Welcome to my blog!

This blog was created with the intention of sharing my life and midwifery experiences with my community as I branch into international midwifery. I hope to keep people up to date and in touch with me, and with the places and people where I'll be.

Monday, May 31, 2010

lovely primip birth

We had a lovely birth today--I caught, a 1st timer, who was awesome...me and the 3 new American midwives, they were my birth team. There was a MW grad there, who asked me if I didn't think I needed to cut a episiotomy, and I explained why not, and there was a dr who kept coming in and hovering and then backing off, shaking his head, because he thought we should cut an epis, and never sees primips take their time and stretch. I really felt that I was protecting her from getting an epis, just standing my ground there. I kept explaining to him why she didn't need one. All was normal, good heart tones on the baby, progressing each push, etc. I wish he could have just watched the whole delivery. This woman kept eye contact with me and I knew that she knew that I was the main one taking responsibility for helping her. I understood everything she said and she understood everything I said. She did amazing with the head delivery: she would push a little when I said, then stop when I said. It was slow and controlled, and she didn't tear at all. Totally intact. The Dr was gone already or I would have showed him. Oh, and he came over a few times also to tell her how to push. He said "I have 3 children". Like, as if that makes him understand her experience. I really wanted to say: "And did you push them out?!" But I thought that might be taking it too far, since i was already making him stand back, literally pushing him away energetically.
> I was just happy that this woman got to have a good birth.
> But I wish it wasn't just me and the Americans doing births like this.
> The other day, the floor birth with Marthonie and the students, that was a very encouraging sign. The first time I've seen something like this here.
So maybe there is change happening? I definetly have seen Marthonie open up alot...to other ideas of doing things, to trusting me. And I have seen the students make progress in their ability to emulate compassion. I see a great need for continued guidance and education with the graduate midwives. I will try to do some of this while I am here, but there needs to be some kind of structure in place for them also. For them to practice skills, enhance their education, etc. One problem, one big problem, is the lack of books and teaching materials in French. They must be out there. But, they're not here.
There was a wonderful rain today...long and strong. Tonight the internet is suddenly working here, at the rectory...so, I am so happy to be able to blog!
Last evening I sat with a few different people and talked to them for awhile...at the plaza and at this outdoor little music club...I am understanding so much more Creole, all the time...I love understanding it...I am so thankful to be at this point, where I am over the hill...more or less cruising now...compared to before...with the language, with how comfortable I feel here...
I love all of you!!!
I miss you guys too!

Friday, May 28, 2010

may 28th 2010

I still don't have internet, but...I am at a new friend's house...this Nepalese guy who works for the UN here...they have internet here in their camp. So...
I saw something 2 days ago on my 30th birthday that really really made my day, and was the best birthday present ever. I walked into the delivery room, where Marthonie and the students were with this woman who they had allowed to labor on the floor and she was now starting to push there, squatting, and they were letting her stay there. they put a towel beneath her. I got behind her and she continued pushing, pulling on my arms as she pushed. It was a beautiful birth, easy, physiologic. Her placenta came there too, squatting there. It was the first time I have seen anything like this here, besides when the American midwives have caught babies on the floor. When one of the MW grads came in and reprimanded everyone for letting her birth there, because "the hospital admisintration would be mad", Marthonie stood up to her and explained why it was better this way for this woman and told her that she would "take the blame". I was really touched by all of this.
Later on, in the evening, I noticed that it was nearly a full moon, basically a full moon, and with both of these things, everything felt in balance.
Things are basically flowing along pretty well. I feel like I am in the groove with Marthonie and the students. I have seen more change than I thought I would at the beginning. There are so many differences here that make it hard to achieve the same level of education that you would expect normally, anywhere else. And cultural differneces in the ways that people learn, and the ways people communicate.
It is all very interesting. This is a very interesting and special experience for me, and I hope for those around me as well.
Oh, I ws going to tell you guys something else: the day after my birthday, it was so sweet, I was included in the birthday celebration of my friends' daughter, who turned 2. They had this party, for the both of us. They had this cake that said "bonne fet reina galjour" and they had this speech and this beautiful prayer before we ate...it was very special. they were so happy to have me as part of their celebration. they sent me home with the cake--on the back of a motorcycle--and i got home and shared it with those at home, where we were also co celebrating someone's birthday who lives there. except there was nothing there to celebrate with, except the beer i had bought and the cake that was donated. it ws so nice though. we each got 1 beer and some cake.
i love all you guys...

Monday, May 24, 2010


Hello to everyone...
I have missed writing in the blog...unfortunately the internet where I am staying is down, and I think it is going to be AWHILE before it is fixed. So, I have been unable to blog...but I will continue to do it as much as possible; it is a relief for me when I can, because I feel connected to all of you and like I am sharing my life/story with all of you...right now I came to this building at the hospital that has internet...so, good.
Things here are going allright. Each day I feel that I can understand more Creole and speak more. When you are learning a language you always understand more than you speak. That is how it is for me. I feel more accustomed to the hospital, although still surprised and dismayed at things there pretty often...I have made more friends in Hinche, so that is nice...
What is going on here currently...well, my 30th birthday is in 2 days...still don't really have any kind of plan for how to mark it...I want to do something, but here, there is nowhere to really go, and I don't have a house where I can throw a party...so, I don't know...maybe I will just spend the evening (after work) alone, reflecting, writing...which I have been doing alot of recently...there is alot of time to think here...maybe too much time...that was what one of the Cuban doctors was saying the other day...I went to the house where they all stay...we were hanging out, talking about living in Hinche. He was saying that you have too much time to think. He was saying that there have been doctors that have come here and left crazy. Everything he was describing...were things that I have noticed and thought about already, but it was interesting hearing him put it all out there. He was saying how, this is a hard place to live. It is a town with no electricity. There is nowhere to go and sit, listen to nice music, dance. There are a few little nightclubs, but they mostly play Haitian Kompa music, which to me and them is very boring and repetitive. To me it is like generic watered down carribean music. sorry to say. I would rather listen to salsa, merengue, anything Latin. I was thinking about this the other day: it dawned on me that I really miss Latina culture in general. The vibe here is different. I think that is part of why I am also not really attracted to any of the men here. They don't have that sensual Latino energy. Anyway, this doctor, he was describing how hard it is for himself and others from Cuba to live here, and, he just sounded so burned out already. He has onloy been here for 4 months. He has 2 YEARS to be here, in Haiti. It is a hard place to be. You also get burned out on the apathy of the healthcare providers around you. That was another thing they were talking about. I am thankful that I only have another 3 months to go. I am at the halfway point of the 6 months that I committed. I may possibly stay longer--through Nov--through graduation of the students--but, I don't really want to. I am trying to just enjoy and appreciate the life experience that I am getting here. I don't want to be pessimistic about it. I really do want to enjoy the culture and people. I stop and talk to alot of people on the street. I let people talk to me. you have to put up somewhat of a protective shell around you, because you are constantly on display. People just stare at you, or yell out "blan!"--it gets taxing when it is people over and over all day every time you go onto the street--but, I try to not take it personally. I know not to but I still have to really make an effort not to. Sometimes I feel like I could stay longer, when I feel really uplifted because I am understanding so much more creole, or when there is a busy day in the delivery room. But, it is also just so hard to imagine staying longer, because it is such a harsh environment to live in. Lots of dust and pollution in the air. Not good access to food. I am not in shape anymore the way I used to be, which is depressing to me. I want to leave after the 6 months, get in shape again, get healthier, and also, spend time with my family in NC. It has been almost 7 years that I have been living apart from them and seeing them 1-2 times a year for 2 weeks at a time. So, we will see what happens. I am still open to the possibility of staying longer than the 6 months, but at this time, I just have to think of it as 6 months.
Interesting things recently...I did another hard manual removal (of the placenta) the other day--this lady had birthed at home about 5 hours prior--the placenta was way up there, on one side of the top of the uterus. Hard to get. But I got it. Also, I sutured someone 5 days after they gave birth--at this same hospital--she had a tear that separated her clit hood from inner labia, shich was just hanging down--it was easy to do, and easy to debride--just with gauze. Haven't had a lot of births, but some...I stayed late the other day and caught someone's baby who I had been supporting since she was in active labor--a 2/1 being induced on misoprostol (cytotec) for 44 weeks gestation--who know if those dates were really correct...maybe they were...anyway, her birth was fun...she benefitted from the support...the midwives here, they don't do any kind of labor support, at all. There was this woman the other afternoon--I stayed after class with 2 american MW's until the night shift arrived (with more american MW's and 3 students) because this woman was in agony, being induced with pitocin after being diagnosed with placental abruption and fetal demise...her first pregnancy, 18 years old...just writhing on the table...myself and the 2 midwives came into the delivery room where she was, and the haitian midwives were just doing paperwprk, not doing anything at all with this lady, except telling her not to cry...
I know that part of the lack of compassion & support for the laboring and birthing women is cultural, and I accept that. I just don't know how much of it is cultural and useless to try to show another way, and how much of it is just training and experience with that model. Same thing when there are dying babies. They just get left on this table to die by themselves. How much of this is worthy of attention, of discussion, of trying to show another way, and how much of if is appropriate, in a place where so many babies and people die all the time...a survival mechanism, to be able to keep functioning, in a place so devoid of resources and help, options...I don't know the answers to these questions, but I think there must be a balance of both realities in the answer...it is possible to improve certain aspects of the care we provide, even in a place that sees so much death...it is also possible for someone like me to accept and validate the way they already deal with this...and respect it.
Certain things I just cannot accept though...like, the other day I walked into the delivery room and there were a few graduate midwives there, one wqas catching a baby...3 were seated, one was asking the mom, who was pushing her baby out, questions like "are you married/where do you live"---and no one was listening to the baby's heartbeat....things like this, it just feels like total negligence to me, and things like this need to be improved. basic midwifery skills, like labor monitoring, neonatal resusitation, etc. VERY IMPORTANT skills.
so, it is a long process. the graduates need continuing education. the current students, I hope that something I do here will be of value to them in their practice of midwifery.
Marthonie, my co-teacher, I am enjoying her alot. She knows alot of stuff that I want to learn, and vice versa. Our skills and experience are quite different and we both need what the other has. We both see that. SO, it is good.
American volunteers come wach week, and it is mostly my job to orient them and put them in the schedule. We have them doing 3 nights/week with the students, which is realyl good. I am glad that they are being utilized, since it takes so much energy and money to come here. Sometimes I have really felt that the volunteers are not being utilized well and that it's a big waste of energy to come here for only 1 week. As things have becoem more and more organized, it feels more worth it.
I hope this posts after all of this writing! I miss all of you and love all of you! I will write again as soon as I can...maybe in 1-2 weeks.

Wednesday, May 12, 2010

settling in more

i am still settling in here. trying to spend more time outside, in the street, with people. trying to reach out/respond to other people reaching out to me. the people here in general are so friendly, so interested in talking to you. it's still surprising to me in many moments because i'm just not used to being in a place where so many people are so open to talking to me like this. they ask all about your family and everything.
the other day i went with a friend of mine out into the country a little ways...it was so nice. so nice to see a different place, outside of town. the air was so fresh, there were more trees, there was a river....he helped me gather mangoes to bring back here...it was enjoyable. i think we are going to go back this week one day.
there haven't been alot of births lately; today there was this woman who had been referred from another hospital where they don't do c sections, who her baby was in a transverse lie, and basically what had happened was that she had probably labored at home for a long time and then finally gone to the hospital. when she arrived at st therese, the baby was totally impacted inside her, one arm was hanging out, and her uterus had ruptured. the OB had to do a hysterectomy and she got a blood transfusion.
i am enjoying getting to know Marthonie, my co teacher, more. she is really delightful and collaborative. it is really nice to be developing a relationship with her.
i am understanding so much more creole now. i can have a conversation with anyone, i can find a way to understand anything that they want to tell me. it is so nice to finally be at this point. not as good as it could be, but so much better than before.
i am halfway through my time here if i only stay the 6 months. i am not fully decided yet whether to stay longer or not. i am thinking of it as that i am staying the 6 months, and then going to NC to be with my family and community there, to have a nice long visit there before moving on to the next thing. we will see.
love you all...

Thursday, May 6, 2010

an almost c-section

So today was interesting...isn't it always so interesting here...this morning I arrive and there's this lady who was sent from a different hospital to St Therese because she had "CPD" (bab'y head can't fit through the mom's pelvis)---I ask how dilated she is, and the MW from the night before says she's complete...she has been there for half an hour, and they have already called the Dr and started prepping her for a c/s. I check her, and the head is low, and she is starting to push a little, and she feels like she has enough room to me. She is exhausted, out of her mind, and just chanting over and over that she can't do it and that she doesn't have enough room for the bb to come out. Because that's what everyone has been telling her. I say that I want to help her, and I start trying to help her. And monitoring her (fetal heart tones). The MW and nurse from the night before get angry with me and are being VERY negative and there are all these people talking at once--the students were all there--no one is trying to help her, or me, no one is tuning in. Except one student, she tuned in and came and stayed by her side and was supporting her. But there's all of this noise and negative talk about how she DOESN'T have room, etc...and they're like: "there's caput!" (swelling on the bb's head). that means that there is CPD! and I'm like: " no, caput is normal. " she has enough room. well, luckily Marthonie walked in, and I told her what was going on, and she checked her too, and agreed with me that she felt roomy enough to try for a vaginal birth, and she tried to explain to the people who were mad that she agreed with me. She really got my back. The Dr arrived, he checked her, and let us proceed. Unfortunately this woman was already so scared and convinced that her body wasn't capable of doing it, that it was hard, but she DID get into it. After a little while I was able to get her into a kneeling position, off her back, and that helped. And people started collaborating and helping (the students). And, she had her baby. It was fine. Everything was fine. The Dr came in awhile later and was very happy to see that he had birthed, and thanked me. I thanked him for his patience, and for him allowing us to help her. He thanked me for my patience. This lady was on the brink of getting a c/s that she really didn't need. It was like, she had come in, and the people here, they didn't eval her for themselves, they just said, ok, she can't do it and needs a c/s. when she was so close to birthing. Geez. The other thing is the chaos, the yelling, having all of these people around, with no one actually helping the mom. So, I was very happy, and very thankful to Marthonie for her support and collaboration, but also very annoyed at the fact that this other MW had gotten so angry at me for wanting to help this lady and for challenging a bogus diagnosis.
We had another birth later in the afternoon--a nice birth--another first timer, who was exhausted and out of her mind, but that is normal, and it was nice, no one was mean to her, the MW's and nurses who were there with me, we were a good team...in the end we ended up cutting an epis, and it was the right thing to do--but, everything was good.
Ok...that is all for now...the days are passing a little faster now...I am settling in a little more to my environment...accepting it more...I feel so thankful for that...
love you all...

Monday, May 3, 2010

May 3rd 2010

So...things have been really up and down since I've been back...there were a few days where I just felt so down, like I just felt so useless, at the hospital, so unsatisfied in my work as a midwife, like I am operating on 20% of my capacity, not finding ways to really effectively teach what I want to...like the other day with the 2 squatting births...I just really felt discouraged.
Then, after realizing how sad I was, and have been here all along, I think part of this sadness was liberated from me, and the weekend was really good. I made myself go out and sit at the plaza, and meet people and talk to them. I made some new friends, one guy, went to his house, met his wife and daughter...his wife is in nursing school and wants to be a midwife...she was naming everything that I see at the hospital, talking about it, all the behavior towards the patients, the lack of awareness and compassion, the lack of true care...with this kind of awareness I think she would make a good MW.
I also went and practiced salsa dancing with this friend, named Blada--he is a pretty good dancer...it was fun, and I hope that we can continue to do this regularly. I can definetly learn some stuff from him.
Yes, it was a very social weekend.
Then, today, it just so happened that the new American MW's hadn't arrived yet--I had thought they would arrive on Saturday--and that they would have a translator today and we would teach the class together on postpartum hemorrhage. Marthonie was out of town--she normally does the Monday class. Well, it turned out that it was just me, and I taught the class all by myself, in Creole, with no Marthonie and no translator. My Creole is nowhere near fluent but I am understanding more and more and able to speak a little better each day. Doing the class today felt like a big step/accomplishment to me. ANd I enjoyed spending time alone with the students. I really like them. I really care for them, and they care for me too. The Haitian people, they really open their heart to you. It's beautiful.
I met some people this weekend who used to live in Port au Prince. They lost spouses, children, parents. They lost their houses, and literally have nothing. It is so crazy, how can there be so much suffering? How do these people continue their lives? They are so stoic. It's really unbelievable the level of hardship that is normal for people to go thru here. I wish that the world could be more balanced, have a more equal distribution of wealth and resources. These people are just totally ignored. So many people here cannot access whatever aid is coming in. I asked someone if he could get a card that enables him to get food handouts each month. No, he couldn't get it. End of story.
Ok...tomorrow all day at the hospital...