A moment of peace at the clinic

Whoa...I feel like I just got run over by a truck! The past 3 days have been a whirlwind. Actually, there were two days where we did 9 births in 48 hours. I am now up to 34 births here at the clinic. On day three, I crashed, coming down with a cold that everyone at the clinic seems to be passing around. So, just to give you an idea...it was a slow day of rest for me yesterday...so I only attended two births:) We started out with an interesting VBAC (vaginal birth after cesarean) which I think I mentioned previously. The local midwives wanted to send her to the hospital because she kept saying, "I am not strong." More importantly, her husband kept saying, "She is not strong." She was four centimeters at the time. I encouraged them, supported them and explained that if they went to the hospital they would still have to labor because cesareans are only done in the morning here, unless the clinic calls in their special doctor who will do them on call. But even he lives over an hour away in the mountains and because it wasn't an emergency, it was unlikely we could get him out of bed! So I ran a warm bath with some nice essential oils and called Mandi, a Canadian student midwife for some extra help. Ibu Ayu quickly went to 8 centimeters and then to 10 in a couple more hours. I was thrilled! But pushing was a different story! It was really tough for her. We asked if we could take pictures of her because of her cesarean scar. I hope you can see in these pictures how intense the scar is. In the US I can't do a VBAC with a woman who has a midline vertical scar like this. After 1.5 hours of pushing she gave birth to a little peanut of a baby. After assessment, he was most likely only 36 weeks, a month shy of term. As I mentioned earlier, due dates are so inaccurate here...very frustrating because we really don't know what we will get at a birth. This was evident when he was born because he did not breathe and his size was very small! When he did begin to breathe, after resuscitation we could see his chest retracting, another sign of underdeveloped lungs. He could have had a developmental disorder of some kind, but we will never know. We suctioned a lot of meconium stained water from his trachea because he wasn't able to cough or clear it himself. After getting an airway we used the bag valve mask but to no avail...time for mouth to mouth. I was the lucky one to do mouth to mouth on this little guy and I am telling you I will never be the same. The beauty of it was...It Worked! I was so happy!!! The baby is doing really well, nursing well, but is jaundiced, which is common in pre-term babies, so he is under observation at the hospital. I hope they don't screw anything up! The hospital, as I have mentioned, is a bit lacking! That event was the beginning of nine births in a row. Some of them happened on Tuesday during our regular prenatal clinic where we had a packed house of mamas waiting for exams. In fact, at one point I was giving another Midwife a break by doing exams when a birth assistant ran in and said, "Rebecca, I need you now!" I ran in to barely get gloves on while viewing a bulging amniotic sac, with a head right behind it! I caught a beautiful little girl born "in the caul" or born in the amniotic sac. You have never seen something so beautiful until you have seen the amniotic sac draped over a bay, peeling them back to reveal a slippery little newborn! Wow! So, as you can see, life is rich here and overwhelming.
After our rather traumatic birth the rest were wonderful. I had a lovely first time mom that I cared for who had a beautiful waterbirth with no tearing! We "white" midwives are getting really good at preventing tears around here. Which is no small feat, considering that poor nutrition makes tissue integrity poor. Unfortunately, this mama left this morning before I got to say good-bye...:( So let's look at pics, shall we?
Here is Ayu and her husband Kadek. Once we turned him around and he saw how strong his wife really was...he was a real champion! He was right there for her the whole time. She is the VBAC.








I wanted you to see this scar because it is so intense! They don't even do this kind of c-section in the US anymore, not since the seventies. Even emergency sections in America are low-transverse and much healthier for mama.


Here we are, after we got baby Putu stable. I wanted to include this picture in order to show you the placenta. Here, we do not cut the umbilical cord until three hours after birth. Here, Ibu Robin asked us to put a heat lamp over the palcenta to keep it warm during the final moments of transfusion. I have been learning a lot about the placenta and the benefits to delayed cord clamping. I won't go into it now, but really cool stuff that is now being confirmed by research about not cutting the cord immediately after birth. We also put fresh flowers over the placenta and the family takes the placenta home, along with all the other bloody trash from the birth and burns it and then buries it in the back yard of the family compound...pretty cool! The birth team and the baby were blessed by priests because this is a family of priests.

Well, I think that is about all for now. Love to all...