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.

Life's Not Fair with HIV

* Names and details were changed...but the story is true

When I first saw Khalia, she was sitting with her mom on the hard wooden benches outside.  Her mother made me promise to take care of her girl.  There were tears in her eyes as she pleaded with me.  Mom's aren't allowed past the heavy, paint chipped door of the labor and delivery ward.  I told her I would be her daughter's "watch mama." 

The nurses took Khalia back to take a cold bucket bath in the filthy shower stall.  Her mother then pulled a very used Coca Cola bottle full of water out of her colorful string bag.  She whispered to me that I needed to take this to her daughter to drink.  It was from Khalia's village where she had grown up.  All the women had "outed" their "heavies" (issues, grudges ect.) and blessed the water.  Now if the laboring mother drinks it, it shows that they are all at peace.  They believed it would make the labor go quickly and easily.  The wrinkled little mother was thrilled that I understood and was familiar with the beliefs from my years in the bush.  I gave it to Khalia, explained what her mom had said, and Khalia drank it up quickly.

Khalia is 17 years old.  Last year her husband bought her for about $3000.  She then went to live in his village as his fourth wife.  She spends her days tending the large gardens and cooking food.  Probably caring for the kids of the older wives too.  Her new husband  gave her HIV on her wedding night.  She is now HIV positive and has TB and herpes to go with it.

Now, here she was delivering her first baby.  The medical staff was standoffish about her medical conditions. (The herpes had done some awful looking things to her) They warned me not to be around her.  I did consider just helping the other 8 ladies in labor but I felt that God would have me to love on Khalia.  It was the right thing to do.  It is what Jesus would do.  I spent the next 8 hours with her. (and I did take precautions with fluids)   She is a sweet and beautiful girl who labored very well.  

She begged me not to leave, even for a minute.  I held her, massaged her, prayed with her, and encouraged her. 

Once she was ready to push, she pushed for almost 4 hours.  They never checked the babies heart tones. 

She got so exhausted.  Her babies head had been slightly in view for two hours.  No amount of squatting or position change was helping.  I finally was able to convince someone to come help us.  I was shocked at how she "helped."   She grabbed a razor blade and cut Khalia four times. Four large episiotomies on her herpes enveloped skin.  A beautiful baby girl emerged over the HIV infected blood. 

Khalia had more love in her eyes as she looked at her new daughter than most of the mom's I see here.  The baby latched on a nursed just fine.  It was hard to say goodbye to her.  I am privileged to have been able to be with her on that day. 
                                                                             

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.

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.

Vaccuming a Baby Head

So, apart from accidently cussing and fainting yesterday...I also got to see my first vacuum extraction birth.  It was brutal, but mom and baby are alive and happy, so it seems to me it was worth it in the end.

These days, I tend to judge a birth by whether or not everyone lived.  I would love to see each mother satisfied with her experience...it just doesn't take much for these women...if they are alive in the end, they are happy.

I could hear Mavis (not her real name) yelling long before I got to the labor and delivery room.  This was her first baby and she was NOT afraid to make noise.  When the midwives told her to quiet down, ( they actually were pretty kind and concerned for her) she just looked at them and screamed louder.  She alternated biting the mattress, rolling around on the floor and throwing things.  ( So much for the "women in other countries just squat, push out a baby, and keep on working in the field" theory.) 

When I arrived she had been in active labor for 24 hours.  She had been at 9 centimeters for 3 hours.  Her baby was slightly transverse. (Basically it was laying diagonally with the side of  head and ear trying to head down the birth canal.  It is a good thing that she was one of the 30% of women in this country who had a skilled birth attendant for her birth.

I walked in to be with her and she clung to me and begged me not to leave.  She was sick of being alone and in pain.  It was one of the roughest births I have helped with so far (except for the ones where there was a death).  We worked with gravity trying to jiggle the baby down into the right position.  I had her try polar bear position alternated with standing and dancing the baby down.  Interestingly, it seemed that she naturally wanted to do those things anyway.

She was complete by 8:30 am and then started pushing.  She pushed for six hours.  At this point she was going on 48 hours of active labor and was refusing food and drink of any kind.  She was constantly falling asleep standing up, and I was trying to keep her from falling over.  She was about 100 pounds more than I was and it wasn't an easy task.  I used every "trick" I could think of.

After 3 hours, I begged the midwives to come check for fetal heart tones, something they hadn't done at all since I had arrived.  It took them awhile to hear anything, and when they did, the baby was in distress. Her head had moved into a better position to come down though.  After two more hours of pushing they brought in a broken vacuum extractor (it would only go up to half of the suction it was supposed to have) and gave her a huge episiotomy and finally dragged out a beautiful baby girl.

It was not a pleasant birth, but when I left, mom and baby were alive, healthy and happy.  Oh, and Mavis named the little girl after me.   I was so proud of her making it through....

Breech in the Jungle with a Cigarette

Underage Smokers

She squatted, she smoked, she grimaced as the contractions came and went. She wore only a ragged loincloth. Under her was dirt and above her were the stars. 

This is where she was going to have her baby,  The neighbor kids giggled as they lit their jungle "cigarettes."  They weren't allowed to have the tabacco until they were at least 12, so until then, they wrapped random jungle plants in dried banana leaves and smoked them. 

I was with my friend Kira on the night her 4th child was to be born.  I had awakened to a rapping on the bamboo walls of my house by her husband telling me it was time. 

We headed out to a little spot her husband had cleared in the jungle.  He lit a fire, stuck a stick (to hold while pushing in the squat position) in the ground, and they laid down some banana leaves.  Now the baby could come.

The wind was strong that night and we were all cold.  In this tribe, there are no birth specialists.  A woman in labor is attended by whoever happens to be around.  Tonight it was me and her mother in law and a bunch of kids.  I had brought a clean razor blade, a baby hat, and clean baby blankets.  I was hoping for a good outcome, as it seemed that a lot of births here ended in tragedy.

Kira grunted and repositioned herself, then lifted her homemade cigarette to her lips again.  She smoked almost constantly throughout her labor.  The contractions kept getting stronger and then they pretty much stopped.

She was tired and we all decided to go back to the village and let her rest until the contractions started again.  When they started again they came fast and hard and out popped a big boy.  Bottom first. 

She rested and lit another banana leaf/tabacco cigarette.

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

Lost in the Jungle

Have you ever wondered what you would do if you were really lost in the wilderness?

One night, about two years ago, I discovered what I would do….

"Hka hka hka" I could hear the familiar cough in place of a knock outside my door. I went outside to investigate.

There was a middle aged woman with one blind eye, two teenage girls, and two young men at my door. I hadn't seen any of them before. They had come to get my friend and I.  A woman with twelve previous children had given birth to twin girls the night before. Both babies were fine, but the woman was bleeding a lot, had a retained placenta, and they feared for her life. They wanted us to come and help.

It was a four hour hike to where she was in her banana leaf garden shelter. I got what I might need and we all started out. It was 4pm and our husbands weren't going to expect us back until the following day.

It is a treacherous hike. It seemed to be either straight up or straight down most of the time. Now it is the custom here, to yodel messages back and forth between the mountains.  About 2 hours into our hike we heard yodeling from the mountains across from us. The woman had died.

We told them to go on ahead, as it was their mother and sister who had died. I had a nine month old baby and wanted to get back.

Our guides would have led us back…but we figured we could find our way back through the jungle. (Don’t ask me why two California girls thought that) So after about a half hour on our own, we could not find the trail. We went up…all we could find was thick bush.  We went down and it was the same. So here’s what we did.

1. Sit down

2. Pray

3. Yell/scream really really loud.

4. Shine our flashlights to the mountain villages across the valley.

What did we yell? Well, we perfected our yodel (The way they yell from village to village). We yelled “the white ladies are stuck in the bush!” in 5 different languages. (Spanish and French were just to mix it up for our sakes) We figured as long as we were making noise, it could attract help.

We yelled once or twice that we didn’t have any toilet paper so someone really needed to help us.

Eventually (a couple of hours later) two young men from the next mountain range over (yes we had been that obnoxious) came to get us and lead us home.

So we were home before 1am and slept safely in our own beds.

If this woman had a skilled birth attendant with her, she would still be alive today. One of the twins died a week later.

 

Almost a Walmart Baby

The day I became a mother, I was 20 years old, and living in California.

I had Braxton Hicks contractions constantly and therefore had a hard time knowing what was "real labor." I got sent home from the hospital twice.

 Afraid of getting sent home again, I came very close to having my baby in Wal Mart.

Luckily, after heading to the bathroom twice in Walmart...I realized that maybe this was the real thing.
So we drove 7 minutes to the hospital.  When I finally made it up to the labor and delivery floor, I was fully dilated and ready to push.  (I know it's not fair to all of you who had 60 hour labors)

He was born at 12:01 am on his due date with his water bag in tact.  He decided to break my tailbone on the way out.  For those of you who find it unfair that I basically skipped labor, it may be some consolation that I could not sit down for many months after that.

It's amazing to me,  how almost eleven years later, I remember every little thing about this birth.

I have had four very different birth experiences myself and I am so thankful for four healthy boys!

At the same time I'm burdened by the fact that for so many women I know and love, the day that they give birth is one of the scariest and worst days of their lives. 

How can you and I help?  I'm thinking about that a lot right now and will write about it sometime soon.

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.

 

 

They Are More that Just Statistics

This is a true story from when I lived a two day hike from any roads or maternity care. Warning: this is graphic; it may not be suitable for everyone to read.

Limaka and I sat together on the dirt, our machetes by our sides.  I twirled a piece of grass in my fingers and watched as my sons climbed trees and cut trails in the jungle.  We had been clearing the weeds around my house to keep the snakes away. 

 “My husband is dead and I had nine kids, but only one is still alive, I want you to meet her.  I’m so excited, she is pregnant and I am going to be a grandma!”   Limaka was bursting with pride as she spoke of her only living daughter, who had recently married and moved to a village 2 hours away.

I told her I would love to meet Lisi, her daughter.  But I never got the chance.

A few days later I heard that Lisi died.

This is what I gathered as to what had happened:

~ She went into pre-term labor (it seemed she was around 30 weeks)

~ The baby was a footling breech who slipped part way out.  It was stuck that way due to the cervix which was not completely dilated.

~ She tried to push for days, and she bled.  They offered to cut the baby.  She refused to let them hurt her half born child.

~They left Lisi and her baby under the house to die.  And they did.

I attended the funeral.  I sat in the smoky hut for hours with her dead body, and joined in the death wail. 

I found out the next day that I was pregnant with my fourth child.  I went to the USA where I had a doula, a midwife, a hospital that stopped my pre term labor, newborn photography, and a baby shower.

Here are some links to World Health Organization on infant and maternal mortality.

http://www.who.int/mediacentre/factsheets/fs333/en/ - infant

http://www.who.int/mediacentre/factsheets/fs348/en/index.html -maternal

 

"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!"

Shut up and have a baby

Three months ago:

I stared at the floor.  It was nasty dirty.  My islander friends beside me all chit chatted about their labor stories from years ago in the local dialect.  We were waiting to check 18 year old Astria into this third world hospital.

 She was in early labor and her mom and aunties thought it would be best if she delivered this first baby here instead of at home in the bamboo hut that they shared.  Afterall, they all had family members who had died in childbirth.

Astria sat up straight on the wooden bench and moaned as the pains returned every few minutes.  Behind the curtain, we heard screams as babies entered this world head first, bum first and feet first.  Then we heard the midwives, exhausted, responding with "shut up and have a baby" (in another language of course.)

The nurse came and got Astria and we had to leave.  She was terrified, left alone in a strange and unkind environment. Hospital rules forbid anyone to stay with her while she has her baby. She looked at her mom longingly and then disappeared behind the curtain.

 I believe a woman needs support in labor.  I wanted to make a difference...