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. 
                                                                             

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. 

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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.