There’s so much I want to tell you, so many little things and mundane things, just to keep you, whoever you are, updated. Maybe it’s important to somebody, or just some piece of trivial news to help you pass a few minutes of your time today (whether you know me or not). I don’t know who you are but I feel compelled to tell you these things. I have a blog, so I should post things on it, that is the point of a blog.
Much of what I have tell you is not that exciting or entertaining. Of course I also like to put out bits of information for the masses, (I’m sure I have a mass following…), for example like how many mothers we loose in this world to death everyday. One woman dies Every MINUTE of Every DAY due to complications in pregnancy or childbirth; and there it is the first bit of information for you so far in this post; there will be more of these in this post but I will let you figure out where they are.
I also have some adventures I could share, about riding in trycees, eating/drinking halo halo, meeting new friends and sharing much laughter, and maybe I will in my next post, but not this one.
I could tell you about all the postpartum home visits and what the houses are like, the ones that are cinder block and mortar, and how some homes are the size of a western master bath, some are make shift shanty’s, using all sorts of materials, like bamboo and corrugated metal, rugs and tarps for walls, ceilings, floors. How some homes take us multiple forms of transportation to get to and we may have to walk up a steep hillside or cement steps asking different people we pass to help guide us to the house we are looking for.
Then there are the prenatal visits in the clinic, and how many woman come in at or near term for their first prenatal visit with us. One just came in yesterday morning, and returned in the night around 1a.m. in active labor and nearly ready to birth her baby. Which by the way she did with tremendous grace and poise.
So I am going to tell you about this particular birth….but have no fear it will not be graphic for anyone feeling squeamish all of a sudden.
This cute young couple rang the doorbell around 12:40a.m. and we let them in. This mother was smiling, and drenched in sweat, and downed a glass and half of water when I offered her a drink, (you hardly ever see people drink water like that here, I don’t know why, that’s just the way it is). We did our normal routine of checking her vital signs and confirming active labor which she was obviously in. She delivered her baby about 45 minutes after arriving here, and although that’s not that uncommon for women to come in and be ready to give birth here, something about her and her husband was different. He was a bit nervous, and excited, which is really refreshing to see, because they are not always outwardly expressive, at least not around people they don’t know well.
Everything felt calm and peaceful as she started to spontaneously push with her contractions, and soon the head delivered and we watched and waited for her to finish giving birth. The baby turned it’s head slightly from side to side and you could see her stretch out her neck just a bit as she was also an active participant in the process of her own birth, [this is something I think we too often forget or maybe don’t even realize regarding the birth of an infant]. She wasn’t struggling to breath and the color of her face was good so there was no need to intervene. After the brief pause the mother started to push again and there she was, a baby girl on the bed, and let out a healthy cry, she was quickly put on her mothers chest, dried off with receiving blankets and although the birth room temperature was well into the 80’s and humid we put a hat on her.
It’s important to get the babies dry or they can loose body heat fast immediately after birth. We don’t clamp or cut the cord right away, in fact we don’t clamp or cut until the newborn exam which isn’t done until 1-3hrs after birth, unless there is some indication to do the exam before then. One thing we do is get the baby to the breast and attempt to breastfeed within minutes after birth. As I’ve said in previous posts breast feeding within the first hour decreases infant mortality greatly, but to get them to breast feed within the first 30 minutes and you half the number again, and especially in a developing country where children under the age of 5 are at risk, this is a big deal. I could discuss all these protocols and give you statistics on why Mercy in Action has chosen certain methods over others in this post but that is not what I am wanting to share with you right now.
The backstory is what made it different…it was her obstetrical history;
Her first pregnancy was in a hospital in 2008 and according to the information we have, this was what we in healthcare call ‘uneventful’ which is a good thing. Of course it is highly probable she received pitocin, whether or not she need it, as well as an episiotomy along with fundal pressure. That is when others literally push on the mothers abdomen to try and get the baby to come out, which is a really good way to seriously injure both mother and baby. These three interventions are routinely done here. Her second pregnancy ended abruptly at 6months gestation and a cesarean section in 2009, that baby died. The third baby she miscarried in 2010. So here she is, her 4th pregnancy and at term and has a pretty traumatic obstetrical history and she decides to come to the clinic for a prenatal visit and then goes into labor that night.
My point, if I can get back to it, is that something was different and it was a nice kind of different. The husband/father thanked us multiple times shortly after the birth. He started telling us in broken English how thankful he was to us and to God to have his wife and daughter here with us. That the labor and birth went so well and that everyone was healthy. This father looks at me (at least it seemed he was looking right at me) and was telling me and the other midwives that God will repay us for what we do. What does that mean exactly?…I know in the bible the midwives were blessed and given homes/families of their own.
I want to briefly take a glance at these midwives. These Hebrew midwives understood and protected the sanctity of life, not just because they attended births and helped the mothers and infants. This was the time when Pharaoh had ordered all the infant boys born to be put to death. So then, this is not just about protecting women and infants during labor and birth, this is a justice issue…..hmmm now that strikes another cord in me….
So this is it people, finally, the main point of this post, sorry it took me so long to get to it…..This mans words pierced me. I don’t know if I can qualify for you what or why I felt anything.
Of course pregnancy and childbirth have been happening since the dawn of time. I do not affect whether or not it is going to happen, but whether or not I will partner with it. I do not have a false sense of my duties or my abilities, I am after all, merely human and there are times and situations that are much greater than I am able to remedy. I have seen tragedy, life and death moments in a birth room, in the U.S., Thailand and even here in the Philippines. It is quite possible I will see it in Haiti as well. These things make me want to learn this art and practice of midwifery well. To develop my skills to be proficient in all aspects so that I would be a help and not a hindrance.
I feel very much like a kind of guardian for mothers and their children. To keep watch for things out the ordinary or that may require some assistance. I recognize that I am watching and attending to something much greater than myself, there is a sacredness in it all. It doesn’t matter what country I’m in, or if I have electricity or not; if I am in a western style home, jungle hut or state of the art hospital.
Again I want to tell you, his words pierced me to my core and reminded me of the point, at least for me;
I desire to be like the Hebrew midwives mentioned in the book of Exodus; they fought for justice, they fought for and valued life.
Before each birth they prayed to G‑d to assist the Jewish women to birth quickly and safely and they prayed for the health and well being of all the babies under their care. The Midrash states that Shifra and Puah actually became G‑d’s partners in creation, granting life to the Jewish children (Shemot Rabba 1:19).