Rainbows and Grapefruit….
Day before yesterday, I was feeling super cabin-fevery and agitated from being captive in the birth center for a straight week. My comrade/ fellow volunteer (who is a super rad queer as well!) and I seized a free moment to go on an evening walk. We headed down a muddy dirt road that led towards the closest mountain. As hot frustration erupted from our lips, the misty rain drizzled down on us. Felt so good to be able to vent and express everything that is frustrating about volunteering here , and everything that’s fucked up about whitey going to “improve” things in other countries in general…. power dynamics, hierarchy, “development”, colonialist mentalities….. So glad she’s here to talk to, to have a radical comrade to process this experience is soooo helpful. And to have another persyn to bring important things up, and facilitate discussion of hard topics is super great.
We eventually took a turn on a little mud path that winded up a mountain side, passing “kochon kreyol” /black creole pigs, cows, goats along the way. When we got to the top, a breathtaking view awaited us, mountains in all directions and a gorgeous rainbow spread across the sky. We gayly frolicked under the rainbow as the light rain washed away all the tension I had held from the week.
Trying to carry that healing moment with me through the births. Sometimes I get super frustrated because it’s really clear that out-of-hospital “hands- off” u.s. white midwives aren’t the best trained people to serve this community!! For sooo many cultural/political reasons of course, but also because sometimes more interventions are really helpful!!! Yesterday, when I came on, I got assigned to a womyn in labor (3rd timer) who came in at 8 cm, and then hadn’t gotten checked at ALL since then (5 hours before),and she hadn’t had her baby yet. The midwife before me just said, “oh she was 8 when she came in, so she must be ready to push soon. She said her water broke, so I gave her some Vitamin C”. I walk in the room, the mother is sitting in a chair grunting/pushing, but without an involuntary urge to push. I don’t like to do a lot of vaginal exams either (especially with broken waters), but if a third timer comes in at 8 cm, and she hasn’t had her baby 5 hours later, I think something may be up! I check her, find her to be 6-7 cm/swollen cervix, with a baby head with a LOT of caput, and the mother also let’s me know that her water broke on Monday!!!! 5 days ago!!! She has a very low grade temp 100.2, and her vagina feels hotter than normal. Especially after recently seeing a fer real uterine infection/stalled labor/boggy uterus/postpartum bleed, I’m not about to depend just on Vitamin C to turn this around! Hello! She needs an IV, she need antibiotics, she needs arnica and to get on her side. Well, atleast that’s how I know to handle the situation.
So, soon after the IV was in, and the fluids started running, the mother’s contractions picked up, and laying on her side she did stop pushing. She got the ampicillin, I gave her arnica, brought her glasses of Emergen-C, massaged her shoulders with lavender oil, and helped her to breathe as she switched back and forth from her left to right side. Her tense muscles began to melt in my hands, as she relaxed into some stronger and stronger contractions. Three hours later, she had her baby.
It was a beautiful birth, but baby came out with a big cone head of caput and two large cephalohematomas (hemorrhage between the baby’s skull and the periosteum) on either side of his head. All the births that I’ve been at so far, there were no birth injuries, so I just gave the baby the oral Vitamin K that’s with the newborn exam stuff. But I really don’t know how quickly it works, and I don’t have experience depending on it for a birth injury, to stop a baby from hemorrhaging, so I really wanted to give the baby some injectable Vitamin K- which of course, there was none of- and as I searched for it, no one seemed concerned that we didn’t have any! I was rummaging through shelves of tons & tons of whole foods vitamins, homeopathics, herbs… which is all great, but what about some BASIC vitamin K ?!! Of course I was freakin a little, cuz I haven’t seen any cephalohematomas that big before. Thankfully, the Haitian nurse came on shift and she definitely agreed with me that baby needed the shot, so she sent somebody to the pharmacy to go buy some. It was so weird to me that the clinic didn’t think it was a good idea to carry injectable Vitamin K!? Like before they even opened their doors, they would be sure that they were stocked up on certain basics to have on hand.
Sooo, it feels a little weird to be working with “hands-off” u.s. midwives in these circumstances, without protocols that everyone must follow (like IV antibiotics for a woman whose been ruptured for days!) Although, I do think people are learning to be more hands-on then they usually are, and when the nurses are around it feels safer/better. And the midwives are really awesome in a lot of ways. And I’m learning a lot from working with them. And of course there are times that I do see lives being saved here, and I’m so glad we were there. Or someone was there with the resources to make a difference. Like if some of these postpartum hemorrhages happened at home, and the mother wasn’t able to get to a hospital, I don’t know if they would’ve made it. The Haitian nurse who works here told me last night that she has one of her children because she adopted her from her cousin, who died of a postpartum hemorrhage at home, she couldn’t make it to the hospital. So I know we have more resources to stop a bad hemorrhage then people do at home, and I know there is a lot of individual womyn who really appreciate we are here. There was a woman with a retained placenta last night, that was really grateful for the speedier jeep ride to the hospital, that’s probably one of the best services we have is a reliable car that can transport women quickly to the hospital. If she had been delivering at home, her transport would have been significantly delayed trying to find a ride in the middle of the night with no tap taps running.
The womyn who deliver here are so appreciative of the care they receive. I did a home visit today with one of the womyn who had a BAD postpartum hemorrhage a few days ago, and she was so so appreciative and happy to see me. I checked her and the baby out, was relieved that she was doing much better, and loaded her up with some fancy hippy vitamins to replenish from her bleed. (Definitely glad the clinic has such quantities of quality vitamins to hand out for free!) She told me that she was so grateful for how she was cared for after her birth, and she would like me to be the baby’s “maren” / godmother. So so sweet. I’m so grateful for her too, and that she’s here to mother her beautiful children. She sent me off with a kiss on the cheek and a huge bag of juicy grapefruits from her tree. I came home and dove into one, tearing it open and letting the juices drip down my fingers and the acidity burn the cracked corners of my dry lips. Savoring the sweet and the sour.