Charis Around the World

Childbirth in Kenya
by Jannekah Guya


Martin and Jannekah Guya with their son, Ezriel and his big sister, Amariah

          My husband and I recently moved to a different part of Kenya, not too far outside the capital city of Nairobi.  I was so sad about the move because it meant leaving all the families, midwives, nurses, and doctors I was becoming so close to.  I was also worried that it would be difficult to find new midwives to work with.  Before we moved I was already praying that God would give us divine connections and that He would go before us and orchestrate our steps.  Proverbs 16:9 says, “In his heart a man plans his course, but the Lord determines his steps.”  This was my prayer.

          True to His Word, as always, God did connect me to a traditional birth attendant who lives near to our new home.  I love it when He does things for which only He can receive the glory. (=  Her name is Mama Christine.  She has three daughters, one son, and several grandchildren, two of whom live with her, along with her youngest daughter.  She has a good heart, and for the most part is as nurturing a woman as you’ll find in this culture in her circumstances.  She seems to love teaching me and always wants me to be hands on.  She never acts like I owe her something, even though she is doing me a great service….and even though I’m white.  An unfortunate consequence of many well meaning NGOs and “mercy ministries” in Kenya is they have created an incapacitating mentality of dependence among the nationals, especially those living in slum environments.  It has caused Kenyans who live in abject poverty to grow up believing that they can’t do anything without the “white man’s” handouts.  In reality, these handouts only deepen the bondage.  The truth is that Kenyans by nature are extremely bright, astoundingly innovative, and magnificently creative.  Handouts stifle this and cause them to forget it.

          Mama Christine is different though, and that might be one of the things I’ve come to love most about her.  She has no sense of entitlement.  She learned her art before I was even born and it has been sustaining her since her husband died about 15 years ago.  She lives in a 10' by 10' tiny one room “house”.  It’s on the fourth floor of a dingy apartment complex that is overrun by rats, cockroaches, and God knows what else.  Each floor of about ten rooms, shares a public toilet and shower room, which is really just a tiny enclosure where you bring your bucket of water to wash yourself.  There’s no running water of course.  Water has to be carried up all those flights of stairs in buckets.  She divides her tiny room in half with a curtain.  One entire half is the single bed where she sleeps with her grand children and daughter.  The other half is a small metal “couch” where the women labor and give birth.  She has a piece of vinyl that she lays under them when they’re ready to push and she uses rolls and rolls of toilet paper to clean up any messes along the way…which I must note is better than the cotton or filthy rags I’ve seen most traditional birth attendants use.  She has a little propane stove she uses to make porridge and tea for the mother throughout and after the labor.  She also uses it to boil water for them to bathe after the birth, which they often do right there behind the door in that tiny room so that they don’t have the shame of being seen by neighbors on their way to the public shower room.  The little stove, along with the Kenyan heat, make that tiny room stifling hot, and the strong smell of propane along with it is nauseating.  Along with our other duties, we try to keep cockroaches from crawling on the mother or the couch she is laying on.  The first time Mama Christine called me to come for a birth, I took a taxi to her house.  The driver couldn’t believe where I’d asked him to take me and was very hesitant to drop me off.  He told me that slum is one of the most dangerous places in all of Nairobi, only after Kibera, the biggest slum in all East Africa.  I don’t know how true this is, but it’s definitely a sketchy place!


          At the last birth we attended together we had two women at once!  The one who was closest to delivery lay on the couch, while the other laboring mother sat on a wooden stool. You can imagine what it’s like for us to all be squeezed into that tiny little space together.  The woman who delivered first delivered a breathtakingly gorgeous little girl.  It was her third baby, so things went about as smoothly as they can go.  She was a pro.  Mama Christine told me later that the woman’s first child had been a C-section, but the doctors had messed her up so badly she vowed never to deliver in a hospital again.  She had delivered her second child with Mama Christine as well.  Indeed C-sections are scary business here.  It’s not uncommon to hear of babies getting horribly cut, or the mother suffering irreparable, sometimes fatal damage.

          After the first mother delivered, Mama Christine gave her some porridge as she nursed her baby.  Then she took a bath and her husband came to walk her home.  It was about 2 am and less than an hour after she had delivered.  We cleaned up and Mama Christine took the vinyl outside to wash with soap and water for the next birth.  But after observing the second mother, a primigravida, we realized that she was very afraid, and Mama Christine knew this would be a problem.  Seeing the first birth seemed to have made things worse for the fearful woman.  Mama Christine called the woman’s husband and told them they needed to go to a hospital.  I had mixed emotions about that, but I know that part of being a good midwife is knowing where to draw the line.  Indeed, just two days before we had a young lady who was so terrified, she refused to push no matter what, and her labor needlessly went on for hours and hours and hours.  I suspect she maybe had been sexually abused and that’s what caused the resistance but it was a horrible experience for all of us.  It was the second time I’ve experienced something like this – I wrote about the first in the December edition of the Charis e-newsletter.

          It took me days and days to process through that birth and all that went on and I realized that I have SO much to learn, not only about birth, but about culture.  You’d think having lived in Kenya for about a total of 5 years I’d have a fairly good understanding, but that experience taught me there’s so much more, so much deeper, and completely new cultural dynamics that come with birth, especially in such an environment.  I don’t agree with some of the things Mama Christine does, but some of the things I know to be “the right way” would be irrelevant and inapplicable in this culture.  Some things are more across the board, however that doesn’t make it any less complicated.  Mama Christine sees me as her student, and rightly so, but how can a student correct the teacher?  Prayer is central to making sense and properly handling all of this of course.  It’s the ONLY sure answer!  And my prayer is that as Mama Christine is such a blessing to me, I will also be a blessing to her, in many ways.  I pray that as I learn more, gain more experience, and am able to do more on my own, that I will be able to slowly and quietly introduce new ideas and methods, that hopefully she will see benefit in.  I asked Mama Christine if she would ever want to move.  She told me that while a bigger house would obviously be a tremendous blessing she could never leave the slum because that’s where all her mothers and babies are.  I was so encouraged and touched by that.  I think it really revealed her heart.

          I’ve learned so much at Mama Christine’s this month, even just in quiet observation of her and laboring women.  It’s been so amazing just to see the confirmation that the God-created birth process and the God-given intuition of a laboring woman can and must be trusted.  There are so many things that such a big deal is made out of in the U.S. that isn’t given a second thought here…. sometimes rightly so, sometimes not.  I’m slowly learning the difference, and I’m learning a lot by watching Kenyan women allow their bodies do what they were created to do, even if it seems strange.  For example, I read once that stimulation of our lips and tongue release natural endorphins.  Sure enough, I watched one mother as she instinctively gently chewed her lips and tongue during transition contractions.  It’s also beautiful to watch women naturally move their laboring bodies.  They sway, squat, kneel, and contort their hips, among many other natural maneuvers.  They have never read any book or been instructed to do this, they’re just listening to their bodies because they have the freedom to do so – they’re expected to do so.

          I watch Mama Christine closely to see how she relates with them too.  In our culture we often rub backs, stroke heads, hold and hug laboring women.  As a doula and as a compassionate woman who’s had babies myself, to do these things are my gut reaction.  I almost can’t help myself!  But culture, culture, culture.  I’m learning that in Kenya, at least at Mama Christine’s, birth is a very personal journey that you go on alone.  Mama Christine sits quietly by as the mother does what her body tells her to.  During a contraction she watches closely, respectfully, and quietly.  Every now and then, between contractions, she’ll almost inaudibly give a suggestion, and the mothers always do what she says.  They trust themselves and their babies to her COMPLETELY.  She is their mother, and that means something so much more and so much different here.  The qualities you and I might think make up a good mother, are entirely different from the qualities a Kenyan woman might list.  That’s a VERY important lesson I’m only beginning to learn and understand when it comes to “mothering the mother”.  When it’s time to push Mama Christine’s quiet suggestions turn into urgent commands.  Again, the women do exactly what she says, no matter what…unless there are underlying issues, as I mentioned above.  Even then Mama Christine knows what a Kenyan mother must do in order to get through to the laboring woman so that she’ll do her part.  It’s hard when I completely disagree with some of her commands and methods, but I’m there to learn and to patiently wait for the day when God will use me to bring the change I desperately long to see in childbirth in Kenya.  That’s why I am SOOO thankful for Charis and all I am and will learn here about being a Godly midwife.  I’m inexpressibly thankful to have a safe source of learning and support that I know I can trust.

          I pray that God will use me to bring a change that will reach birth attendants and laboring women in every mud hut, tiny room like Mama Christine’s, and into the hospitals, where change might be needed more than anywhere else.  This week Pastor Miriam, whom I mentioned last month, called me again.  One of her church members delivered a baby in a local hospital.  The baby died at birth and they were told it was because the cord was around the baby’s neck.  Clearly there was more to it than that.  To know that they went through the entire pregnancy and labor without any problem what-so-ever, only to needlessly lose the baby at the last moment is so tragic I can hardly stand it.  After her long labor, instead of the comfort and incomparable joy of taking her precious baby in her arms, she received only the terror of being told her baby was dead.  And of course the emotional trauma doesn’t affect her alone.  Pastor Miriam told me that when she went to visit the couple, the husband wept, which is almost unheard of in this culture and was quite alarming to Pastor Miriam.  Furthermore, Pastor Miriam is also about 6 months pregnant and this has had a huge impact on her mental and emotional state concerning her upcoming birth.  Please pray for this precious couple with me, that God will heal their hearts, restore their joy, and remove their fear.  And please continue to pray with me for a divine change in the childbirth situation here in Kenya, and all over the world!  May we reclaim it for its, and our, Creator!

One of the precious babies Jannekah helped into the world last month.

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