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.
Showing posts with label volunteer doula. Show all posts
Showing posts with label volunteer doula. Show all posts
Saturday, 26 April 2014
Friday, 18 April 2014
First Day...No Babies
I'm in! I finally have permission to work here in this new town as a volunteer doula.
It is in a somewhat rural health center instead of in a busy town hospital. They do serve a large area though, and most women here have between 6 and 12 babies, as the prominent religion does
not allow birth control.
Today there were no births or seriously laboring women. I spent the morning there, learning the ropes, helping stock medicine cabinets, and getting to know the midwives. I spent a couple of hours chatting with a lady in early labor, but she seemed like she could be days away still from holding her baby. They told me it is usually much busier, I'll let you know if that turns out to be the case! If
Meanwhile, I'm happy to be in the door. If a couple of weeks prove that this is just not a busy enough place, I may look into driving a little further to a larger hospital. One would be enough each time, but honestly, doula-ing isn't that awesome with no laboring moms!
It is in a somewhat rural health center instead of in a busy town hospital. They do serve a large area though, and most women here have between 6 and 12 babies, as the prominent religion does
not allow birth control.
Today there were no births or seriously laboring women. I spent the morning there, learning the ropes, helping stock medicine cabinets, and getting to know the midwives. I spent a couple of hours chatting with a lady in early labor, but she seemed like she could be days away still from holding her baby. They told me it is usually much busier, I'll let you know if that turns out to be the case! If
Meanwhile, I'm happy to be in the door. If a couple of weeks prove that this is just not a busy enough place, I may look into driving a little further to a larger hospital. One would be enough each time, but honestly, doula-ing isn't that awesome with no laboring moms!
Thursday, 28 November 2013
Transitions
I am moving to another town about 6 hours away from here. I have been working to leave behind 2 well trained doulas and 5 half trained doulas. The well trained ones will continue to train the newer ones. They are continuing a full fledged volunteer doula program here when I go...I am pretty excited about that. I know they will do a great job.
I am hoping to do the same thing in my new area, but we will see how it goes.
Meanwhile, I have seen some wild births, and some sweet births. I'll write about those later...
I am hoping to do the same thing in my new area, but we will see how it goes.
Meanwhile, I have seen some wild births, and some sweet births. I'll write about those later...
 |
| Me and a mama in transition |
Monday, 11 November 2013
Why Volunteer as a Doula?
1. It
is a way to show love.
2. In many places the women are alone in a scary place (the hospital isn't exactly a friendly place) at a vulnerable time
3. A
woman with doula care is:
50% less likely to have a cesarean birth
41% less likely to need forceps or vacuum extraction
41% less likely to need forceps or vacuum extraction
When you are at the local hospital here, the these things could possibly
kill you due to infections that often come with them, I believe that being a doula
can actually reduce the maternal mortality rate.
4. In an understaffed environment like where I work with women, An extra pair of hands and eyes can make a difference of life or death. So many times I have been the one who noticed a woman hemorrhaging or a baby struggling to breathe,
It's not for everyone, but I sure do love it!
Monday, 14 October 2013
Doula-ing with a Language Barrier
Okay. If you
ever find yourself trying to support a woman in labor when you do not speak
their language, here are some ideas for you.
Tips
for supporting women during Stage 1 of labor:
If there is any way
to watch a woman be supported by another woman in her own culture, that is the
best way to learn.
Are there any
bilingual (English and the language where you are) people that you can
interview? Ask them how to support a woman. Also, come up with a list of
things you would like to be able to say and then get a translation.
Memorize those phrases.
Smile, love her, be
with her, touch her, hug her. Be there to hold her weight
so she can achieve whatever positions feel best to her.
Use counter
pressure and massage if this seems appropriate and is well received.
Follow her hands, she
will often rub her own back where it feels good to her.
Sing softly,
this says... I am calm, there is no emergency, what is happening to you is
normal.
Offer water or
other liquids to keep her hydrated
Mostly just be with
her
When
Labor is Slow:
Consider the position
of the baby. If the baby is sitting off-center on the pelvis, the
head may not be able to put enough pressure on the cervix for
dilation. Changing positions and moving the pelvis every 20 minutes
or so may help to change the baby's position.
Some suggested
positions would be:
· Lunges with one foot
up on a chair or something
· Hands and
knees or standing next to the bed while swaying the hips
· Walking
Tips for supporting in Stage 2
When they are pushing, remember that
asking them to squat enlarges the pelvis and unsticks stuck
babies. Most women are hot when pushing, they often like being
fanned and a cold, wet cloth on their foreheads. They are usually thirsty
too.
Tips for supporting in Stage 3
Fill up a water bottle with hot water
(not too hot) and wrap it in a towel, and put it next to her. Most
mamas end up cold and shaky after birth. Smile at her, she will be able
to see that you are proud of her and that you think her baby is beautiful.
I hope this is helpful to somebody!
Sunday, 15 September 2013
Seeing them grow up and almost 70!
Today we celebrated this country's independence. During the festivities I had three ladies that I had doula-d for approach me with their babies in tow! It was so fun to see them again and to hold the little ones. Volunteering as a doula has been so very rewarding. I've been a part of almost 70 births now!
Saturday, 13 July 2013
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!
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!
Monday, 8 July 2013
Double Doula-ing
I have been mastering the art of double doula-ing. No, I am not talking about mom's having twins. I'm talking about two moms moving into one space so that I can support them both at once. I would never ask them to do this, it's their idea.
It is much easier if their contractions are opposite of each other in timing. Then I can support through the pains one at a time. Unfortunately this is not usually the case, which leaves me trying to massage/focus on two women at once. It reminds me of trying to pat my head and rub my stomach at the same time.
I feel rather silly looking, rubbing two backs at once, but I'm glad to be there for them. I think it is time to train some more doulas to come along with me.
It is much easier if their contractions are opposite of each other in timing. Then I can support through the pains one at a time. Unfortunately this is not usually the case, which leaves me trying to massage/focus on two women at once. It reminds me of trying to pat my head and rub my stomach at the same time.
I feel rather silly looking, rubbing two backs at once, but I'm glad to be there for them. I think it is time to train some more doulas to come along with me.
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.
Monday, 1 July 2013
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!
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.
Thursday, 13 June 2013
Any Doula Tips or Tricks?
I get to go back to the hospital tomorrow. I wait every Friday with anticipation, and I wonder what tomorrow will hold. Some days there are babies popping out all over the place and others are quiet with just two ladies in labor and a bunch of post partum moms.
Do any of you doulas out there have any simple doula tips or your favorite tricks to share? Or maybe you have just been through labor yourself and know what worked for you. Keep it simple as I tend to just use my hands and voice...and the favorite a the wet wash cloth on the forehead and a hand held fan for the pushing stage. So far everyone of the ladies that I have assisted have LOVED this. Please share in the comments section if you have new ideas for me. I love to learn from others.
Do any of you doulas out there have any simple doula tips or your favorite tricks to share? Or maybe you have just been through labor yourself and know what worked for you. Keep it simple as I tend to just use my hands and voice...and the favorite a the wet wash cloth on the forehead and a hand held fan for the pushing stage. So far everyone of the ladies that I have assisted have LOVED this. Please share in the comments section if you have new ideas for me. I love to learn from others.
Sunday, 9 June 2013
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.
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.
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!
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.
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
Thursday, 23 May 2013
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.
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.
Saturday, 18 May 2013
Four Fun Births
It seems like death and life are so closely intertwined here. Three times yesterday, I saw babies enter the world to the eerie tune of the "death wail" just outside the window where these women were giving birth.. As people left this earth in one room, new ones entered in the labor and delivery ward.
I spent all day at the local hospital as a volunteer doula. I walked in on the birth of twin baby girls. They were about 6lbs each and born vaginally. It was awesome. After the babies, the mom hemorrhaged and was quite weak afterwards. I got to be her extra hands for the first couple of hours, cleaning little meconium bottoms and holding the babies while mom washed up.
Another little baby was named after me. I spent a lot of time with this mom, from the time she was 2 centimetres until after her baby was born. At one point, she had not made much progress for a few hours and the baby was very high up and posterior. We worked on movements and positions she could do to help with this and it was so exciting seeing that within a few hours her baby had turned over and was engaged. Little Kimberly was born up to her chest before I could get anyone to come help.
Then there was the girl who walked in just a half hour before I left. She came in with a friend, who promptly got kicked out (hospital rules). After a few minutes everyone suspected that this first time mom just might be pretty close to delivering. Sure enough, ten minutes after she arrived she was completely dilated and ready to push. I got to hold her hand and talk her through what was happening and then watch her as she giggled in delight over her precious new baby boy on her chest.
It is such an blessing to be able to be with these bright smiling, beautiful, and strong ladies as they become mothers. I love being able to be kindness and love to them. It is just plain old fun.
I spent all day at the local hospital as a volunteer doula. I walked in on the birth of twin baby girls. They were about 6lbs each and born vaginally. It was awesome. After the babies, the mom hemorrhaged and was quite weak afterwards. I got to be her extra hands for the first couple of hours, cleaning little meconium bottoms and holding the babies while mom washed up.
Another little baby was named after me. I spent a lot of time with this mom, from the time she was 2 centimetres until after her baby was born. At one point, she had not made much progress for a few hours and the baby was very high up and posterior. We worked on movements and positions she could do to help with this and it was so exciting seeing that within a few hours her baby had turned over and was engaged. Little Kimberly was born up to her chest before I could get anyone to come help.
Then there was the girl who walked in just a half hour before I left. She came in with a friend, who promptly got kicked out (hospital rules). After a few minutes everyone suspected that this first time mom just might be pretty close to delivering. Sure enough, ten minutes after she arrived she was completely dilated and ready to push. I got to hold her hand and talk her through what was happening and then watch her as she giggled in delight over her precious new baby boy on her chest.
It is such an blessing to be able to be with these bright smiling, beautiful, and strong ladies as they become mothers. I love being able to be kindness and love to them. It is just plain old fun.
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