By Jennifer Gallardo
The generator hums loudly as the song of three women in labor rises and falls over the sound. Two women lay in the postpartum room, nursing their babes. One girl, one boy. In between taking heart tones and labor sitting, I complete their birth certificates with their little feet imprinted in ink on the shiny paper. I fill each line carefully with flowing calligraphy, as the parents spell out their names. In Haiti I am told it is customary to only put the mother's name on the certificate. I ask the papa's for their name and they proudly spell it for me. Every baby needs a papa too.
One of the mommas in the dark reception area sounds like she is pushing. I bring her into the birth room and prepare a space for her on the bed. I place a birth stool by the bed. She lays on her back on the bed and I check her: 7 cm. I explain to her in my broken Creole that she can get in any position she wants: standing, kneeling, hands and knees on the bed, sitting on the birth stool. She stands up right away and then kneels on the floor with her head and arms on the bed. I call her husband, Jorgie, into the room and tell him to rub her back. He is surprised to be invited in but looks pleased. I look at her chart and see that she lives in Cavier, the hillside slums I visited yesterday. I also see she is a primp so we may have a bit of a wait before baby is here.
Another momma in a bright pink dress walks the hall and wails loudly. I look at her chart. She has not been checked for over four hours. When I invite her into the birth room to be checked and choose a bed, Jorgie steps out without being asked. This momma is 8 cm. Second baby. She chooses a bed as well.
I sit on a plastic porch chair in the birth room waiting, grateful for the fan that blows gently on me. A large green praying mantis sits on the edge of the table and is interested in my bright blue shirt. He looks like a leaf and slowly walks towards me.
My thoughts turn to Cavier again. It has weighed heavy on me today. I think of how there is no water, except for that which is taken in buckets up the mountain. I think of the cramped one bedroom shacks that line the mountainside; dirt floors, no electric, no water, no toilets. I remember the homes so small that all that fit is a bed and a chair. I think of the steep narrow dirt trails that criss cross the mountain side from house to house. I try to imagine navigating those trails in labor, or even worse, in an emergency.
I see the MamaBaby Birth Center with new eyes. No longer do I notice the unfinished trim on the doors, walls that could use new paint, rickety wooden beds I bought seven years ago, and the loud generator because we need more solar panel batteries. Instead I see one of the moms in labor get fresh cold water from the cooler. Another mom walks to the toilet. Moms lay on clean sheets in their chosen beds. They pace and walk on tile floors that were mopped twice today. The generator provides us with light in each room. Midwives help and keep mom and baby safe. Clean and sterilized instruments to cut baby's cord await neatly in packs. In the corner medication and oxygen are available if needed.
I am happy to see the primip Momma walk out to be with her husband, Jorgie. He sits and watches her pace back and forth in the main hall.
The momma in a white dress walks into the birth room of her own accord.
All three mommas rock and moan in the birth room. Our student midwife sits with a mom and rocks with her. The men wait outside in the main hallway. The mom in the white dress sits on the birth stool but she has no bed. We are in need of more beds and the third bed in the birth room was moved upstairs to be fixed. There is a bed in the main hallway, the momma's favorite place to sit as the only other choice are hard wooden benches without backs. During the day up to six moms will sit together on the bed, waiting for their appointment. Then the benches crowd up after the bed.
I think that the momma in white might give birth before anyone else, as this is her third baby. She was four centimeters a couple hours ago. I ask the men to bring the bed in. They do and no sooner do they set it down then the momma starts to push. I rip off the sheets and put new sheets on, a large cloth water proof pad, and a chux pad. I feel grateful for Jill, our volunteer supply manager, as I remember too well the times I would come to Haiti and only be allowed to use one pad per woman. There is a good supply now.
A baby boy is born gently and placed on momma's belly. The cord pulses until the placenta is born, then is cut. Momma is prepared to go to the postpartum room, leaving two moms laboring in the birth room.
The lights flicker and the room goes dark for a moment. We are grateful when they turn on again. The generator turns off. City lights are on again.
Another baby joins us earthside from the momma who is a primip that lives in Cavier. She has a beautiful large baby girl and she needs a few stitches. Baby's papa waits outside the door, as the momma in pink is still in labor in the birth room, pacing and moaning.
The last momma labors into the wee hours of the morning until my head nods off while I sit listening to the roosters crow.
I head to bed and as I lay there sleepily with heavy eyes I hear the familiar knock on the gate. Rap rap rap with a rock. Another mom in labor. Maybe I am dreaming. I fall asleep and wake up to two more babies born safely into the midwives hands and the waiting room filling with moms and babies to be seen today. Good morning MamaBaby.