Sticks and Stones

Throughout three years of work in the ward, I've stifled my giggles when I hear some of the ludicrous things the staff tell mamas. The midwives will use scare tactics to silence noisy laborers and belligerent first-timers. While I've met some very gentle, soft-spoken nurses and midwives, I think they are the exception and not the norm.

On one occasion, I was trying to coax a woman to stand and walk. She was early in her labor but refused to leave her back. A midwife, whom I'd never met before, came over and in the local language told the mama to quit acting like a white woman and get off her back. Pardon me?! When I commented back in her language, she looked startled and her face softened. She hadn't known that I would be able understand what she was saying!

On another visit, a mama was getting really vocal with each contraction, but when her distress sounds continued between contractions, the midwife popped her head through the curtains and told her, "If you don't stop making so much noise, the baby's gonna come out of your mouth!" If that doesn't frighten an uneducated, first-time mama, I don't know what would!

I've heard tell of babies threatening to come out of belly buttons and rectums and other unsavory places. Can you imagine? Yikes.

I have wondered if the limitations of the trade language confuse the first-time mamas too; not in what to do, but rather in what is happening to their body. When we instruct a woman how to push, the literal translation is, "poop from your butt." The 8-year old boy in me is snickering. While communication is essential in helping a mama through her labor, you can't deny good, old-fashioned instincts. Even if there's someone telling you that your baby is gonna pop through your belly button if you scream one more time, we're all glad that's not true! That's a recipe for PTSD.

So how do I, and others like me, stop the fear cycle from running a-muck? 

A woman's response to labor pain fascinates me. Watching a contraction sweep over her is a study both in creative design and human instinct. At first, the pains are small, easy to manage, and a woman can easily talk through them. We make small talk between pains, and I can ask her about her family and where she comes from. As her labor progresses, the contractions become increasingly more powerful. Soon, she can no longer talk because each pain requires her undivided attention. I can see the contraction coming on, even before the mama's belly tightens. She may be sleeping peacefully, when all of the sudden, she moves a little and grimaces. Her toes may curl, or she holds her breath. And then it's upon her; the top of her uterus curls over, making her belly lift in a tight, hard peak "like a pumpkin," as we frequently tell mamas. 

I often think about God's grace in these moments. He gives women a rest between contractions! Isn't it wonderful that the pain of childbirth isn't one, long, agonizing uterine cramp?! One woman cried and thanked me and flicked my chin (bless her heart) when I reminded her of this common grace. 

Studies have shown that mothers from developing countries often associate childbirth with despair, hopelessness, and fear. Fear is often the result of facing something we don't understand. These mamas realize that labour is going to effect them somehow, but unless they've done it before, they don't know what it will look or feel like, and so they fear it. How often have you heard women telling the horror stories of their labors? I know it's the same way among women here. These people are great storytellers, and I have no doubts that baby deliveries make it into some of their greatest tales. 

As the pain increases throughout a a woman's labor, she can become overwhelmed by the intensity, feel out of control, that she can't escape it, or as if each contraction is doing something to damage her. How could something so painful be producing good results? Sometimes I remind women that the pain isn't damaging, but really, each pain is helpful! It's bringing them that much closer to holding their baby. I tell them that God has created their bodies to do this work, the pain is temporary, and at the end is a tremendous blessing. Last weekend, I told a mama that her body had a special hormone that would help her forget the most difficult parts of her labor after it was all over, or at the very least, help her feel better about them. She laughed! She was in transition, and she laughed. I was so proud of her. On a related note, earlier I told her that if she didn't take her underwear off, it would "kalabusim bebi bilong yu" (imprison her baby). She didn't laugh about that... 

Each woman labors differently, but there seems to be a common theme among the majority here in how they vocalize their pain. 

In early labor, they moan and say, "Aiyo." (something like "oh my goodness"). 

As the pain increases, the word changes to a phrase, "Aiyo mama yo." I'm not sure how to translate this one. Haha.

And then it becomes, "Mi les ya. Mi kisim taim!! ("I don't want to do this. I'm really having a hard time!" for lack of a better translation.) Sometimes women will hit their own bellies and hiss at their babies. 

Then, in the most difficult moments, women will yell, "Katim mi na rausim bebi!!!" (Cut me and get the baby out!) Whew. Never a dull moment.

I'm reading The Birth Partner by Penny Simkin. She explains the difference between pain and suffering. She defines pain as an "unpleasant physical sensation," while suffering is a "distressing psychological state that may include feelings of helplessness, anguish, remorse, fear, panic, or loss of control." She writes, "When women recognize that labor pain is really a side effect of a normal process, not a sign of damage or injury, fear cannot increase their pain." In other words, pain will not increase because of fear.

It encourages me to know what a powerful role a mama's perspective plays in how she feels about her labor, and how she copes. This is further motivation to keep educating, and supporting them. Fear diminishes as knowledge increases. Maybe these women will go back to their villages and tell the story of this labor and how it was different than others; that it was better. 

Ultimately, my prayer is that they will recognize Christ in their labor, and want to know Him as a result; that as their knowledge increases, their fear will give way to wonder at the grace given them.