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. 

 

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.

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. 
                                                                             

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.

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!

A Chicken, a Needle and a Natural Birth

When I was pregnant with my first child in the USA, I read a lot about childbirth and how to have a natural childbirth.  I wanted this mostly because I went to the epidural class at the local hospital (just in case) and the guy there passed around a GIANT needle and talked about sticking it into my back and how there were many risks with an epidural, including death.  Hmmm...do I want to go with the contractions that have never permanently damaged a person, or the giant needle that may kill me...?

I may be the only person in history who chose natural childbirth, not because I am so brave, but because I am a chicken.

So after that, I decided to skip the drugs, and I read every birth story I could. I wanted to learn all the "tricks" to getting through labor on my own. 

I have been to over 40 births here now, and helped almost 40 other women in labor besides that.  I have noticed something.  None of these women have ever seen a pregnancy book.  Not one of them has been to a childbirth education class, and only some have attended other women's births.  They have natural labors because the other choice is a C section. 

The thing is, they seem to just go with their instincts as far as positions and laboring....and it lines up with all the things we write books about and think we are so smart to know as doulas.  Funny how moving around, changing positions, and using gravity to our advantage is just what they instinctively know to do.  I guess so much of what we read and are taught is supposed to just come "naturally."

Maybe we are born with the knowledge of how to give birth well, just like the rest of the creatures in creation. 

.

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....

A Cussing, Fainting Missionary lady

My head hurts.

I just spent a very long and wonderful day at the hospital as a doula to many lovely women. 

Unfortuately, I had to learn an important lesson the hard way.  No matter how "needed" I am, I need to take little breaks and eat and drink to keep up my stamina.  After birth number five, I started feeling really lightheaded, and yes, I passed out on the floor. 

That is why my head hurts.  It was embarrassing. 

I also shocked all the staff with my dirty mouth. They call me the missionary lady and have high expectations for what words I may or may not use.  Due to a language mess up on my part I accidently swore a few times while trying to say. "I think we need to put a new sheet on the bed." I just mixed up two words that were very close. I never did explain myself either as  there was a baby coming out right about then.  Oh well.

Part of the reason that I didn't take breaks is that I had two women in a row that were terrified for me to leave them.  Both had been laboring completely alone for over 24 hours and both would cling to me and beg me to stay if I even took a step in another direction. 

There were four girls and one boy born today, and apparently there have been five girls for every boy born at this hospital for over a year now.  This would cause future problems if we were in the USA - but here, some guys have 5 wives...so I guess it will all work out.

Tips for Doulas Working Overseas

Are you a doula who is considering working overseas ?

Here are some things I have found to be very helpful:

1. Dress like they do.  When you are entering a culture that is not your own, it is helpful to at least try to fit in.  You are weird enough without wearing tight jeans where the women wear only skirts. In a birth setting, you don't want to be making people uncomfortable. 

I wear the traditional dress of the women here when I go to the hospital.  The women and midwives appreciate that and tell me so.  Of course, once a woman hits 6-7 centimeters I don't think she would care if I was wearing only a bikini...at that point is all about getting through and holding that baby!

2.  As much as possible, speak the language.  Learn whatever you can, and interview native speakers on how they say birth related things  I am fluent in the language here, and I cannot imagine having to be labor support without being able to speak!  I know it would be possible, but hard.  I need to be able to encourage, explain what is happening and just say whatever needs said. 

3.  Be willing to swallow your own culture and "birth agenda."  Your own culture regarding childbirth and what that should look like is not the only right way.  Be a learner, be there to serve.

Dad's may not want to be there...and the reason may run deeper than "just change the hospital policy." There can be taboos that come from fear of spirits and of a woman's blood.

4. Love, Love, Love, the women you are with and make her birth experience the best it can possibly be.

Breastfeeding in a Topless Tribe

I have had four babies and I breastfed all of them. 

I have nursed my babies in airplanes, canoes, kayaks, helicopters, during armed hold ups, in airports, malls, restaurants and movie theatres.  I've nursed them in coffee shops, hospitals, grocery stores, churches, 21 different states and seven different countries.  I've nursed them in huts, museums, resorts, at weddings and funerals, sitting on the beach and hiking down jungle trails. 

My favorite place to be breastfeeding though was in our tribe in the jungle.  Women are often found topless, and I didn't have to constantly wonder if I was offending someone by feeding my child.  I loved it.  Here are some interesting things I have noted in a culture that has breastfeeding down.

We always say "initiate breastfeeding as soon as possible,"  (which is good!).

They often (but not always) give the baby to a lactating sister or friend to nurse for the first 1-2 days after birth (and it turns out just fine!).

We have all sorts of rules on how to do it, and first time moms fear that they won't do it right or cannot breastfeed at all.

They don't have rules about the whole thing.  They just do it, they expect
to be able to do it

They are just really not stressed out about the whole thing....I think that is the biggest difference I see.

That's good too since it is supposed to be illegal here to buy a bottle without a doctor's prescription.

I wish I had known that kind of confidence in my body's ability to feed my child when I was just starting out!

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.

Survival

"Well, those women are just used to it, they see death all the time.  I'm sure it doesn't bother them like it would bother us."

I have heard this response so many times from Americans when I tell them that where I lived, 50% of children die before five years old.

 Just about all my friends in the bush had lost half of their children.

It is a hard thing for us to wrap our hearts and minds around.  When someone in our close community loses a child, we see it as absolutely devastating, as we should. Why then, just because a person eats differently, believes differently, and celebrates differently - do we assume that the loss of a child does not HURT?

If you held that woman as she wept, even months after the child was gone,

if you could look into her eyes,

you would know that those mothers mourn and feel the deaths of their children the same way you and I would.

They smile, they keep going...not because it doesn't hurt them as much as it hurts a middle class white lady....it is because these women have to keep going in order to survive.  Her life is hard and she does not have the luxury of shutting down.

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.

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.

 

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

 

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

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!"

They are just like us

Some dear friends of mine