Recently, I have been contemplating childbirth. Not that I am wanting more children, mind you. N bata wasa – translation, I am satisfied – what I tell the villagers when they beg me to have more kids…. :^)
I think all of the contemplating came from a few sources – my sister-in-law was pregnant when we left the US, and also, right before I left the US, I got to spend the morning with a great OB-GYN who taught me how to use a Doppler to detect fetal heartbeats. I spent the morning in a beautiful office, with sinks and soap in every room, and access to lab work and ultrasound machines. It reminded me how very blessed we are in the US.
Last Saturday, October 1st, my sister-in-law was in labor and gave birth to a beautiful little girl named Maren. She was about a month early and spent some time in the NICU. I can imagine the scene from when I had my kids at the hospital – squeaky clean floors, lots of medical personnel, all kinds of equipment and excitement. Thankfully, we hear she is doing well. I am so thankful for medical technology and for the wisdom that God has given to doctors.
About 6 hours later, I also had an experience with a birth – but it was slightly different. You see, I have a friend, the daughter of one of our believers here in town. Her name is Gnouma. She had a little boy- about 3 years old – and showed up on my doorstep when we returned from the US – looking very pregnant.
She visited me several times over the past few weeks and I began to tease her that I thought there might be 2 or 3 babies in there. She was never overly amused and said that if she had more than one, she was giving one to me. As her due date grew closer, my thoughts turned to her throughout the day and I spent most nights expecting to be called out to her hut for a delivery. I asked her dad about her often.
Finally on Saturday, I told her dad to have her come that evening and let me check her out. She showed up an hour later, complaining that she had been having contractions and back pain and pressure. I offered to check her then for the placement of the baby, or to meet her at her house. She opted for my front porch, and the next thing I knew, she whipped off her skirt and lay down behind a short wall.
Okay then. I got my gloves on and checked her – and could feel the baby’s head. I told her to walk back to her house and that I would meet her there. A few minutes later, someone called me from the front porch as I was bustling about, grabbing my bag and letting my family know what was going on. It was the girl’s aunt –who had met her walking on the road and told her to come to her hut to deliver the baby, since most of the village had gone to the farm. No problem, I said. I am on my way.
I grabbed some leftovers for a quick lunch and headed out the door. The hut was just a short walk from my house. I had on some cotton Capri’s and a comfortable shirt, but was wrapped up with a cloth as a skirt so I would not be indecent in the village. We got her settled and I checked her again. Baby was definitely coming but I had no idea how long it would take. Gnouma was exhausted, having been up much of the night with contractions. She lay on the floor, on top of a plastic covering and I sat on the wooden bed. It was dark in the hut, but fairly cool, considering that is was blazing hot outside.
As she rested, I looked down at my bare feet on the cow dung floor and contemplated what my new OB-GYN friend did during her deliveries at the hospital. I watched chickens and a cat and some goats wander by outside – stopping to peer in the open door, intrigued, no doubt, to find a white woman there. After she rested for a while, I asked Gnouma to get up and walk – hoping to stimulate the contractions again. She was amazing- did everything I told her to without complaint.
After a while, I checked her again and her bag of water broke. I could see the baby’s hair. She pushed and I encouraged and out came the baby’s head. I suctioned its nose and mouth and she pushed again – out came baby. A beautiful little girl. I was pumped since she already had a boy. I got her dried off and the cord clamped and cut and wrapped her up.
Now it was time for the placenta to come – the baby’s friend, as they call it here. She pushed and pushed – we tried everything. No luck. She tried jamming a stick down her throat – a common practice here in the village, I have come to discover – one which I am anxious to put a stop to. No luck. I was starting to get a little concerned. Only one time in my village nursing career have I had to manually remove a placenta –it scared me to death, and I did not want to repeat that.
I told her to lie down and try to push once more. She did, and what I felt was not a placenta, it was another head. It’s another baby, I said loudly. Sure enough, one big push and out popped a little boy. I suctioned him out and dried him off and cut the cord. I couldn’t stop smiling. This time, the placenta was easy to deliver. I was still smiling. Gnouma looked at me – why are you laughing? she asked. You called these twins – this is your fault. I just smiled.
We went out front and washed up the babies – scrubbing their heads and faces and bodies with a rough plastic scrubber. I stopped short of suspending them from each limb and giving them a good shake like my African midwives do. We dressed them in donated shirts and hats and wrapping them in little blankets. I helped Gnouma wash up and get settled on the bed. I put ointment in their eyes and tucked them in beside mom, telling her to rest a little and then try to nurse them. I needed to run home, I said, but I would be right back. The whole time I was saying, I can’t believe she had twins.
I updated Jim and Hannah, grabbed a few supplies –including Gatorade – and headed back. I was still smiling. I gave her some Tylenol, started her on vitamins, and encouraged her to nurse the babies. When I went back a few hours later, I saw those two little ones again and marveled at the miracle of birth. Here I was, in a small crowded grass roofed African hut, listening to lots of women chatting and admiring the babies. Little kids with snotty noses ran around, chickens clucked outside, several of us were piled on the bed beside Gnouma and the babies – including a dozing 6 month old.
I couldn’t help thinking of the differences between the medical care in the first world and what we deal with in the third world. I am thankful for every opportunity I have to teach hygiene and good after care instructions. Some days I feel like I am making progress.
And then we have days like yesterday. Jim is gone and I had gone into the village to say hi to people. I was sitting outside the hut of my friend Kanko when the village midwife happened to wander by and mentioned that she had someone I might want to see – if I had time. She had delivered a baby the night before but they were never able to deliver the placenta. What do you mean? I asked. Well, the mom had delivered the baby at midnight, and here is was after 6 pm the next day. Where is the mom? I asked. In her hut, was the answer.
I got scared, and then I got mad.
SERIOUSLY – this woman had been lying in her hut for 18 hours without delivering the placenta and NO ONE came to get me. Well, it is Sunday and you don’t work on Sundays – was the reply. I guess MAYBE the plan was to come on Monday to have me check her. I was so frustrated that I could barely speak. They took me to her hut. As I ducked in under the grass, a terrible smell hit me – the smell of rotting flesh – never a good sign.
Sure enough, there she was, with the umbilical cord tied neatly with cloth in two places to the inside of her leg. I ran back to my house to get my supplies, and to call my teammate to talk through my options. I could manually remove the placenta with my hand – but was very afraid to do that after 18 hours. The only other option, though, was to put her on the back of a motorcycle and bounce her down the road for 3 hours in the dark to the hospital. That didn’t seem like a great option either.
I grabbed my bag and some antibiotics and my trusty Gatorade (good for rehydrating even the nearly dead!). The midwife met me on the road. I tried to keep my voice calm…. I started in with the thoughts swirling through my head -You realized that she can die from this, right. And if she doesn’t die, she might not be able to have more kids. Her child-lying –down place might be permanently ruined. Of course, she said, as if it was completely obvious. I decided it was best no to say anything else, going with the "if you can’t say anything nice" principle.
We got back to the hut and I had mom start drinking the Gatorade and started her on 2 different antibiotics. I was so afraid – what if the placenta falls apart in my hand? What if the mom goes into shock? What if she starts to hemorrhage? I am 3 hours from a hospital and Jim was gone so I had no vehicle. There are also no vehicles anywhere in town. I got her prepped, knelt down beside her, put my hands on her, and started to pray.
I prayed that Jesus, who is stronger than anything and who had created this woman, would help us to get the placenta out. I prayed that He would protect her and her baby. I prayed that, through this event, that the whole village, and this girl in particular, would know that Jesus was powerful and that His was the only road that led to heaven.
Then I started. I reached in with my triple gloved hands and began to peel the placenta away from the uterus. I didn’t have to do much. I could feel it loosening. I could see it. I told her to push. The midwife told her to push. And out it came – intact, as far as I could tell. I praised the Lord. It was amazing. We got baby nursing –which had not been done yet in the 18 hours since his birth. He is beautiful and was very hungry. I told them what warning signs to watch for in case of infection and went home hugely relieved. Today, several times, I have talked with people about it – using it as an opportunity to tell how great God is and to teach about the dangers of what could have happened.
All in all, given my choices, between shiny floors and cow dung floors, between comfortable hospital beds and mud huts, between lots of medical personnel and just one person trying to make a difference, I wouldn’t trade this life for anything. It feels great to know that you are making a difference – no matter how small. Even on those – 2 steps forward, 3 steps back kind of days…..
