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Volume 8 |
~ News From
"Your Birthing
Family" ~ |
Issue 4 |
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Charis Around
the World
Tidbits From Ebony
Bleak Birthing in Ebony Hospitals: Part III
by Elizabeth Carmichael
Midwives graduating in Ebony
Dear Charis Family,
Here is the final installment of this story. Thank you for your
patience as it has unfolded. I urge
you to read the good, creative, appropriate ways birth is taking
place all over the world and remember also the places where it
is a nightmare. May the Lord’s Kingdom truth and His ways expand
to all the darkest places….
…. The birth assistant, who had come with the nomadic mother,
wrapped up the first baby very tightly in shredded rags she
had been keeping in a pile on the floor. She wrapped him SO
tightly that I was concerned for him, so I made her loosen the
swaddling a bit—especially around the umbilical cord. My mind
reviewed the moment of his birth. When he was delivered, the
midwives immediately clamped the cord as they have been
taught to do. Their awkward, ungentle ways resulted in the image
of four different clamps dangling from the cord as they cut it. They have also been trained to place the baby on the mother’s
stomach after birth, but they only sort of propped him right
above her pubic bone while they cut his umbilical cord. Mama
couldn’t even see him and he didn’t enjoy any skin to skin with
her as nomadic women keep all of their clothes on during birth
(so a large skirt was wadded up around her lower abdomen).
Set aside, away from the mother, Older Brother got wrapped up so
thoroughly that even his face was covered. I kept my hand on his
head as his brother was delivered.
The little brother,
the second twin, had a hard time on his journey. He was a
footling breech, which I had never observed before. The midwives
yanked on the one foot that was coming out. They turned to tell
me that his other foot was up by his face (so, he was in a
“splits”). There was much distress about how to keep the hands
and arms against the body. With the work of the midwife, the
other foot came out and the baby had meconium all over his
back and legs. The midwives said the hands were up so they
reached in to sweep down the arms. They twisted his torso over
and over again, this way and that. It was fascinating and
grotesque at the same time. The German midwife who was with me,
supervising and assisting the local midwives, explained that
they were trying to get the baby’s body to turn so that his head
could go through Mama’s pelvis in a transverse position. But,
they were incredibly rough and I wondered if they were causing
more harm than help.
The midwife reached underneath the baby to put her figder in his
mouth and grip his cheeks with two other fingers, in order to
pull his face and chin down toward his chest. It all seemed to
happen in slow motion as I watched, but it really didn’t take
that long. I have certainly seen longer situations, but none so
rough as this. I have also seen the results of footling
deliveries in Ebony—dead babies left hanging out of their
mothers with their heads still stuck inside. It all begs the
question I still have yet to find an answer to…”What IS normal
birth?!” Here, “normal,” is really, really sad.
I couldn’t tell if Little Brother had any cord problems, but
they finally got him out and I went to the side of the mother to
hold her hand. She was watching as about four midwives tried to
stimulate the baby’s breathing. I told her, “Well done. You had
two little boys. They are beautiful.” I was just trying anything
to connect with her because nobody else was. Her IV was leaking
and she was asking about that and about the continued pain she
was having. While I stood by her, another midwife was delivering
the placentas forcefully using chord traction. It was very, very
soon after the birth to be doing that, and she wasn’t using Pitocin either (which is just as well to me, but the use of it
IS recommended if you are going to be using an AMTSL approach).
Click
here For more information on Active Management of
the Third Stage of Labor.
Click
here for the World Health Organization "Use of
active management of the third stage of labour in seven
developing countries".
Please note that I am not promoting this practice.
Information is only for the purpose of introducing this
largely promoted and funded practice among public health
care / maternal health care circles around the world. |
Little Brother was not breathing. Everyone was hustling around
him trying to stimulate him to breath. He had a decent color at
birth, but he had been completely limp. He woke up for about ten
seconds, however, and let out a cry. His eyes opened, but they
seemed dark and empty. I’ve only seen that look one other time
in a baby….but, she ended up able to live.
The midwives rubbed and rubbed him while holding him on his
side. The German friend of mine went to get a bulb syringe and
something to bag him with. The midwives started losing hope and
moving more slowly. My friend was increasingly frustrated, as
the local midwives around her seemed to stop intuiting what was
needed or what they could try. Again, it was like everything
started to move in slow motion. When my friend found the mask
for bagging the baby, it was filthy, so the midwives had to stop
and clean it.
At that point, my precious friend, German midwife of many
decades, lost it! You know when you have met “Nice Midwife,”
don’t you? The lady who loves birth, it’s all beautiful, she
doesn’t freak out easily, is cheerful and sets your mind at
ease. Then, there is this other moment….which probably occurs
for many midwives….when you meet “Mean Midwife.” My friend’s
“Mean Midwife” came out and while she continued to help the
baby, she let loose on those younger ladies, declaring how she
felt about an emergency pediatric oxygen bag sitting dirty on
the shelf! The midwives started giving him oxygen with the bag,
but he wasn’t improving. Nobody tried compressions, which my
friend now regrets. One of the challenging aspects of the whole
situation is that my friend and I were not there to help or
assist in any way. My friend, not employed to practice in this
hospital, took a calculated risk in helping at all. The birth
was attended by three OB’s and two midwives. And all seemed
helpless and lost.
They rushed the baby upstairs to the Operating Room (remember,
it is upstairs, and there is no elevator in this place). Their
thinking was that there might be a better mask up there, and my
friend thought they might intubate him. When we arrived
upstairs, we learned there is no pediatric intubation kit in the
whole hospital, nor is anyone trained to do such a procedure. There was no more fighting for life to be done. We had to give
up.
He had started taking very shallow breaths, however, so we
wrapped him in a blanket and took him to the NICU. His mother
never got to see or spend any time with him. I went back to be
with her in the delivery room and hold her hand. She really
wanted someone to hold her hand and she told me not to leave her
again.
These people, this mother and the lady who was with her, they
don’t look welcoming. They look scary. Their skin is dark and
leathery. They have tattoos all over their faces, marking them
for their tribe. They are stinky and have hair completely matted
with dirt. They don’t smile. They are bitter and tough. They
respond differently to everything than we would. Oh, but how
Jesus loves them!!! He made them! He was in that room as she
delivered her babies! The Holy Spirit was in her womb knitting
them together, writing all their days. His thoughts toward them
are more than anyone could fathom. He sees every individual hair
on her head, despite the dirt.
She was writhing in pain with her uterus cramping back down to
size. Thankfully, although she struggled, she was not having
bleeding problems. I just held her hand and told her about her
two babies—individual characteristics I had seen, how I had
prayed for them, what was going on with them. After a while, she
wanted me to go back and try to find them, so I left her and
said goodbye. Her name was Zarbibi.
In the NICU, the father of the babies was bringing medicines for
them. In the hospitals here there are no ready supplies. Even as
an emergency unfolds, a family member must run out to a pharmacy
or medical supply store to buy the necessary items. When we
finally left the NICU (it was a very crowded, non-sterile
place), Little Brother was still breathing and Big Brother was
doing fine. Unfortunately, we found out that Little Brother did
pass away shortly after that time.
At one point, right after Little Brother’s delivery, I did think
he was going to die and I couldn’t help but cry as I held his
mother’s hand. I know God heard me, despite the outcome. I know
He was there and that His heart was also breaking. It is so
intense to be at births in Ebony. You take a lot of things in. From the smells of the hospital, to the unthinkable practices,
the other languages, and, finally, to the moods of the doctors
as well as the patients, it is overwhelming. It is a place where
there is no space and grace to process emotions, and, yet, it is
a very emotional experience.
When we left the NICU, my friend was needed for one more consult
before we left the hospital. The other nurse was
unfamiliar with a particular C-section stitch, so she wanted my
friend to remove it. When we went to the outpatient area, it was
packed with about 50 women!! Probably ten to fifteen of them
were actual patients, all accompanied by multiple family
members. As we examined the woman needing her stitches removed,
she covered her face with her veil—if we had to look at her
lower parts, she sure wasn’t going to let us see her face!
A lady in the crowd exclaimed in the local language, “Oh, Lord! Repent! They are not Muslims!”
Her statement sums up a thought that terrifies me here. I often
put myself in their shoes and wonder if they do NOT see Light in
us, but if, instead, they believe that we MAKE them more sick
and injured, bringing harm and pain rather than good. Once, when
a friend and I tried to resuscitate a girl who had drowned, we
thought, “This village is going to think that it is our fault
that she died.” When I visited a family for the first time a few
weeks ago and the next morning their son was killed, I thought,
“I wonder if they think he died because I visited them.” On this
day, I wondered if they thought that Little Brother died because
we happened to be at the delivery.
I’m not an animist or superstitious. I don’t believe my presence
causes these tragedies. But, I am an amateur anthropologist by
nature, and I know the power their perceptions have over them. The Outsider is the Enemy. They never have the slightest inkling
that the Enemy is within their ranks.
To the lady who exclaimed, “Repent!” I turned and smiled. As my
friend helped the young woman by gently removing her stitches in
a clean and skilled way, I sat next to the Repented to say, “I
can speak your language? Where are you from? Let’s have a
chat……”
Time. Patience. Conversation. Perseverance. Power…..His power. These are the things I’m holding onto in hope, as I pray for
change in this land.
Our International Charis
Family
Your stories from around the world touch us and we pray for your
safety.
Thanks, Love and Blessings to every one of you! |
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'Behold,
I will bring them from the north country, And gather them from the
ends of the earth,
Among them the blind and the lame, The woman with child and
The one who labors with child, together,
A great throng shall return there...And My people shall be
satisfied with My goodness, says the LORD.'
Jeremiah 31:8, 14
~~~
©2013 Charis Childbirth Services, All Rights Reserved
Feel free to forward this newsletter to friends in its entirety,
leaving all attribution intact.
April 2013 |
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