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.

A Little Girl in Labor

She was twelve years old.  She had been in labor for two days and was HIV positive.  As I held her and rubbed her back through the contractons, it was hard for me to wrap my mind around the fact that this girl was only two years older than my son.

A smaller clinic 3 hours away had sent her to this larger hospital because they felt her labor was taking too long.  None of her family came with her.  She was so scared, and very much alone.  She kept calling out for her mom.

I encouraged her to walk if she could, and she did. She walked and walked and walked.  Eventually she had a baby boy.  When he started to nurse for the first time, the look on her face made me want to cry.  Her expression was that of  joy and amazement and love for this new little miracle that had been inside her only moments ago. 

I don't know her whole story, and I don't know what life will look like for her as she heads home. I doubt it is pretty.  All I can do is pray for her.



Left: you can see a woman walking away with a bag of firewood.  Right: the next generation of little women

CBS News

Just saw this article from CBS news


CBS News/ May 12, 2013, 9:14 AM

Where not to be a mother in 2013

Maasai mothers hold their babies as they queue to vote in Kenya, on March 4, 2013, during the nationwide elections. / Getty Images

The most dangerous day to be a baby is its first day on Earth, regardless of where that baby is born. As many as one million one-day-olds die annually, according to a report from the non-profit organization Save the Children. Additionally, as many as three million newborns die in their first month of life every year, almost all of them from preventable and curable ailments.

The annual State of the World's Mothers report highlights the critical importance of a mother's health and nutrition in preventing such disasters.

The report also highlights a sadly familiar roster of countries where moms are most vulnerable, as all of the worst places to be a mother are in sub-Saharan Africa. The bottom 10 in descending order on Save the Children's list are: Ivory Coast, Chad, Nigeria, Gambia, Central African Republic, Niger, Mali, Sierra Leone, Somalia and DR Congo. The report ranks 176 countries on five indicators: risk of dying during pregnancy or childbirth, under-5 mortality rate, education, income and female political representation.

South Asia still has the highest number of newborn deaths annually, with as many as 423,000 dying every year on the day they are born.

Some of the reasons for the poor country rankings include women getting pregnant at younger ages, undernutrition and poor medical care. Sub-Saharan Africa has 11 doctors, nurses and midwives per 10,000 people -- less than half the 23 considered necessary to deliver essential care, according to The Economist.

There is some hope in the worst corners of the world for mothers though, as some governments take notice of the problem. The report highlighted Malawi, which has reduced its newborn fatality rate by 44 percent since 1990.

With 98 percent of newborn deaths occurring in the developing world, the top 10 countries to be a mother are mostly in Europe and largely very aggressive in delivering equal opportunity and state-funded care to mothers. The top 10 in descending order are: Finland, Sweden, Norway, Iceland, Netherlands, Denmark, Spain, Belgium, Germany and Australia. The United States was ranked 30th.

While there is an interest to improve the situation for mothers globally, Save the Children CEO Carolyn Miles writes in the report that "what is lacking is the political will and the funding to deliver these solutions to all the mothers and babies who need them."

© 2013 CBS Interactive Inc. All Rights Reserved.

But isn't Birth Normal and Safe?

Now I realize that in North America we are fighting hard to tell women that birth is normal and safe.  This blog may bother some of you. 

It is true that in North America and many parts of the world, there are too many medical interventions which are causing harm to women.  So that is why we have to tell women..."your body knows what to do" and "birth is normal unless proven otherwise."

Now look at a woman in a developing country. (I'm not saying these things don't happen elsewhere, or that they happen to everyone here.)  Add pregnancy to these possibilities:  smoking, unclean water, a husband who beats her, severe anemia from malaria, a poor diet, and maybe some HIV and TB and a couple of STD's.  All this with no birth control, little education, and no prenatal care. These factors cause major issues for women and babies.

That is the difference between here and there.  If you are a pregnant woman reading this, please don't let it frighten you.  These stories are not applicable to mothers in North America, except to raise awareness so that you can help. Yes, I do believe that birth is usually safe and  an absolutely wonderful and NORMAL experience for a healthy, well fed, woman.

I found this list of countries and how many women in each have a skilled birth attendant when they have their babies. I thought it was interesting.


Here is the Link: http://kff.org/global-indicator/births-attended-by-skilled-health-personnel/


A skilled birth attendant can be a nurse midwife, a direct entry midwife, or a doctor.

Lost in the Jungle

Have you ever wondered what you would do if you were really lost in the wilderness?

One night, about two years ago, I discovered what I would do….

"Hka hka hka" I could hear the familiar cough in place of a knock outside my door. I went outside to investigate.

There was a middle aged woman with one blind eye, two teenage girls, and two young men at my door. I hadn't seen any of them before. They had come to get my friend and I.  A woman with twelve previous children had given birth to twin girls the night before. Both babies were fine, but the woman was bleeding a lot, had a retained placenta, and they feared for her life. They wanted us to come and help.

It was a four hour hike to where she was in her banana leaf garden shelter. I got what I might need and we all started out. It was 4pm and our husbands weren't going to expect us back until the following day.

It is a treacherous hike. It seemed to be either straight up or straight down most of the time. Now it is the custom here, to yodel messages back and forth between the mountains.  About 2 hours into our hike we heard yodeling from the mountains across from us. The woman had died.

We told them to go on ahead, as it was their mother and sister who had died. I had a nine month old baby and wanted to get back.

Our guides would have led us back…but we figured we could find our way back through the jungle. (Don’t ask me why two California girls thought that) So after about a half hour on our own, we could not find the trail. We went up…all we could find was thick bush.  We went down and it was the same. So here’s what we did.

1. Sit down

2. Pray

3. Yell/scream really really loud.

4. Shine our flashlights to the mountain villages across the valley.

What did we yell? Well, we perfected our yodel (The way they yell from village to village). We yelled “the white ladies are stuck in the bush!” in 5 different languages. (Spanish and French were just to mix it up for our sakes) We figured as long as we were making noise, it could attract help.

We yelled once or twice that we didn’t have any toilet paper so someone really needed to help us.

Eventually (a couple of hours later) two young men from the next mountain range over (yes we had been that obnoxious) came to get us and lead us home.

So we were home before 1am and slept safely in our own beds.

If this woman had a skilled birth attendant with her, she would still be alive today. One of the twins died a week later.

 

What do I take to the hospital?

What do I bring when I go to the hospital here as a doula?

1. Pads to share with ladies who did not bring any.

2. Soap so that I can wash my hands.

3. Toilet paper because well, it's nice to have in the bathroom.

4. Last time I brought and donated 15 cups, because all the women in labor were sharing one cup for water and there was no dish washing going on.  I have lived in the jungle long enough that it didn't bother me too much at first...but then I thought about TB.

I have my kids make me a paper fan and I bring wash cloths to cool foreheads.

That is about it.  The contents of my "doula bag."

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/