I'm hoping for a phone call.
My friend Jana is due with her second baby and hopes to deliver a 15 minute drive from here at the hospital. She has been selling bananas so that she can afford to do so. (My family will be eating A LOT of bananas in the near future as I have been buying them.)
The thing is, that only the very rich here own cars. (We do not own one but we can rent one) There is public transportation....but not between 6pm and 7am. So if a woman goes into labor during the night and things progress quickly...she has no way to give birth under the supervision of a skilled birth attendant.
That is why I am expecting a call from Jana. She plans to call and have us drive her to the hospital if she goes into labor during the night.
Unfortunately for most the women in this country, transportation is not even the issue. For most, there is no access to skilled birth attendants unless they hike for a couple days to find one.
I'm excited to be a part of her birth.
Showing posts with label midwifery in developing countries. Show all posts
Showing posts with label midwifery in developing countries. Show all posts
Wednesday, 9 October 2013
Tuesday, 1 October 2013
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.
Saturday, 21 September 2013
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.
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.
Friday, 13 September 2013
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.
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.
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.
Child Mortality in the News
FACTBOX: Fighting child mortality around the world
A woman feeds her malnourished child at a paediatric ward in Banadir hospital in Somalia's capital Mogadishu August 7, 2011. REUTERS/Omar Faruk
NAIROBI (Thomson Reuters Foundation) – Eastern and southern Africa are reducing child mortality faster than any other regions in the world, the United Nations children’s fund (Unicef) said in a report on Friday, but more than 18,000 children die needlessly every day.
The report, 'Committing to Child Survival: A Promise Renewed’, highlights the extent of child mortality globally and discusses what steps need to be taken to prevent babies and young children from dying.
Below are some facts and figures from the report:
The report, 'Committing to Child Survival: A Promise Renewed’, highlights the extent of child mortality globally and discusses what steps need to be taken to prevent babies and young children from dying.
Below are some facts and figures from the report:
- 216 million children died before the age of 5 between 1990 and 2012 – more than the total population of Brazil, the fifth most populous country in the world.
- Half of all under-five deaths occur in just five countries: India (22 per cent), Nigeria (13 per cent), Pakistan, Democratic Republic of Congo (both 6 per cent) and China (4 per cent).
- In sub-Saharan Africa, one in every 10 children dies before their fifth birthday, nearly 16 times the average rate in high-income countries.
- Globally, the leading causes of deaths among children under five include pneumonia (18 per cent), pre-term birth complications (15 per cent), birth-related complications (10 per cent), diarrhoea (9 per cent) and malaria (7 per cent).
- Immunisation is among the most successful and most cost-effective health interventions, saving two to three million lives globally every year.
- The 24 hours around the time of childbirth carry the greatest risk. Each year, more than 1 million babies die on the day they are born.
- If a mother is under 18, the risk of her infant dying in its first year of life is 60 percent greater than an infant born to a mother older than 19.
- To end preventable child deaths, women must be provided with good quality maternal care and nutrition and newborns need a safe delivery. Insecticide-treated mosquito nets, vaccines, proper breastfeeding, nutritional supplements, rehydration treatment for diarrhoea, safe water and sanitation are also important.
- In Rwanda, community health workers are using SMS to track pregnancies, report on danger signs during pregnancy and to send alerts to health services to ensure women can access emergency obstetric care quickly.
Sunday, 7 July 2013
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.
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.
Saturday, 29 June 2013
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.
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.
Saturday, 15 June 2013
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....
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.
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.
Friday, 7 June 2013
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!
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!
Wednesday, 5 June 2013
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!
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!
Saturday, 1 June 2013
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.
(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.
Thursday, 30 May 2013
Breech in the Jungle with a Cigarette
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| 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.
Tuesday, 28 May 2013
She Decided to Help
I know someone who wasn't afraid to step forward and be a part of the solution. The following is a guest post from a woman named Jamie Dellesky. Look her up on her website: http://www.dellesky.com/
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| Jamie in the Philippines |
1,000. I still
remember the day that number broke my heart. Shattered it into a million tiny
pieces. That’s the average number of women & young girls who die each day
because of pregnancy & childbirth related complications. That’s the
equivalent of the number of passengers in 4 jumbo jets crashing everyday.
Experts say that 80 % of these complications can be prevented if there were
simply a trained birth attendant present.
About two years
ago, as I was reading about birth in developing countries, the above statistics
were what I found. Alarming. Heartbreaking. I had spent the past 11 years
serving women in my community as a doula & I could see first hand how
skilled + knowledgeable care helped to protect the lives of mother’s and
babies. I had no idea that my sisters in other countries, specifically
developing countries, were losing their lives giving birth because of a lack of
care.
As this began to
pierce my heart, I then began to ask God about how I could help. Surely, there
was something I could do. But what could one family do that could make a
difference? The more I researched, the more I kept finding that the world
needed roughly 300,000 new midwives. Midwives that are trained in life saving
skills, midwives that can go to where the women live to make accessibility
possible, midwives that can give safe, kind & loving care, the kind of care
that every mother and baby deserve.
A simple
equation began to work itself out in my mind. If what is needed are midwives +
I am capable of learning =then I need to train to become a midwife. After
much prayer and leading from God, that’s exactly what I did.
Last year, my
husband & our 3 boys gave up our home, our jobs, sold most of our
possessions & packed up the rest and moved to the Philippines to train with
a non-profit organization that runs free birth clinics for women in poverty. I
spent the year learning how to care for high-risk women & provide life
saving skills for those who needed it. We worked hard to learn more about
the problems of resource poor countries & the issues that affect women and children.
We witnessed not only the problems that create this global health crisis, but
also the solutions. So many women that we served in the birth clinic could have
very easily died during or after their births had they not had the life saving
care we were able to give. Excellent care that is free & accessible
as well as loving and kind, this is what we see to be working. This
past year of training built a foundation for us that will help us to go into
other areas of need in the world.
For us now, that
place is Africa. Of the 20 worst countries to be born, 19 of them are in
Africa. We are moving to Tanzania to partner with a local church in Dar es
Salaam. We will be working on developing an outreach to mothers & babies in
a very poor area of this city. This outreach will include aspects of health
care that are needed such as health education, nutritional support & baby
care. The life- time risk of a woman dying in childbirth in Tanzania is 1 in
23. Our long- term goal is to eventually start a free birth clinic in this
neighborhood.
We also hope to
start our own non-profit that can reproduce a healthy model of care within
resource poor countries. A model that offers loving care from local
midwives with life saving skills.
We have come to
realize that if a lack of midwives means high maternal/infant mortality, then
the answer is to provide more midwives. Its not hard to do, there’s enough
money & resources in the world, it’s simply a matter of redistributing it.
*This family is raising funds to go to Africa. If you feel you would like to help with that, their website is listed at the beginning of this post.
Friday, 24 May 2013
Midwife/Doula Opportunities Overseas
So I have been talking about the need for more midwives. (see post "Midwives Needed.")
There is no use talking about a problem unless we also talk about a solution. I mentioned the need for more midwives in my post "Midwives Needed." If that piqued your interest, here is a list of overseas opportunity links for doulas, midwives, or aspiring midwives.
*I have known people who have good experiences with Mercy in Action. I don't have any personal experience with the others. If anyone knows of programs which I have not included...I would be
interested in hearing about them and adding them to this list.
http://www.mercyinaction.com/midwifery-doula-internships/ - In the Philippines
http://www.bumisehatbali.org/ - in Indonesia
http://www.midwifeschool.org/application_internship.html Another Philippines
Monday, 13 May 2013
Midwives Needed!
Every minute 60 babies and 2 pregnant or birthing mothers die in the developing world. Every minute. All day. All night. Without stopping.
Between the time you ate breakfast and the time you ate your lunch...that would be 600 women dead, and 18,000 babies dead.
I have known some of these mothers and seen the bodies of their babies.
Most of the deaths that I have been writing about could be prevented if a skilled and trained birth attendant was available.
This is a link from the World Health Organization on the need for midwives:
http://www.who.int/mediacentre/news/releases/2011/midwifery_report_20110620/en/
Between the time you ate breakfast and the time you ate your lunch...that would be 600 women dead, and 18,000 babies dead.
I have known some of these mothers and seen the bodies of their babies.
Most of the deaths that I have been writing about could be prevented if a skilled and trained birth attendant was available.
This is a link from the World Health Organization on the need for midwives:
http://www.who.int/mediacentre/news/releases/2011/midwifery_report_20110620/en/
Thursday, 9 May 2013
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!"
Wednesday, 8 May 2013
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...
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...
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