Return of the Doula (sans Obi-Wan Kenobi)

How's that for a cheesy title! And how nerdy is it that it keeps cracking me up?? Oh dear.

After a near two-month absence because of a long strike at the hospital, I returned to the ward this month, anxious to be with the mamas again. In fact, I was so excited that I dreamt about babies all the night before! I am happy to report that I have seen nine deliveries this month already and have held more sweet babies than I can count. Hooray for new life!

Side Note: All the details of the strike are fuzzy but money was misappropriated, vital needs weren't being met, people were laid off and after promises of soon-to-come supplies, the staff returned to their work. Today was further proof of the horrible conditions when a missionary from another organization popped into our little mission clinic asking for a feeding tube. When we asked why, she explained that a friend is a patient at the hospital and is so sick, he can't eat. The staff there pulled the existing tube before they realized that they didn't have another to put in. Folks, tell me, what do we have to complain about?! Seriously.

On my first day back, I was visiting with a midwife when I learned that she had been sick during the strike. Aint' no big thing. Just typhoid. Wait...what?! She brushed it off like it were the common cold. Some days I think, "Where am I??"

That same day, a sweet woman was referred to our ward from a local clinic. After a failed augmentation two days prior and an attempted vacuum extraction the day before, she still hadn't delivered despite being 10cm dilated! Yikes. The midwives augmented her again in preparation to vacuum extract again. Poor woman. When they thought she was adequately "juiced", the midwife produced a contraption that I hadn't seen before. It was a power-free extractor made of plastic and something from slightly less frightening nightmares than the metal cup and chain I've referred to before. I was intrigued. The midwife gave it to me to hold while she gloved up which afforded me an opportunity to check it out. My friend and I couldn't resist the urge to snap a quick picture, although it felt like a lie because I wasn't going to get to use it - fortunate for the mother, I'm sure! When the cup was in position, the midwife pumped up the pressure with her hand, watching a small gauge on the back of the extractor. 

And then she pulled. And pulled. And pulled.

I was beginning to think the baby was going to be stuck permanently when slowly, inside the clear plastic cup, I began to see the dark hair of our little one. After much more tugging, me mopping the brow of our champion midwife and an increased drip of pitocin, the baby came. Not in the usual burst as shoulders break free, but in a struggle of pushing and pulling, right up to the end. Hear me: BIG BABY.

He was huge and he wasn't breathing. Out with him came the thickest meconium I have ever seen and lots and lots of blood. The midwife rushed him to the warmer as the pediatric resident came wandering in. He moved slowly to get oxygen (a second tank when he realized the first was empty) and suction before the midwife jumped in and took over. I stood back and watched in awe. She ran the whole show, instructing the resident and other midwives how to care for her patients. She was remarkable. Later, we praised her quick thinking and knowledgable work and in modestly she brushed it off with quiet thank you's and a laugh.

Around the time that the baby was beginning to perk up, the mama started to hemorrhage. The midwife worked quickly, instructing me to find the pitocin tablets in her pocket. I felt like I was moving in slow motion - finally getting my hands on the foil packet and popping out three tablets which the midwife quickly pushed into the rectum of the bleeding mother. It worked like a charm and controlled her hemorrhage enough that the midwife relaxed a little and could turn her attention back to the baby. 

In surprisingly little time, our boy pinked up and cried loudly. A conspicuous hat was pushed over his terrific cone head and he was promptly given to his mama to nurse.  The exhausted mother looked at me and asked, "Do you have a master?" I'd never heard the question phrased this way before. I replied that I am unmarried. So the baby was given the name of my friend's husband! This was followed by lots of pictures and sweet conversation.

At the end of the day, it's hard to walk away from such scenes - the mama and baby, safe and doing what comes so naturally. I have run into one of these mamas outside of the hospital only once. And one sent me an e-mail (Can you believe it?!) and a picture of her 6-month old that I had helped welcome into the world. But the rest are never seen or heard from again and I wonder what becomes of them. 

Most babies aren't named until several days after their birth but following the tradition of a doula friend who used to work with me, I name the sickest babies, just to give them some kind of identity should they not survive. I don't tell anyone. I just use their name in prayer. And of course, I don't know whether or not they live but when I walk out of the ward at the the end of the day, baby {blank} is still breathing. 

The ward never fails to surprise me and I'm so thankful to be back in the swing of things. 

Joy to the World!

Christmas has come and gone just as quick as you can sing the merry words in a carol. The season was hot and muggy and the sounds of sleigh bells were replaced by the crooning of frogs and the buzz of crickets. Throw in a few crazy, tropical bird sounds and I felt as far away from wintery Colorado as I could possibly be. It was okay though. Last Christmas was horribly depressing as it was my first away from family, but this year was different. I've been taken in by a family who loves me as one of their own and I them. To be with these dear ones though the holidays was like a balm on my homesick heart. 

I managed to sneak into the ward one last time before Christmas. Things were relatively quiet and despite the gloomy surroundings, the mood of the staff was decidedly cheery and festive! A couple of weeks prior, I burned two CDs of Christmas music for one of the midwives. I agonized over which music to give her; not wanting to offend with my Michael Buble or bore with my instrumental. It was ridiculous how much mental energy was wasted on this train of thought. In the end, I chose a smattering of songs and Joyce seemed very happy with it. 

On this last visit before the end of the year, I was witness to two births! Both deliveries ended with the entrance of a healthy baby, thank goodness.

The day started with a woman bleeding all over the floor in the outside hallway. I went out to mop it up but forgot that the ringer on the bucket was broken. I bent down and began wringing rusty-brown water from the stringy mop. In the immense focus (and physical strength) it took to accomplish such a task, I splashed a bunch of the nasty water all over my legs. I mopped up some blood and plunged the mop back into the bucket for a "rinse" and again, I attempted to wring the mop by hand, again, splashing bloody water all over my legs. There was a crowd of ladies watching. I kept looking up and commenting on the amount of blood or nonchalantly trying to reassure them about my mopping abilities. Now I was embarrassed so I rushed to finish. I'm no wimp but I am certainly not sporting muscles from daily gardening, climbing mountains and hauling children everywhere. I can only imagine what they said after I left... Ha!

In true character of the ward, it wouldn't be right to end the year without some drama! One mama hemorrhaged and against the midwife's instructions, she tried to stand and walk to the bathroom. She passed out, dropping her cup of milo on the way down. I heard the crash and ran to check on her. I found her lying in a puddle of chocolate malt, broken glass and blood. Even more startling, as she fell, she grabbed the bassinet where her baby lay, pulling it down with her. When I got there, the mother was still clutching the baby's bed and the baby was about to fall out! We got both picked up and back in bed. Neither came to harm and I spent the next little while mopping up milo. By now, I had mastered a way around having to actually touch the mop with my hands. *high-five for me*

The other delivery was a third or fourth baby to a practiced laborer. She had a very difficult second stage and became really cranky and belligerent at the end. And who can blame her? I can't count the number of women who have yelled, "Just get it out of me!" Despite vacuum extraction, she delivered a healthy, chubby baby and she didn't even tear. Yes. I'll say it again in case you missed it. Vacuum extraction. No tearing. 

2014 was a wild year of adventure. It also had its fair share of heartaches which were then always completely overshadowed by glorious grace. I am reminded of the innumerable times that I felt I would positively burst from gratitude and that soul-deep joy over being shown the character of my Jehovah God, knowing what He accomplished through the cross and feeling so fulfilled when loving on those mamas and their babies. I think God's own words can best describe this.

"Praise be to the God and Father of our Lord Jesus Christ! In His great mercy He has given us new birth into a living hope through the resurrection of Jesus Christ from the dead, and into an inheritance that can never perish, spoil or fade. This inheritance is kept in heaven for you, who through faith are shielded by God's power until the coming of the salvation that is ready to be revealed in the last time. In all this you greatly rejoice, though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that your faith - of greater worth than gold, which perishes even though refined by fire - may be proved genuine and may result in praise, glory and honor when Jesus Christ is revealed. Though you have not seen Him, you love Him; and even though you do not see Him now, you believe in Him and are filled with an inexpressible and glorious joy, for you are receiving the end result of your faith, the salvation of your souls."                               I Peter 2:3-9

A happiest of New Years to you. May you better understand the all-sufficient love of Christ and what a gift it is to know Him! 

Baby by Vacuum?

Two words: Vacuum Extractor. Sound scary? Well it is. At least I think so. 

I had heard about this contraption and had even seen it sitting on its shiny metal cart, tucked away against the wall just waiting for its next victim. But I had never seen it in use...until this weekend.

Just the word "extract" sounds unnatural and painful - like what happens at the dentist when you have to get a tooth pulled. Or the machine in the Princess Bride that sucks the life out of people.

Well it is unnatural and it's the method by which the doctor "extracts" a baby who is stuck (for lack of a better word). I had visions of horrific events that precipitated the vacuum extractor's use and my overly active imagination was checked because I got to witness this first-hand just the other day and it wasn't the torture I had anticipated.

The mama in question had fully dilated but didn't have the urge to push. The baby's heart rate was climbing and it was in distress. The one doctor who was currently in the hospital and qualified to perform the extraction was finishing a C-section and wasn't available right away. 

Welp, that leaves one, very uncomfortable and increasingly more fearful mama and myself, the new doula, trying to keep mama at peace and somewhat comfortable while attempting to track what's happening as hospital staff communicate at warp speed in a foreign language.

Eventually the doctor arrived clad in rubber rain boots and a giant rubber apron. He opened a sterile tray and pulled out a metal cup-shaped device, about 3 inches across, with a little chain attached. Honestly, my first thought was, "Oh that looks like the thing that expresso grounds are packed into when you make those fancy lattes!" Leave it to me to be thinking about coffee at a time like that.

The doc put some cream into the metal cup, I assume to create a vacuum, and then put it up inside the mama and right onto the the baby's vertex. Then they plugged the contraption in, turned the suction on and told mama to push with her next contraction, whether she felt the urge or not. 

What was interesting (and hurt just to watch) was when the doctor put a pair of hemostats through the chain and pulled! *insert shudder*  Between the vacuum suction, the doctor pulling and the mama's contractions, out came a huge baby girl! 

This was a 41-week, first baby, born to a petite woman via vacuum extractor so she tore horribly and it took the nurse over an hour to get her stitched up. 

On the bright side, the baby was healthy and the mama was trying to hobble out to see family shortly thereafter. Have I mentioned how resilient these women are? 

So, thus ends my first experience with The Extractor. However unusual and painful it was, it turned out to be far less dramatic than my imagination had made it out to be. 

So glad. So very glad.