Classy Doulas and Lifeless Babies

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

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

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

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

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

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

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

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

Tribal Midwives and Jungle Waterbirths

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

Answer: A very fun Saturday.

I learned a lot, for example....

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

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

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

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

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

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

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

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

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

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!