The Stuff of Life

Helen lay on her back, legs splayed, the end of the bed removed to allow the midwife to get closer...and pull harder.

She was delivering her first baby and having a very difficult time. When I saw her bloody ear, lips crusted with dried blood, and the evidence of a bloody nose, I asked if someone had hit her. This wasn't an unusual question. Many women arrive in the ward bruised and cut. If it isn't the rigors of their hard lifestyle, it's at the hands of their husbands. One mama had to nurse her infant with one hand because the other was covered in bulky bandaging. When I probed her, she told me that her husband had cut her with a bush knife just days earlier. 

Helen couldn't speak so she just shook her head in reply to my questions. The midwife explained that Helen had had such a difficult labour, she had smashed her head into the metal on the bed and bit through her lips. These details should have given me some idea as to what kind of labour journey I was about to embark on with this woman.

I put on gloves and moved in close so that I could support her while she pushed. First babies can be a longer wait but this one was taking too long. And Helen was small. We encouraged her pushing for a long time before the midwife took scissors and gave her the largest episiotomy I've ever seen. The first cut was at least two inches in length and each time she pushed, the midwife cut a little more. 

Still the baby would not come.

The midwife was getting anxious and called for more help. I held one of Helen's legs and the second midwife held the other, high up on her chest, while the first midwife pulled with all her strength, twisting and pulling, pulling and twisting.

And still the baby would not come.

Then the midwives swapped places. The second midwife took up the position of the first, leaning back and applying all of her body weight to pull the infant out. I cringed while she twisted and yanked on the baby's neck. Already I could see that the infant was oxygen-deprived and it was bleeding from it's nose.

Finally, with one more herculean effort, the baby came free and was flopped, limp and purple on his mother's chest. 

No cries. No movement.

With glacial pace, the midwife clamped and cut the cord and moved the baby to the warmer to assess him. I stayed with Helen but kept glancing over toward the warmer where the staff were slowly hooking up oxygen and getting the neonatal mask from it's drawer. 

I wanted to scream. It was all taking too long! Each second was precious and each second they spent fiddling with a bit of tubing or trying to get a good seal on the mask was time wasted. At one point, someone drew up an immunization and injected it into the baby's limp leg.

Why?! I wanted to yell. What good will that do? Help the baby breathe!

For some time, the midwife struggled with the mask and each puff of air leaked out around the baby's lips, and his little chest didn't rise and fall.

Meanwhile, exhausted Helen had delivered the placenta and was still complaining of considerable back pain. Each time the midwife would come over to suture the record episiotomy, she would get called away. I rolled Helen onto her side and rubbed her back. When the midwife would head our way, I'd help Helen onto her back again to spare her a scolding from the tired midwife. We went on like this for a while until...

Helen lost consciousness and began bleeding uncontrollably.  

By now, there were three doctors trying to resuscitate the baby. One stepped over to access Helen and immediately started giving orders. Midwives were running for one thing or another, lines of fluid were started, and Helen was washed so that any new bleeding would be easily distinguishable. 

The doctors working with the infant wrapped him up and covered his face with his blanket. He wouldn't be saved. Now everyone turned their attention to the mother. They hung bags of blood and monitored her vitals but no one made any attempt to get her to the operating room.

"It's too late. Surgery won't help her." The attending doctor told us.

They brought Helen's husband in so that he could be with his dying wife. He sat on the floor next to her bed and with one hand, he reached up and touched her feet while repeating her name over and over through his tears. 

A man from the lab came into the ward and told us that they didn't have anymore blood for her and that the father should be typed and donate, if possible. There are inherent risks when giving blood in a third world country, yet something in me jumped up; all fear and reservation gone.

"I know my type. I'm O and I want to give!"

"Me too!!" My friend volunteered.

The three of us followed the lab tech down to be blood typed before going over to the blood bank. He pricked our fingers and squeezed our blood in dark, shiny drops onto a large plexiglass plate divided like a grid. Little pools of blood from other people were still sitting in other squares.

"You're all O. You all can give."

We followed him again out of the hospital and around to the public entrance to the blood bank. The corridor smelled like stale urine and other filth. A man and little boy wandered up. The man was wearing street clothes and chewing on the remains of a toothpick. I was beginning to wonder if I had made a wise choice.

Clearly relaxed and in no hurry, he unlocked the door to the bank and we stepped through onto mopped floors and in among neatly arranged donation supplies and records. I immediately felt relieved. Things are looking up, I thought. Let's get these donations done and the blood upstairs!

The entire donation process took at least 45 minutes and I was anxious the entire time, thinking of our patient who needed it so desperately. I watched him like a hawk as he opened up his supplies. The needles were unused and wrapped, opened just for us. He pushed a 20 gage needle into my vein with a practiced, steady hand and the blood ran into the bag hanging next to my bed. He taped the needle and moved to the next bed to repeat the process with my friend. By the time he got the husband started, I was finished and he came back around and removed the needle from my arm and tied off the tubing. 

Our blood went warm, right upstairs to our hemorrhaging mama. I've never given blood in an emergent situation such as this and I've never had it used so promptly. I was thankful that there were no further delays.

The last image I have of Helen is of her, lying unconscious, face so pale. The bright, cheerful paintings next to her bed looking rather out of place in what is otherwise such a desperate scene. We left only knowing her poor prognosis and we didn't know if our blood had made any difference.

It wasn't until yesterday, two weeks later, that I learned that she survived! She received a total of 10 units of blood and spent a week in the hospital. She didn't have a chance to grieve the death of her child amidst her own emergency. I can imagine her loss is officially sinking in now. Pray for her when you think of her. 

The other stories from this day are of the woman across the room who also hemorrhaged around the same time as Helen. This woman passed out and narrowly missed dropping her infant on the floor when a midwife reached across her chest and caught the baby by its arm. Both mother and baby are well. 

Another woman, whose baby lay transverse, was told she couldn't have a c-section. I'm not sure if this was because of unavailable staff or a free OR theatre, or for other reasons, but when I left, she was laboring hard and no one was caring for her.

It's days like this one that strengthen my resolve to get more training. When there is so much that is preventable and lives are still lost, my heart feels like it's going to explode. I'm burdened afresh for the estimated 830 women that die every day from preventable causes related to pregnancy and childbirth. That can change!  

It's a Three-Ring Circus

The adventures of my last trip to the haus sik.

It was a full ward just off of a crazy night so there were only two midwives working. All the ladies were within two or three centimeters of each other so there was lots of moaning and wailing. I have to confess, at one point I thought, "It really sounds like a dairy full of mooing cows in here!" (no rude connotations - just a reference to the sound similarities)

The first mama I worked with was considerably overweight and delivered a humongous baby girl. Not only was this mama large but she was strong. She held my hand so tight during transition contractions that she broke all the blood vessels in my thumb. Yikes! I took a picture to show you but it was far less impressive in the photo than in real life.

The head midwife (who happens to be a man) was working fast and giving out shots of muscle relaxants like they were lollipops. He was also offering me lots of great information about each thing he was doing. I could have followed him and gleaned that knowledge all day but there was lots to do so I'd pop in on his exams whenever I could. At one point, I offered to take a still-slippery infant to get a weight and as I picked him up, he squirted meconium all over my right arm. I put him down on the warmer and while cleaning him up, he squirted more meconium all over my left arm. I burst out laughing and looked at the clock, mentally counting down the minutes to my shower.

Another mama in labor with her third, was extremely clingy. I'd expect this level of leach-ism from a first-time mama but not a veteran! I worked with her for hours only stepping away for moments at a time to check on other ladies. Each time I moved to leave, she would reach out and grasp for me. When I did get away, it was a game to avoid eye contact because if she'd lock eyes with me she'd call my name until either I responded or a midwife shouted at her to be quiet. On one hand I felt like I really shouldn't leave her and on the other, I wanted to get away for a breather and there were four other mamas in transition in beds just a few feet away!

One of the times that I managed to sneak away, I visited the bed right next door because the woman was squeaking out between grunts, "The baby is coming!" She had been dismissed multiple times by the midwife being told that, "No, the baby is NOT coming and there are lots of other ladies to look after." I was beginning to sense that this may not really be the case anymore.

I poked my head in at the same time as the midwife. He studied her chart while I put on gloves, getting all ready to offer my assistance while she pushed. However, no sooner did I have my gloves on when the midwife informed me that he was going to go make a cup of tea. Pardon? Now??

Kid you not, he walked away just as she was crowning. I called for him to come back but he was already out of the ward. I grabbed a large piece of gauze and supported her perineum
while instructing her how to push and breath, just like I'd seen the midwives do. After the head was fully delivered, I held it, my fingertips supporting the neck, while I gently twisted, pulled down to free the shoulders and then up, putting the big, baby girl up onto her mama's chest.

I was holding the cord clamp and the hemostats getting ready to cut the cord when the midwife walked back up. (I was a little surprised he wasn't carrying his tea.)

"Did you catch this one?"

"Yes."

"Well done! You should be a midwife." (Those five words totally made my day...)

I stood there staring at him, gape-mouthed, while he took the clamp and hemostats from me, cut the cord and delivered the placenta. I moved out of his way and slipped out a few minutes later to check on clingy mama who now knowing that I was next door, was calling my name.

When my friend and I left to go home about an hour later, CM was still laboring on her back, making little thrashing movements and complaining an awful lot. Bag in-hand, I went over to tell her goodbye. She latched onto my arm and wouldn't let go. I explained that our ride was waiting outside. I told her that she was capable and savvy because she'd done this twice before and I prayed with her. I even waited through a couple of contractions because I thought it would just be mean to ditch her when she couldn't verbally respond to me. 

When I stood up to move away, her hand tightened on my arm. I'm not joking, after several long minutes of trying to talk her into letting me go, I pried her fingers from my arm and we hurried away! She was muttering and shaking her finger at us as we fled. 

What a day! It went by so fast and I left with bruises and covered in poop. However, I delivered another baby! What?! I love being a doula and I still have LOTS to learn but who wants to be a doula when you can actually deliver the baby?! 

Seriously considering a vocational change. 

It Ain't Always Pretty But...

I had a friend in high school who would always say, "That's pretty!" But before you could respond, he'd tack on, "Pretty ugly!" He thought it was hilarious. 

Ah, but perhaps there lies within that lame joke, an iota of truth. It was far too easy for me to romanticize the entire labor and delivery scene based on what I'd watched on T.V.. My friends could tell horror tales of their own deliveries all they wanted but they were holding the sweetest, cutest, most delicious smelling baby in their arms. How bad could it be?! 

Oh and, there's serving as a missionary in a third world country. Boy, has that been blown WAY out of proportion and glorified juuuuuuuuuust a little bit. Bleh.

Well here's me telling you that it can be "pretty ugly!" 

This may not be necessary and it's certainly not helpful but I feel the need to unburden myself and share some of the ugly things I've encountered while working in the ward. Buckle up and bear with me because there's a point to all of this.

I hope you're not eating your breakfast because here it is. Poop. Wow. Sorry, but it needed to be said. Until I started working in the ward, I didn't realize just in what terrific quantity it would be in. It really is astounding.

Word to the wise: Don't swing a bed pan like you're out for a Sunday stroll. You'll splatter an innocent bystander with your pee. Just sayin'. Once upon a time, I was that bystander.  

Last weekend, I was filling a cup of water from a cloudy trickle in the "tea room" when a giant, GIANT rat jumped up from where he had been hiding in with the cups. I mean, this guy was the stuff nightmares are made of. (I could pause here to discuss just how revolting it was that he had been hiding in with the dishes but that would take too much time.)

I stifled a scream. 

He looked at me and then ran into a huge hole in the wall right next to the sink I was using and there he stayed with his big, nasty tail still hanging out like he was mocking me. 

I've had amniotic fluid run off the bed and down the front of my clothes. That was startling.

Frequently, there is no water in the ward which means no flushing toilet - the one toilet that is shared by all the staff. I leave your imagination to paint that picture for you.

I've seen some very advanced cases of STD's and tuberculosis. 

I've stepped in all manner of bodily fluids and tracked them throughout the ward. What's crazy is that all the mamas are barefoot and walking in all of that too.

I'm sure I don't need to tell you about the blood but I'm not exaggerating when I tell you that there's blood on EVERY surface in the ward. There's blood on the ceiling. I have no clue how it got there. And there's usually some freaky looking blood clots in the bathroom that all the mamas share.

There are huge holes in the walls where cockroaches come and go at their leisure.

I cannot lie to you and tell you that I am unaffected by these things. Thankfully, I'm blessed with an unsympathetic gag reflex but even the steely-stomached can't come away unscathed. 

I will close with this. It is possible to see, smell, talk about (in this context alone) and potentially touch all of the afore-mentioned things and still be a classy lady. And these mamas need such a lady to be willing to see, smell and potentially touch these things so that they can focus during that difficult contraction, feel that they are capable of such hard work, and believe that they are valued and worth the support and encouragement. It has been a pleasure observing such women at work around me.

Frankly, there are needs like this all over the world though. There are people in the yuckiest and most inconvenient places that need someone who is willing to look past it all and see them.

So put on your gloves, your face shield, your galoshes, your hazmat suit - whatever - and get out there! I guarantee that in your efforts to be a blessing, your heart will be humbled and you'll end up having your socks blessed clean off!

  

Even Chuck Norris Would Be Impressed!

I went to the ward alone this past weekend. I normally go with one other but no one was available so I decided to brave the adventures el numero uno. Being that I live in a third world country and don't have a drivers license (nor do I want one), I had to find someone to give me a ride into town. If I could digress a moment and mention that Western culture stresses independence so strongly - the importance of a person to know themselves and act as an individual. Well I'll tell you what, I used some of that independence to get here but then lost a lot when I moved into this fenced-in compound. All that to say, it's ALWAYS nice to get out!

I participated in three labors during my 8 hours in the ward. I think that sweet moment of delivery is the best part and because I was the lone doula, I got to move from one best part to the next without feeling like I was hogging all the fun! 

All three babies were strong, healthy boys and the first two were delivered after beautiful labors. The third looked a little bit different... Through most of this mama's labor, she was like a focused athlete and was in this terrific rhythm with her breathing and her swaying with each contraction. I watched in awe as she performed instinctively with little to no help from me! She'd close her eyes, moan in low tones and refuse to even sit down. Her exhaustion was starting to catch up with her because more than once her legs buckled and I had to catch her.

And then came transition. Imagine the growl of a grizzly bear crossed with the war cry of Attila the Hun. Yup. The transformation was startling but mama had shown such focus and endurance, I figured we were good. I think, as it happens with lots of ladies, she became overwhelmed by the speed and intensity of her contractions and then she lost it. She began throwing her arms in the air and groping around for some invisible something, perhaps to draw her focus. Problem was, she had her eyes closed so each time she flung her arms, I had to duck and dodge out of the way! Sometimes I would put myself in the way and let her find me with her arms hoping that she would hold onto me because remember, she's been standing for hours now and is literally teetering. She would accept my help half of the time but if I moved, even just to get her water or go to the other side of the bed, she would open her eyes and clutch at my arm.   

Whelp, then mama squatted and peed on the floor right by her bed and in her weak attempt to stand, she slipped in it and I caught her... The adventures went on and on. When the midwife came to check on her she had already been pushing for a bit. We got her up on the bed and again, I moved a little, trying to stay out from under foot but mama found the soft (too soft) part of my upper arm and worked it over like she was making meat loaf. It was all I could do not to cry out - it hurt so bad!

She eventually delivered but with a LOT of coaching from midwives and me. She seemed to lose the will to have her baby naturally and kept asking for a c-section so her pushing was half-hearted and not very productive.

All of us were exhausted when it was all over. Two things I learned from this day: First, labor is unpredictable, as are the women I work with. What starts out as a beautiful example of physiology and mental will-power working in unison can quickly turn south so be prepared to change your game plan and figure out what works. Sometimes, you don't get to DO anything but be present and available. AND second... Pay for the darn gym membership. Work on those muscles because you're going to need them.

  

Spit Out Your Gum and Don't be a Creeper!

A little nugget of wisdom... Don't chew gum and work with a mama at the same time. Unless you are extremely sanguine and relaxed. I popped a piece in one day and unbeknownst to me, I was chewing that stuff within an inch of its life. I'm surprised it didn't just disintegrate in my mouth! With each contraction, I chomped harder and faster until hours later, my jaw was crying for mercy. There are other means of obtaining minty-fresh breath. Just saying.

On another note, my doula friend is leaving me for another region. I'm sad. Don't get me wrong. I'm so excited for her and her family and where the Lord is leading them but my selfish side is just sad. She has been a tremendous encouragement to me as I've stepped out into the unknown and very unusual realm of labor and delivery. She has taught me so many valuable doula skills and opened the door for experience that I would never have gotten anywhere else and some really special relationships with the national staff at the hospital. But above all, she's taught me this tangible love of another and has demonstrated such grace and gentleness. 

Last week we were bent over in tears, laughing so hard at our awkwardness the last time we were in the ward together. A mama in transition was demonstrating none (and I mean NONE) of the usual signs of this very physically-taxing change in labor. She was up, walking, sipping on water and smiling like she'd just been told she'd scored the prize-winning hog. It was confusing for my friend and I who had been checking on her and monitoring her dilation all the way up to 10 cm. She had been quiet through the entire process and we praised her composure but now... Don't you wanna push mama? 

There were no other laboring women in the ward at the time and in our eagerness to see this thing through to the sweet end, we hovered. Yes. We were helicopter doulas and if this lady made the slightest sound or movement, we were there, offering water, a little massage or a word of encouragement. It was all well and good until she got up to go to the bathroom and we followed her. All you listening out there - if a woman is stable on her feet, shows no signs of pushing and for crying out loud, is smiling (!), let her have a minute alone to pee! 

My friend and I visited while we waited for her but little did we realize, we had followed her right up to the bathroom door and were blocking the poor lady's exit from the bathroom. When she opened the door, we had to move so she could get around us! But, as before, she was smiling and acting like delivering a baby was her usual Saturday activity. Bless her heart.

After that awkwardness, we backed off. I can't imagine that it makes a mama feel at ease when the doulas are acting like groupies. 

In the end, we needed to leave and she still hadn't delivered but I am confident that she did just fine without us. In fact, she was probably glad to have a little breathing room.

  
  

The Miracle of Life!

I'd like to start with a shout out for the abdominal lift-pelvic tuck! A mama I worked with wasn't progressing very well and was getting really frustrated and vocal. The out-of-control kind of vocal. She was up and down off the bed which was wonderful so the next time she stood, I explained what I wanted her to do and tried to show her. She was so miserable and my explanation wasn't helping her understand. She also wasn't too keen on me pausing in the back rubbing to explain anything so the next time she contracted, I stood beside her, lifted her belly with my right arm and rubbed her back with my left. Because of my lifting, she naturally tilted her pelvis forward. It was great! We did this through two contractions. I can't imagine how awkward we looked. The pictures in books and online, show this gentle, supportive maneuver that generally doesn't involve any struggle or grunting from the doula. Oh well. I'm pretty convinced the abdominal lift is what kicked this mama's labor forward. She delivered an hour and a half later. Woop woop! 

I have never cried at a birth...until now. I've been wide-eyed or worried and of course, ALWAYS happy when each mama delivers and it truly is beautiful. Those who mock (generally guys) and mimic in a silly high voice about birth being "the miracle of life" have clearly missed something in their experiences with it, or have just missed out all together. It IS a miracle!

The other day, I was vigorously rubbing a mama's back and providing lots of counter-pressure. I was also giving LOTS of hip squeezes per her request. I'm telling you all of this to point out that I was pooped. My arms and back were protesting, along with my bladder. With promises to come back as fast as I could, I dashed away to the bathroom.

When I returned, I found her husband had sneaked in through the curtain on the side of the bed where he wouldn't be observed by any nurses or midwives and he was rubbing her back!! I gave him two thumbs up and promised not to give him away! 

Some minutes later, mama called for me. Maybe all those years of farm labor (don't laugh mom) have paid off because she wanted my firm massage. Her husband whispered very sweetly, "Good luck!" and sneaked back the way he came.

Some minutes after that, mama wanted to stand but was feeling dizzy so she put both arms around my neck, laid her head on my chest and hung with me supporting her. It is such a privilege to have a mama put her trust in me to hold her so closely during a time that she will never forget, like the birth of her child. Which is why it was so beautiful when she asked me to get her husband to come hold her in the same way. Again, I told no one and he held his wife while she moved into transition.

When it came time for her to push, he was kicked out and I took to her side again. When their daughter was born and bellowed out that lusty cry of a healthy baby, I peeked through the curtain and there was that great big man, sitting on a bench a few yards away, just crying like a fool. 

Mama let me carry their daughter out for him to see. I laid her in his arms and he just stared and sniffed and wiped the tears away and in a low voice whispered, "We were praying for a girl."

This is when I walked away and started crying. It was absolutely beautiful. I haven't seen anything quite like that here. The culture dictates that women who come to the haus sik labor almost alone and most husbands don't seem to take a tender interest in their wives. This was the exception and I was so pleased to step aside and let the husband comfort the wife. It was as it should be. 

Later on I headed over to check on mama and new baby and got more of their story. This was their first child. Due to medical issues, they weren't sure she would be able to carry to term. When they found out she was pregnant, they began praying for a girl (also counter-cultural) and so when she delivered a healthy baby and a girl nonetheless, they were over the moon. 

The couple insisted I take their phone number (oh alright, twist my arm) and I am excited to call them for a visit soon! Oh I love this work.    

   

God's Providence

I couldn't wait to get to the ward this past weekend. I had been looking forward to going for days so when I walked down the hall towards labor and delivery and heard the familiar sounds of advanced labor, I was excited! Sweet babies! New mamas! A satisfying day filled with back rubs and the bestowing of courage! Perhaps a little too cheerful? 

There were two mamas pushing and doing a very good job. I immediately moved to one bed, that of an HIV positive woman, and introduced myself. Within minutes she said, "I can feel the head!" I took a little peek and sure enough, something was happening! Her membranes were still intact and her baby was crowning still in it's sack! 

The baby's head was born before I could get a nurse's attention so I very awkwardly supported it with one hand and encouraged the mama to slow down and breathe in little puffs. 

The nurse barely had her gloves on when, out came that sweetie, water bag and all! What a gift from God that she was protected from her mama's disease! 

I never want to step on toes, damage the relationship I have with the nurses and midwives or just royally screw something up so I stick solely to my doula job. Thus, I watched for what felt like an eternity while the nurse just looked at the baby lying on the bed! I think she was hesitant to touch it as it was from a woman with HIV. 

I'm sure it was only seconds later, she scooped that baby up by one leg and laid her across her mama's chest. It was only then that I noticed the amniotic fluid pooling on the plastic mattress and dripping down my leg and the front of my blouse. Awesome. And we're only 30 minutes into the day!

The ward was quiet - unusually so and it afforded my friend and I the opportunity to team up and work with another woman for the rest of the afternoon. 

She dilated fully and then rolled over for a nap! After a long rest, she squatted, with the help of my rebozo tied to the bed frame. After much pushing and a lot of encouragement, she delivered a tiny, lifeless baby. And my heart leaped into the back of my throat. 

The baby boy was so small and so white. The nurse took him to the warmer and began CPR. She was struggling to get a tight seal with the ambu bag and wasn't getting good breaths in the infant. A midwife came and started to hook up a nasal cannula but found the oxygen tank was empty. I wanted to scream as I watched all of this take place in what felt like slow motion.

At the time, I wasn't giving these two ladies enough credit (and I can imagine they would've preferred I wasn't watching). They've seen it all and they've dealt with it all. After this weekend, I have a great deal more respect for these tough women!

They worked together and a long 20-some minutes later, color was returning to the hands and arms of the baby and he let out a little cry - the sweetest sound on earth. After some more time and oxygen, while not out of the woods, he was breathing more steadily and looking quite nice and pink.

As we were leaving to go home, I marveled at God's providence. He protected a baby girl by allowing her to be born inside her bag of waters and He kept the ward quiet so that we could pour all of our attention on a first-time mama and the nurses could pour all of their energy and knowledge into a tiny, baby boy.  

It was a good day.  

Business As Usual

It was a GREAT day in the ward last weekend. Several students were working with their instructors, the doctors were making their rounds and my friend and I were supporting in a full ward so it was crowded! Here's a list of several surprising things that took place:

~ My first task of the morning was to dry up a chair-full of rain water that had leaked from the ceiling. As soon as I was finished, a woman, very relieved and great-with-child, rushed over and sat down.

~My friend and I found two ladies laboring in a back hallway as there were no open beds.

~There was a power outage in the middle of the day. It didn't cause any problems and almost everyone seemed not to notice.

~There were no gloves to be found right as a mama was crowning so I took off my left hand glove and gave it to a student - a glaring reminder of the lack of general "conveniences" that we enjoy in the States.

~A midwife put on a family planning video for the mamas who were waiting for beds. The video dramatizes a village woman dying from a complicated labor. It's pretty depressing and the LAST thing I'd want to see right before or after delivering my own child.

~It was a pleasure observing and talking with the students. They were so gentle and calm and seemed to have genuine hearts toward the mamas. I think their presence added a peaceful element to the ward rather than a chaotic one.

~Towards the end of the day, a midwife turned on her favorite music for all the ward to hear. What was it, you ask? Why bluegrass and country, of course! It was a strange sensation to be in a place so far from home and hear the familiar. It made me homesick.

~I spent hours squatting next to a mama in a space no bigger that 3 ft. wide. Only second to the birth of a healthy baby, that type of support is the most rewarding to me. I want to be right down next to them, in the midst of their pain and fear, speaking truth and comfort and massaging aching muscles.

~I am proud to report that I recognized and followed the changes in stages in one mama's labor. The looks, the sounds and the postures were accurate to what I've been learning outside the ward. So exciting to apply my new knowledge practically!  

~I have another namesake! It is such a pleasure and so fulfilling to walk through labor with these women. I love this work!

Beginnings!

Where to begin... I’m new to this - new to it in every sense of the word. Until a month ago, I had never provided labor support to any human (cats and goats certainly don’t count) and being unmarried with no children, I have never experienced labor in all its particulars. As you can imagine, witnessing delivery for the first time was amazing…and eye opening. But I’ll get into that later.

I live in a third world country far from the comforts of sleep number beds and Starbucks or consistent water and power for that matter. My training and background work is medical but not in the realm of labor and delivery. Over two months ago, a dear friend of mine opened my eyes to the difficulty women here have when delivering their babies. Infant mortality rates are through the roof and mother mortality rates aren't pretty either. The records for this country don't take into account the deaths happening in the bush so I'll just tell you the broader picture. Every day worldwide, 32 thousand children under the age of five die. Every day, 800 women die from pregnancy and childbirth. Here, hospital care is meager and cleanliness standards are appalling. In our labor and delivery ward, there is one toilet for all the women. A couple of buckets are used between them all for pre-delivery “bathing” and the ward sports a whopping two (count them – two!) pillows that get moved around between the seven beds.

Not only is the environment rough, these ladies labor almost entirely alone! Family members aren't allowed to come into the ward with them. They are checked in by a nurse or midwife, given a bed and then left to themselves. A nurse or midwife is suppose to come around every 4 hours to check their progress but if the ward is busy or they are short staffed, that can drag out much longer. Only when a mama is ready to push (and I mean seriously you-can-see-the-baby’s-head push) does a nurse or midwife stay with them to catch the baby.

To be in excruciating pain, afraid and exhausted, without the support of a husband or mother or sister must be so incredibly lonely.

This is where my friend comes in. She has been providing doula support to these ladies for some months now but there are more than she can care for alone so she has trained me and one other to accompany her! I'm not paid for this special job but I've gotten to witness God's faithfulness again and again and that is abundant compensation for all the hard work.

I look forward to using this space to tell of my adventures, the heartache and the Father’s provision as I support and love on these special mamas.