Still Geekin' Out Over Placentas

Hi Friends! 

I know it's super uncool to read one's own blog, but I was feeling sentimental the other night and decided to refresh my memory of some of the things that happened in Papua New Guinea while I was working in the labor ward. Of course, that jaunt down memory lane made me cry. But it also kinda got me excited about writing another post with a long-overdue update! 

As I expressed in my last post, God is just as present and about His work here as He ever was in PNG. I knew when I wrote that, that He would reveal Himself and continue His work in my life, and I looked forward to how He would achieve His will for me. Well, He has been shaping and smoothing my rough edges, as He is wont to do. There have been some ugly tears, some serious wrestlings, and an occasional melt down moment of doubt, but my sweet Jesus reminds me each time that He's faithful and trustworthy and Holy. 

I've been "home" in the States for a year and a half now. I'd like to think I'm settling in nicely! Things like high-speed internet and fresh arugula immediately became apart of my first world lifestyle. I cringe to think that within a week of returning, an even remotely slow internet connection became a frustration. Ahh, how quickly we can adapt to the new normal when it serves our purposes. I'm mildly ashamed to admit that I've put on a few first-world pounds, as well. Much less walking and greater, more exciting options for this foodie have made that transition...bad. Or is it good? Or both?! 

God has shown Himself a good provider over and over through connecting me with like-minded believers in each location I've lived since returning. The church I attend when I'm in Colorado is rich and deep and scripture-centered. The people are intentional about their walks with the Lord, and intentional about discipling others. Before leaving town and in-between when I had no clue what I was doing with myself, worshiping with these brothers and sisters was a balm to my weary heart. 

I spent several months in Boise and joined a home group through a church just blocks from where I was living. These folks brought me into their fold immediately. During a particularly difficult internship and a season of serious doubt regarding life direction, I would leave each meeting with these dear ones feeling filled up. I would frequently sing "God Is So Good" on the drive home - an overflowing theme in my heart.

(I often sing my emotions. This has since gotten me in trouble, as I don't always pause to see who is around before bursting into song. I'm working on this - heaven help me.)

Tucked in this timeline somewhere was an aggressive surgery that resulted in a significant left-sided facial palsy. My left eye wouldn't close and my smile drooped. There was also a large, unsightly wound on that cheek. Protecting my all-seeing eye, eating SUPER SLOWLY, and keeping that wound covered became the name of the game. There was a lot of worry about whether or not I'd regain use of that half of my face. I prayed a lot for patience and trust in this season of healing. I found it incredibly difficult to not be able to express myself as I once had. Smiling felt awkward, and some words were hard to pronounce. This face just didn't feel like mine. I forced myself to go out in public and be "normal" because I figured that if God had written this into my story, I had to keep living life. I also decided that if my half face was the new me and how God designed that I should glorify Him best, then so be it. 

Fast forward to the present. I'm pleased to share that 4 months later, my face has nearly completely recovered! It happened so slowly, that others noticed before I did. My eye is the last to come around, but it's much better and I see a little improvement each day. My left nostril flares again. Guys, we gotta celebrate the little things. 

So where in the heck am I now, you ask? I am now in the land of beer and cheese and beer-battered cheese and am interning at a busy birth center in Wauwatosa, Wisconsin. I seriously could not have asked for a better placement and have been thoroughly enjoying my time with the four midwives and their patients. These midwives practice with wisdom and humility. They seem to have found that enigmatic balance between the weird schedule of a midwife, and home and family priorities. It has been remarkable to observe them in action, learn from their experiences, and be entrusted with their patients. I'm enjoying myself so much, I don't want to miss a single birth! 

When I'm not at the birth center, I'm enjoying the company of a friend who just happens to live a few blocks from me and served for a short time with me in Papua New Guinea! And if that doesn't make the world feel small, the home I'm renting with two other girls "just happens" to be owned by some missionary friends from PNG! God laid out His blessings for me and then pretty much pushed me and I fell into them. This angsty, recovering control freak looks on in awe at His goodness and for a moment, the white knuckle grip I have on my life lets up juuuust a little. Of course, I don't have as much control as I'd like to think. I need to trust more. 

So here I am - eating cheese and holding babies - and plan to for at least another year. After that...only God knows. Lord willing, I'll graduate in May 2020 and will then be eligible to sit for my licensure exam. So much to do and learn between now and then, but I'm takin' it one day at a time. 

The other night, I dreamt that I was pregnant and laboring in the New Guinea haus sik. My baby was not doing well and needed help; interestingly, an identical scenario to one I'd seen when I was there. My preceptor was there in my dream, running throughout the hospital frantically looking for a doctor who would perform my c-section. As is classic in dreams, no one would acknowledge or help us. I woke feeling stressed and sad. But my dream also served as a reminder of why I'm doing this. Why I'm living away from my family again. Why I'm up at all hours. Why I carry clean underwear, snacks and a watch in my car at all times. Why I read about fetal development and placentas. Each moment is preparation. Each moment an arming of myself, so to speak, so that I can return to the battle and fight for vulnerable women and babies. 

Stay tuned...

Parting is Such Sweet Sorrow

In June, my time in wild Papua New Guinea came to an end. After four years, it felt like home and the people who lived there with me, family. I imagine four years spent anywhere would make any parting difficult, excepting prison of course. Heh heh. With seven months between me and that departure, it feels like a dream. The emotional distance seems a greater loss to me than the span of miles.

Over the years, I wrote multiple times outlining my weaknesses. Cringe. There was always a moment of anxiety before posting one of those blogs. That's the closest I'll ever get to streaking. Just saying. To write my heart felt raw and vulnerable, yet so necessary. My need of a Savior was/is no greater than yours, and so I hoped that something I wrote would resound in you and cause you to look to Him too. Over four years, I so heavily leaned on Jesus that my tears must have puddled at His feet. And then there were the days when the victories were so overwhelming, I wanted to tell everyone I saw. Aaaaand....just maybe I repeated some of those stories over and over. Sorry, friends. (You know who you are.) The joy was just spillin' over! That mission trip "mountain high" that we hear about from pimpled teenagers fresh off the plane from Guatemala; well, it's real. But what goes up must come down and it was in the valleys that I encountered God in ways I could never have imagined. But you know that. I wrote about that. 

The matchless joys were hard won, friends. The hardest battles produce the sweetest victories, yes? Even if you're a little beat up. Please read me: the battles were won by the Lord. Sometimes, I stood back in awe and watched Him work. Hallelujah! Other times, He was working and it wasn't until later that I recognized His presence and rejoiced. I am sure that there were even more times that my Mighty Warrior fought hard and won, and I never even knew it. Just thinking about it brings me to tears. There were days in the labor ward when it felt like the light of Christ was the only light there.  

So after all that soul reshaping, the most difficult part of leaving Papua New Guinea was the fear that I would lose that fellowship with my Lord. I know it seems silly, but life in the States is pretty great. There are hard things here too. Some dear ones are walking through indescribable pain here. But from over there, everything here seemed idyllic in comparison. The thought of going back to easy street made me so sad. As much as I ached over the brokenness in New Guinea, I recognized how the Lord had used it to change me, and I wanted more of that. More of Him. 

On my last day in the ward, I took donuts. Folks, if you want to bring people out of the woodwork, bring glazed pastries. I wrote a long letter thanking the staff for allowing me to serve among them and for teaching me so much. I also shared about my plans for the future and my heart to become a midwife. I got hugs and farewells from staff I had never met. I loved it! It was such a sweet day. A midwife mopped over the top of my foot. What an appropriate parting gift. 

I enjoy thoughts of visiting again in a few years. I don't know if it will happen, but allowing myself the pleasure of loosely planning such a trip eases the pangs of homesickness for my tropical island. In the meantime, I continue to look for Christ in my current surroundings. He's here! He has already shown Himself to me; present and steadfast, continuing to shape me into someone that more closely resembles Himself. I bow before His authority in these things. The peaks and valleys of life are here too, and my Savior will walk beside me and hold my hand in the familiar way. 

"But this I call to mind, and therefore have hope: The steadfast love of the LORD never ceases; his mercies never come to an end; they are new every morning; great is your faithfulness. 'The LORD is my portion,' says my soul, 'therefore I will hope in him.'"            Lamentations 3:21-24

The Oil of...Well, Not Gladness...

Over a year ago, a dear friend of mine sent a package full of goodies. Among them was an assortment of essential oils and a diffuser, complete with a book about how to use them in pregnancy and labour. It was an incredibly thoughtful gift. I was so excited! My initial excitement waned as I envisioned how I might use the oils with the women in the ward. The ward is smelly, and the women are smelly and often very dirty. I knew a diffuser wasn't going to cut through the odors and infuse the room with the relaxing properties of an oil blend. And I couldn't imagine how I was going to explain to a laboring mama just exactly what I wanted to rub on her and why. Some of my doula suggestions are already received with strange faces of confusion or indignation. With each moment on this train of thought, I was increasingly more convinced that it would not be the best idea to introduce the developing world to essential oils. At least, I wasn't the person to do it.

Of course, I was so disappointed. This sweet and intentional gift was going to be for naught, and I felt guilty at the thought of enjoying the oils in my home all to myself. After much deliberating, I decided to put one of the blends in my hospital bag to have on hand should I work up the nerve to use it.

A couple of weeks later, I was in the ward and working with a mama who was particularly physical. I didn't wander more than a few steps from her during the entirety of her labouring. As she moved into transition, she began to hang from my neck with each powerful contraction. She wrapped both arms around me and swayed and moaned. We moved together for a long time like this. 

I was getting really tired and looking for a way to step away for a break. I'd forgotten about the oil in my bag until *BAM!* In a stroke of genius I thought, "I'll put some on my neck, so that the next time I hold the mama, she'll smell it and it will be soothing to her." Loving the smell myself, I put on a generous amount. I walked back over to the mama's bed and resumed support. One of the midwives had been mopping, and it was about this time that she turned on the big stand fan to dry the floor. I was standing close to it, and as I had been working hard and was pretty sweaty myself, I was thankful for the cool breeze.

All of the sudden, another midwife down wind from me shouted, "What's that smell?!" I have never heard this question asked by a member of the staff, and this was not an excited exclamation of delight. Nay, it was an expression of surprised disgust. She wrinkled up her face and lifted her chin to smell the air.

My own reaction was to lift my nose to the air and sniff in an attempt to help solve the mystery. Hmm, I don't smell anything unusual. Oh, wait...

Then it dawned on me. The oil!! She was smelling the oil and found the foreign odor repugnant. My spuce and frankincense weren't delighting her like I'd hoped. In fact, they were having the opposite effect.

Internally incredulous, I thought, "What smells? Are you serious?? You work in this ward, and you're asking what smells?" I wanted to laugh out loud, but knew I would have to explain myself. I hurried away and wiped the oil off my neck as best as I could. I never confessed that I was the source of the offensive waft. The smell lingered a little and I was glad, but I'm sure the midwives were turning up their noses long after I left. 

I have since taken the oil out of my bag and enjoy it at home. To the sweet friend who sent it: You are a gem, and the ladies here have no idea what they're missing. I look forward to learning how to use the oils with laboring mamas who are more familiar with things like clary sage and peppermint. 

*raise your oil bottles in solidarity* 

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.

Practicing Thankfulness

In light of the recent events at the hospital, I don't think I have to tell you that I have not been eager to return. Each weekend I wrestle, thinking of reasons why I should go, immediately followed by reasons why I shouldn't have to. It rained heavily the entire day before a recent trip in, and I actually thought, "Maybe the road will wash out and I won't have to go." Wow. Well, the road didn't wash out so I put on my skirt, packed my bag, and headed to the hospital.

It was a quiet day which wreaked havoc on my mind and heart. I was eager to be busy and fill the time, but with only two laboring mamas, one of which was knocked out on pain meds, there was little to do. I milled around for a bit before deciding that I had better get out of there. I walked over to the post-natal ward to see if my friend was working. She wasn't, so I wandered outside. I prayed as I walked. 

"Lord, this is hard. I don't want to be here, and feeling like this makes me even more sad! My heart is just tired." 

As I prayed, the Holy Spirit said, "What here is good? What things are going well? Can you thank me for my gifts and the things that bring joy?"

So I began. I thanked the Lord. At first, it was the material things within view of where I was standing. Over time, the thankfulness spread to people, ideas, truths, and the gifts that you cannot hold in your hands or wrap your arms around. I've compiled the list here for you to read. God's gifts come in many forms. 

1) Gloves. I'll touch anything with gloves! And germ protection is paramount.

2) Trash cans. What would we do if there wasn't a place to put rubbish? It would be nasty.

3) Shoes. Walking barefoot in gunk is gross.

4) An unclogged sink. As often as the toilet clogs, the sink never has.

5) Alcohol hand sanitizer. Surprised it's available? Me too.

6) Gauze. We use this stuff for everything. It comes in giant rolls that we cut and rewrap in shorter lengths. The supply seems never-ending.

7) A mop bucket. There was a time when I rung dirty water from the mop by hand. I can't tell you what a pleasure it is to use a functioning, ringing mop bucket.

8) A mop. Cleaning the floors standing upright is a no-brainer.

9) Beds. Until you've delivered a baby on the floor, you cannot fully appreciate this luxury.

10) Four walls and a roof. Bear with me. Many have labored in worse places.

11) IV fluids. This is a game changer for so many women. Seriously, life-saving.

12) Clean needles. No questions about where they've been or what pathogens they carry.

13) Curtains. Shower curtains, but a bit of privacy nonetheless.

14) An infant warmer. A new one too! Keepin' those babes warm is essential.

15) A vacuum extractor. As terrifying as this contraption is, I've seen it rescue many babies.

16) A blood pressure cuff. Obviously.

17) A thermometer. No need to explain.

18) A pinard. The rather old-fashioned way of listening to the baby's heartbeat. Doesn't require batteries and can be tucked into any pocket, fanny pack, or teased fro.

19) Buckets. They catch fluids and carry stuff.

20) The bathroom door. Don't roll your eyes. Have you thanked the Lord for the bathroom door?

21) Water. Sometimes there isn't any water, but those days are fewer in number than the days we do have water.

22) Electricity. Also hit and miss. But really, how often is electricity needed to bring a baby into the world?

23) Windows. They're open 24/7. I can imagine a hot, stuffy labour ward would be miserable. 

24) Rain. Cools the air and provides a conversation starter.

25) Tape. Tape to hold the IV. Tape to label the health book. Tape to hold the eyelids closed. Tape to hold the cupboard open. Tape to cover the sore on one's foot. Tape to keep one's shoes from falling apart.

26) Pitocin tablets. They're not swallowed. I'll leave it there. For the woman who is hemorrhaging, these will save her life.

27) Hot tea. A staple beverage that warms mamas and provides post-labour fluids and sugar.

28) Tongue depressors. Not used to depress tongues, but to stir tea!

29) Cord clamps. Because dental floss isn't always available. *wink wink*

30) Newborn shots and eye ointment. There's no such thing as herd immunity here.

31) Laughter. A common language that connects people across cultural divides.

32) Hand gestures. When words are inadequate, a few well-placed hand gestures will do the trick.

33) A c-section. I'm thankful that, however long it takes to get one, a c-section is still an option here.

34) The collective knowledge of the hospital staff. 

35) The midwives. These dear ladies see so much. Their hearts are seared by experiences unimaginable, but they still provide care. Sometimes that care doesn't look the way I think it should, but then I remember that they are working long hours in a tough environment with limited supplies, little support, and often no pay.

36) The surgeons. They too work long hours, and for little thanks.

37) The mamas. Whether experienced laborers, or first baby newbies, they need compassion and care, and they teach me something new every day I'm with them.

38) Family. It's unusual to find a patient alone outside of the labour ward. Most are watched over by a sister, brother, mama, or papa. Or by something I have been, a "watch mama." Someone who isn't family, but who cares deeply. 

39) Life! New babies are miraculous; every organ developed to sustain life in such a little person. When I stop to think about all that could go wrong, I'm astounded at how often it goes right.

40) God's continual presence. Imagine the world without His presence. I can't.

41) God's assurance that He has won the victory over sin and death! Glorious hope!

42) The knowledge that all people and things are seen and thoroughly known by their Creator God. 

43) A place free of civil war and persecution. There are difficulties, but I've never feared for my life. What a gift.

44) Openness to the Gospel. No one tells me that I have to keep the Truth to myself, or that it's unlawful to talk about the Hope that I have.

For about an hour, I walked in circles around the corridors of the hospital thanking the Father for everything I could think of. It didn't come easily at first, but it's amazing what this exercise did for my heart. It brought my focus back around to the hope-filled truths and joys of things right in front of me. It didn't negate the hardship, but instead, put it in its place. Subject under Christ. 

"There is none like you among the gods, O Lord, nor are there any works like yours. All the nations you have made shall come and worship before you, O Lord, and shall glorify your name. For you are great and do wondrous things; you alone are God."  {Psalm 86:8-10}