Second Day in the Birth Room

By Jennifer Gallardo 

I wake up at 7:30am to the sound of two women in labor. The babies are born before I can make it to the birth room.

At 8:30 am the women start singing with Ginny. I go down and videotape a bit of their singing. So beautiful and touching that they start their clinic day like this every morning. They are singing, “How Great Thou Art” in Kreyol

A second momma labors throughout the day with much wailing. We hear her laboring sounds the entire day. She comes in at 5:30 am at 5 cm and by 6pm she is 8 cm and Rose Edith is preparing to transport her. She does not want to go and the baby heart tones sound great and all moms vitals are normal. I ask Rose Edith if she is willing to wait a while longer. She reluctantly agrees. They are used to small babies here that come out quickly. This small mom had a lot of amniotic fluid, her baby appears large. I stay in the birth room and massage the momma with clary sage and coconut oil. At 8pm the momma is 9 cm… with cervix from 9 to 3 0’clock. I think that is good progress. I imagine this mom may need coaching and pushing on the birth stool. She flails about and wails that she is dying. Carmel, our midwife, shines. She loves on the momma… holding her, rocking her, singing to her. The momma joins in the prayer song at times. At 10:pm Rose Edith says it is time to transport. I ask if we can check the mother again but Rose says no, because she will get an infection as we have checked too much. The mother of the mother, the grandmother to the unborn baby, has joined in on the wailing. This is not my turf. I need to show respect to Rose Edith, our head midwife, so I bow out of the picture. I cannot even speak the language that I need to communicate what I want. My choice would have been to put the momma on a birth stool and do coached pushing, but when I mentioned that to Rose she said she will not tell a mom to push, that a mom must push on her own and have an urge to push. OK, I say. Transport. I smile and hug Rose Edith and tell her she is a good midwife. They call Claudin so that he can take them to the hospital.

The generator turns off suddenly and headlamps and flashlights come out.

Another baby is about to be born, and the students look confused because the mom is on hands and knees. I glove up and step over to be ready to help, and to protect the baby from unnecessary head traction. :) Indeed the students are a bit confused with everything upside down. The head comes out and the student starts to bulb and I say, “no”, then she puts her hand hesitantly on the head and starts to pull, but she doesn’t know which way to pull. I gently move her hand away again and say, “Normal, normal, patience, patience”. Her hands hover and mine do too as we wait a full minute for the next contraction. She is nervous about the wait. The shoulders start to emerge and she begins to pull the baby towards her. I guide her hands to push the baby towards the mothers belly. I am in a better position (to the side of the momma) to grab the baby, so I do, though for a moment it was a tug of war with the student wanting to bring baby to the back of the mom, and me trying to tell her to push the baby to the front of the mom. Baby looks a bit shocky and is slippery and covered in lots of fluid and birth juice. I keep getting handed a bulb syringe and I keep asking for a baby blanket to wipe the face. I finally am handed a baby blanket and can dry baby’s face and stimulate him, and he takes a lusty cry at about 30 seconds after the birth.

The lights have come back on as they refilled the generator with gas. I finally have a chance to look around the room and notice the empty bed from the mom that transported. Just like that. Whisked away in the dark. I wonder what they will do at the hospital and if she will push her baby out or require a cesarean. Concerned that I may have offended someone by taking over their hands and knees birth, I hug the students and tell them “bon travay”. I kiss the mom on the cheek and tell her “bon travay”. When Claudin returns from the hospital I ask him to translate for me and I call Rose Edith and the student to meet. I ask if I offended anyone today and apologize for taking over the hands and knees birth. The student says she appreciates me helping as she had never done a birth on hands and knees, and now she will remember next time that no head traction is needed and which way to catch the baby. Rose Edith gives me a hug and says she is not offended. Phew! A delicate balance between teaching and learning, supporting and sharing knowledge.

I sit here and type this and it is past midnight and the generator is back on and rattles so noisily that I can barely hear myself think. Soon we will have solar panels!

 

I notice so many needs MamaBaby has. The beds need some TLC. The walls could use paint. The whole place could use a deep clean. We need some more furniture. The ambulance needs a little work. I envision a couple years from now, being on our own land, having more than one bathroom for the midwives and staff, having gardens and more space. I reel myself back in. Gratitude for what we currently have. Solar panels being put in. A building to serve women, with running water, a clean bed, and skilled midwives. Very skilled midwives. I am in awe of these women, both the midwives and the pregnant women they serve.