Charis Around The World

Tidbits From Ebony

Women waiting outside the clinic for prenatal check-ups--every Wednesday and Thursday.

August 17, 2008
Ohmay Delivered a healthy baby girl!
Ohmay (pronounced like “Oh my!!”) is a woman of the “Cousin” faith. There is a large pocket of Cousin communities in this country. Some segments are even known to be quite violent and ruthless, desiring their nation to become completely “Cousinized” by adopting the Cousin form of governmental rule. Ohmay’s own community is far away from much violence, however. They are just a people, living among many other people of different faiths and walks of life, trying to survive and have a life that holds some meaning and some value.

The clinic were I am working existed for nearly a year before even ONE Cousin woman trusted the midwives enough to receive prenatal care and to deliver her baby here. In 2007, Ohmay was the first Cousin woman to honor the clinic by experiencing the delivery of her child here! Since then, several women from Ohmay’s community have also come for prenatal care, many of them also delivering in the clinic. Another interesting development has occurred as well. One of the traditional birth attendants (TBA) of Ohmay’s community has started coming to all of the births and assisting as a doula for these Cousin women and babies. She is very open hearted and wise, eager to learn from the clinic midwives what constitutes as safe and appropriate practices for birth, newborn care and emergency situations. This woman has been a blessing and encouragement to the midwives here, helping them realize that Father is using their work to impact deeper segments of the surrounding region than they themselves could accomplish!

The TBA has appeared at the door of the clinic several times in the last month. She came for three births that I was able to be a part of here at the clinic. The first was a baby born without a portion of her skull. She died within an hour. The second was a baby born with a cleft pallet—a great heart break to the family. The third birth she was a part of ended in a healthy baby delivered by a mother who had retained portions of her placenta and had to be transported rather dramatically to the hospital two hours away because she began to hemorrhage. She received a blood transfusion and is now doing quite well (as is her baby), yet this was a huge financial blow to the couple and a scary event for all those involved.
All of these mothers are members of Ohmay’s family.

So, as Ohmay awaited the birth of her fourth child, she also faced the grief and hardship associated with these other deliveries. When Ohmay came to us and told us her water had broken, we at the clinic were quite nervous. In some parts of this country there are laws that enforce a time limit upon maternity clinics after spontaneous rupture of the membranes. At this location, we usually operate on an 18 hour policy—mother has 18 hours to deliver before hospital transport is required. This is dictated by law and by the doctors at the hospital which receives our patients when transport is needed. Because the hospital is so far away, we often become even further constrained by time. So, the time allotted to a woman who has SROM is only 16 hours before she must be transported and face the very significant threat of a cesarean.

Ohmay’s waters ruptured yet she was having no contractions. This meant that, in order to help provide her with a normal delivery, free of charge, we would have to encourage an aggressive attempt to begin labor. Ohmay walked around for hours, drank water, massaged her nipples and even spent some time on a breast pump. Our doula intern, who is a massage therapist in the US, spent some time giving her labor inducing massages and stimulating acupuncture points (which really worked, by the way!). Still, though, Ohmay was progressing very slowly along our timeline. After an internal exam, the midwives were not sure that her membranes had completely ruptured, so they decided to take the liberty of giving themselves, and Ohmay and her baby, more time! We all breathed a sigh of relief when the decision was finally made. We knew this was the right choice despite the legal risks. We knew that OHMAY knows her body and her options and that she was making the choice she needed to make for herself and her child. Ohmay went home to relax and came back to the clinic periodically to check her vitals as well as the baby’s fetal heart tones. Thank our Father that the baby did not show any signs of distress during what turned into a 36 hour attempt to stimulate labor!

There are some who may feel this situation is excessive and that we should have placed her in a doctor’s care or taken her to the hospital. It is hard to explain to a Western audience how inconceivable those options are in this location. Cesareans literally ruin lives, ruin marriages, and depress communities here. The medical practice, aside from the distance to REACH the hospital, is grossly outdated and, for lack of a better term, crude. The maternity clinic is no swanky rose garden, but the approach to patients is family friendly, mother friendly and characterized by great skill and wisdom. All those involved knew that the safest, most affordable, most desirable option for Ohmay and her baby was the clinic!

After two long days and one night, the midwives finally received the call that Ohmay was really in labor! In fact, it sounded like she was about to give birth ANY SECOND. Two of our midwives rushed out to her home with their “home birth” kit. But, not long after they left, Ohmay and her husband showed up at the clinic, having taken public transportation to get there. The midwives turned around and rushed back.

As Ohmay walked up the road toward the clinic, she sucked down a raw egg, right out of the shell!!! I know, I know! It seems so dangerous in some ways and so disgusting in every other ways!!! But, it is a cultural practice here that is quite common. The culture teaches that eating a raw egg in labor makes the birth “slippery.”

Ohmay was already fully dilated and ready to have her baby! Her time at the clinic prior to delivery was very short. I was on “baby duty.” I wouldn’t be the one to catch the baby, but I would receive it from the midwife and help with any resuscitation efforts, with bonding, cord cutting and other general newborn care. Unfortunately, Ohmay’s contractions were not very strong. She especially struggled with this when the baby’s head was already out. After two long minutes  the body was delivered. We have seen so many near cases of shoulder dystocia as well as simply unhealthy babies and mothers here recently, that we always have to take a deep breath and prepare for the worst. But, a precious girl emerged from her mother’s womb (finally!) and she just needed a good, loving rub down before she finally started to breath. When we stopped bothering her precious body for a while, she opened her eyes and explored her mother’s face, giving a much needed distraction from the pains of delivering the placenta.

Because of the mass amounts of women who suffer and die due to hemorrhage in the third world, medical  organizations have begun promoting something called Active Management of the Third Stage of Labor (AMTSL). This involves ALWAYS giving 10 cc's of pitocin as soon as the baby is born, then assisting in the delivery of the placenta with cord traction and fundal massage. These are not ideal practices for those of us with a more “natural” mentality. Yet, in regions like this, women are often anemic and malnourished. They have little chance of survival if they lose even a minimal amount of blood. This  approach can be hard to swallow, yet statistics show a dramatic reduction in maternal hemorrhage and mortality in third world regions where it is practiced.

Because Ohmay was having some trouble delivering the placenta, her family prepared another egg for her! First, a male family member blew on the egg for some time. I believe this was some sort of Folk Cousin practice. When the egg was appropriately blown upon, the TBA cracked a hole in the top and handed it to Ohmay. After just giving birth, with her baby in her other hand, Ohmay chug-a-lugged that raw egg into oblivion. The TBA also prepared an empty glass Sprite bottle which she treated as some sort of religious prop. Ohmay took the bottle and blew into it continuously until the placenta began to come out. The placenta WAS delivered shortly thereafter, but I am not sure there is really a correlation!

There were other Cousin practices going on at the birth that I just kept in the periphery of my mind. Ohmay’s husband stayed in the room (not very common in this culture) and faced the “Holy City,” reciting in Arabic, “God is great! God is merciful!” I couldn’t agree more! It reminded me to keep praying in Jesus’ name for Ohmay and her new baby.

Usually, Cousins dedicate their babies to their religion within the first week, sometimes hours, after birth.  So, once the birth was finished, I pulled aside one of the local midwives. We sat on a bed in the next room and prayed over the baby, dedicating her to the Lord Jesus Christ before she was claimed for any other religion by her parents.

Ohmay and her baby are very healthy. They are just resting in the room next door even while I type this. One more woman who had a pleasant and safe delivery, and who will receive thorough post-partum care. One more baby born into the world medication free, in a healthy, clean environment, encouraged to breastfeed immediately, and offered as a pleasing aroma to Jesus. God is great! God is merciful!

Much love,
Elizabeth Carmichael
 

A sign hanging in the local church: "Stay Focused In Serving God Faithfully"