fall over" thing, in the blood and gunk all over the floor.  I credit my years on the slick jungle trails to having not actually fallen on my behind yet.

3. At the very first birth I watched at the hospital here, I was holding the mom's hand and talking her through contractions when the midwife says, "Put on some gloves, you can deliver this one!"  I told her very politely that "no, I am not trained to do that." (someday hopefully!)

 

 

Everybody loves a piggyback ride

"Am I doing it wrong?"- a birth story

She is in her third year of university...quite an accomplishment for a girl in these parts.  Today though, she is having baby.

Koris was dropped off at the hospital at 7am.  I arrived a half hour later to help support the women in labor.  The ward was crowded .  There were 12 postpartum moms and newborns piled into the back hall, they laid on the floor and nursed their precious bundles.  They reminded me of teenagers at a slumber party.

She was assigned to bed #2, but she was more interested in climbing the walls and pacing like ping pong ball.  She  made alot of noise and the midwives asked me to care for her. 

I held her, talked her through what was happening to her body, gave her food and drinks, prayed with her, and helped her with whatever she needed.  Pain medication is not an option here, although the artificial rupture of membranes and pitocin to speed labor are common.

Concerned, Koris asked me, "Am I doing it wrong? Is all this walking the wrong thing to do?"  I told her she was doing awesome, that when I was in labor with my 4 boys, I walked for hours.  I told her she was going to get this pain over with, and get this baby out, at the rate she was going.  Mostly I just kept encouraging her that she was doing great.

After 5 more hours, a lot of back rubbing, counter pressure and squatting...she was ready to push.  She didn't want me to leave her side. 

A beautiful baby girl was born.  I got to see 7 other babies born that day. Each one a miracle.

Cross the river and get on the bus...we're gonna have a baby today!

If you were a mom in labor here in my neighborhood on this island nation here's how your baby's birthday might play out:

1. Get your clothes, baby blankets, chord clamps, and food together. 

2. Get on an innertube and cross a river that is 60 ft. from side to side

3. Walk a half mile and then stand on the road to wait for public transportation

4. Pile onto the back of a flatbed truck with 40 other people.

5. After traveling 20 minutes you will arrive at the hospital. Now walk past 6 security guards with clubs and up to the maternity ward.

6. Here you sit on a bench for a couple hours (unless you are really making enough of a ruckus that the nurses fear imminant birth)

7. You pay the equivalent of $15 USD and are escorted into the delivery room, alone.  Try not to slip and fall on all the "birth fluids" all over the floor.

8. You are one of 14 women and there are 7 beds.  So, you are shown where a bucket is, told to fill it up and go take a "bucket bath."

9.  Now there are 3 chairs and if those and the beds are full, you get to walk or sit on the floor.  Happy laboring!

10. If a bed opens up, there will be a cervix check. Then you will be free to walk, sit, lay and just get through labor.  You are not allowed though, to be noisy.

11. Every few hours you will be checked on.

12. "Let us know if the head starts coming out!"