tag:blogger.com,1999:blog-7147418603624120162024-03-05T12:03:01.144-08:00A Doctor, a Midwife, & a Partridge in a Pear TreeTarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.comBlogger75125tag:blogger.com,1999:blog-714741860362412016.post-78006194374883932792018-07-11T14:23:00.002-07:002018-07-11T14:41:26.349-07:00Attachment Knows No BiologyA small, 10x10 NICU room has been my 2nd home for nearly the past 3 weeks. This is my view from the vantage point of the rocker recliner, as I rock, feed, love on, and cuddle our foster baby.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoXlvKPwdRJPSMMHV3yReTnR-E4EZSgBQiC852QFLJT4c_VJIdmjy1iy6E8qlOaRHoC7bMRdQ_QkcyLnOozxxSw1uOsTSc6zsq3aC3ugu4uqXY5gXg4MimF1jNV70qnBu6M3DR6fFDG7rp/s1600/Nest.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1600" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoXlvKPwdRJPSMMHV3yReTnR-E4EZSgBQiC852QFLJT4c_VJIdmjy1iy6E8qlOaRHoC7bMRdQ_QkcyLnOozxxSw1uOsTSc6zsq3aC3ugu4uqXY5gXg4MimF1jNV70qnBu6M3DR6fFDG7rp/s400/Nest.jpg" width="400" /></a></div>
Not pictured: lots of wires, a monitor that incessantly beeps, alarms that ding, an uncomfortable vinyl sofa, and a thermostat that doesn’t actually control the temperature in the room. ❄️ There are medications every 3 hours and feeding times that feel like they come so soon after the last one. I’m both bored and I’m busy at the same time.<br />
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I sat with one of the Neonatal Nurse Practitioners this morning and talked about what the plan will be for the next few days. I struggle with feeling as though I have no place to ask too many questions, make suggestions, or express my opinion and desires. This is nothing that anyone at the hospital has put on me- this is my own insecurity and fear of judgement. Like, “Who is she and what does she know?” But I know if this were my own child, I would feel differently.<br />
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I choked back the tears as we talked this morning.<br />
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They tell me he’s a different baby when I’m not there.<br />
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I was staying with him during the daytime but yet he was struggling with nights. Then I began staying the night with him, and now he has good nights but struggles during the day.<br />
During the day, the nurses tend to his needs, cuddle him, love on him, and even take him for stroller rides. (They are seriously so amazing.)<br />
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But here’s the thing- out of all of the awesome care providers he has and the people in his life, there has been and is only one constant. That’s me.<br />
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I’m not his blood. I can’t honestly even say I love him like a mother loves her child (yet), but what I can say and do feel is that I’m committed to him. I love him for the human being that he is. From the moment I said, “Yes” to the phone call, I was committed. It’s how I do things- all in or not at all.<br />
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And that’s the thing about attachment. It’s not defined by or limited to biology.<br />
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When people say they could never be foster parents because they’d get too attached, I understand what they are trying to say. I do. They’re saying it would be hard. They are saying it would hurt. I believe it. I can see that now. But, that’s the point of fostering.<br />
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The most significant relationship in a child’s life is the attachment to their primary caregiver- biologically connected, or not. Attachment and connection are so vital to brain development, emotional regulation, and our ability to form and maintain relationships. <br />
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If you foster- or parent- or live- without attachment, you’re missing the whole point. We can have all of the basic necessities, but if we lack love and attachment as children, our ability to feel secure, to be able to express emotion, to adjust, and to form meaningful relationships, will suffer for the rest of our lives.<br />
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Even in 3 short weeks, we can look to this little guy and see the power of attachment.<br />
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I shared my thoughts this morning- It’s my belief this baby needs to be home. We need to be home. It’s time. Very soon the morphine will be stopped, and once it’s stopped, the clock will start a 72 hour countdown. That 72 hours will be a test to see how he does without the morphine and assure us that he can be at home. It’s not uncommon for a baby to need to be “rescued” by being given a “rescue dose” of morphine, when withdrawal symptoms get to be too much. The downfall is that if a rescue dose is given, the 72 hours starts all over.<br />
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The prayers we have been covered with are so appreciated! It’s my prayer that this will not be our view for much longer!<br />
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💙Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-21532160898905562802018-04-24T12:13:00.001-07:002018-04-24T12:19:10.918-07:00What 'Postpartum' Should Look LikeGadgets, Gear, Spanx, and Make-up.<br />
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We have a culture that is often focused on which Boppy pillow, DokATot, and latest baby gadget is the best, rather than focusing on what birth is really about- a new life entering the world, and the power of the woman who grew and birthed that life. Our postpartum time is often filled with visitors wanting to hold the sweet baby- not necessarily help in any way- and mothers often go back to everyday expectations of life much too soon after giving birth. So, what can we do to support a new mom in her postpartum days? And what "stuff" <i>really</i> matters?<br />
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The “work” of labor and delivery is truly LABOR- hard labor in all aspects- emotional, mental, and physical. It is arguably the equivalent of running a marathon...that you have not trained for...which you have no idea if it is a 5k or a full marathon. To labor and give birth is to use every muscle fiber in your body (which you will likely feel the day afterward!). I have had moms whose shoulders ache, whose thigh muscles throb as if they have been doing repetitive squats, and who have broken blood vessels in their eyes from the physical exertion that it took to birth their baby. For the mommas who have a cesarean section, there is other trauma and healing from having had major abdominal surgery- and even sometimes a birth that wasn't what was planned. This isn't to portray birth as scary...but to speak to the challenge that is birth and the <i><b>power</b></i> that is the female body.<br />
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After delivery, the body shifts from growing life inside, to continuing to sustain and grow that life outside of the body, with breastfeeding. The task of producing rich breastmilk is another feat! For all these reasons and more, the postpartum time for a new momma is an important one- for her body and mind!<br />
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If the female body can grow, birth, and sustain life, what are we doing after such an accomplishment, to nurture that body? In our culture, we don't always hold this time- the postpartum period- in reverence. We fail to see and treat it as a sacred time. Yes, a baby has just been born. But so has a mother!<br />
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So, with all of that said, here is a list of a few things every postpartum momma should have, some material comfort items, and some not.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicsut0hmhLvDP7-ozUicU8SPKVHdPWMlPJGhwdvR-5Qm45JJ73Y6cVF95EmDx8SfnsEUvhlqWc_zaT9zL2oTXN84L2V6L5M1kNsxil0eKd77uCcqjiR4DAnRSyrLSCYOFnzmuoQ-cWkvRE/s1600/postpartum.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1169" data-original-width="1600" height="465" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicsut0hmhLvDP7-ozUicU8SPKVHdPWMlPJGhwdvR-5Qm45JJ73Y6cVF95EmDx8SfnsEUvhlqWc_zaT9zL2oTXN84L2V6L5M1kNsxil0eKd77uCcqjiR4DAnRSyrLSCYOFnzmuoQ-cWkvRE/s640/postpartum.jpg" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A lovely postpartum stash</td></tr>
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1) <b>Depends/Disposable adult underwear</b><br />
Yes, I know. It's not the coolest, sexiest, most attractive garment, but I promise you, it will be worth it. The first couple of days when bleeding is heavier, it is so nice to not have to worry about pad placement and ruining your underwear. Go to the bathroom ---> take off--->toss in trash--->replace. It's comfy, it's hassle free. Just.do.it.<br />
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2) <b>Frozen witch hazel pads.</b> They feel like heaven on your bottom and perineum after you have given birth, particularly if you have stitches for a vaginal/perineal tear. It's cold and soothing, and helps to reduce swelling. Take a heavy absorbency sanitary pad, and moderately fill it with witch hazel. Be careful not to drench it...it will become a solid ice block in the freezer. Curve it slightly upward (as the curve of the body when it's in the underwear) and place it in the freezer. You can stack several. you can also do this with cotton rounds. They are particularly useful to put right on the perineum or up against hemorrhoids. Add in Lavender for a healing perineum or c-section incision and Cypress for hemorrhoid pads and it will make all the difference!<br />
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3) <b>Essential Oils</b>. Yes, I love essential oils! There is truly an essential oil for everything- from supporting every body system, to supporting mindset and emotions. From helping with skin healing to promoting circulation, there is an oil to ease those postpartum discomforts and help you through!<br />
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4) <b>Rest.</b> I'm not talking about rest in the immediate hours after giving birth. I'm talking days. Weeks. I tell my moms for the first 3 days, stay in the comfort of your own space- your bed. Stay nearly naked (refer back to #1), skin-to-skin with your new baby. Rest. Nurse. Rest some more. Bond. Limit your visitors. You see? These things are interrelated. You're nearly naked, looking like a beautiful mess of a new mother, so why have company over? We also need to keep in mind that company also brings unwelcome company- germs. <br />
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What more important task do you have than to establish breastfeeding, provide nutrients and antibodies to your baby, and get to know this precious new person? You can do it all by resting and staying close to one another!<br />
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5) <b>Nourishment. </b>In the immediate days after birth and through the postpartum period, the body needs to be nourished and replenished. Hot teas, infusions, broths, and hearty soups are staples for this! We always make homemade bone broth from our leftover bones and freeze it for soups and stews later. It can be made from beef bones, or a turkey or chicken carcass. It's simple to make and nourishing to the body and mind. Best of all, you can do this ahead of time and freeze in large quantities. It's also easy enough that anyone- including Dad- can do it. <i><b>Recipe at the end! </b></i><br />
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6) <b>Time.</b> I see it as a midwife and I've lived it as a mother. The postpartum period isn't held in high regard as it should be. We aren't afforded Time. Such a simple thing, but yet not something we typically give and get after having a baby.<br />
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I was once leaving a 24 hour postpartum home visit and said to the new mom, "Just in case you were considering it, please do not go to church on Sunday. Stay home. Rest." The momma (who is from Guatemala) looked at me as if I was crazy! "Ah...no. I stay home," she said. "In my culture, we do not go anywhere for 30 days after having baby." I was in awe. This is not the norm. Perhaps it should be.<br />
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Ever heard of the 4th trimester? It refers to the time from birth to the end of a baby's third month. At birth, the brain of the human infant is still immature. Human babies are fragile and vulnerable, depending on the constant care of their mother. At birth, they have innate reflexes and abilities- breathing, sucking, swallowing, pooping. Yep, just the basics! As the end of the 4th trimester nears, they become increasingly more able little beings- regulating their body temperature, interacting more, nursing less often, and being more alert. Shouldn't this vulnerable, dependent time of the newborn tell us something important about the 4th trimester for the mother as well? I think so!<br />
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So forget about fancy gear, breastpumps, and various other gadgets and 'nice-to-haves' for now, and consider this simple, short list. Let us not forget about the 4th trimester for both mom and baby, and all the ways in which we can comfort, nurture, and support them both. <3<br />
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<b></b>Here's that recipe for the nourishing bone broth!<br />
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<b><u>Nourishing Bone Broth</u></b><br />
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One big pot of water<br />
2 tablespoons vinegar (helps to draw the minerals out of the bones) . Can be substituted with lemon juice.<br />
3 carrots, peeled and coarsely chopped<br />
3 celery stalks, coarsely chopped <br />
1 large onion, coarsely chopped<br />
1 bunch each of parsley and thyme<br />
2 Bay leaves<br />
About 8 peppercorns<br />
Marrow Bones- we only use organic, hormone-free animal bones such as beef bones, whole turkey, or whole chicken. You can either use a whole chicken with the meat still intact, or use the remaining carcass, after you have already eaten the meat for a previous meal.<br />
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• If using a whole chicken, cut off the wings, remove the neck and cut both into pieces. Remove the gizzards from the cavity. Like mentioned above, an already eaten off of chicken or turkey carcass is fine. Throw it in!<br />
• Place marrow bones or chicken and pieces in a pot with water, vinegar, and all vegetables and herbs.<br />
• Bring slowly to a boil, and remove the scum that rises to the top.<br />
• Reduce heat, cover and low simmer for 6 to 8 hours. <br />
• Salt and pepper to taste, or wait until consumption<br />
• Strain the stock into another large pot. Remove the bones and any meat pieces with a slotted spoon. You can save the loose meat to be used for chicken/turkey noodle soup, etc.<br />
• Cool in an ice bath (or, as we do during the wintertime here in Alaska, stick it in the snow outside), and refrigerate until the fat rises to the top and congeals. Skim off the layer of fat. Refrigerate up to 3-4 days or freeze for future use.<br />
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<3Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-23284440098882438722018-03-14T19:35:00.004-07:002018-03-14T19:35:53.306-07:00Birthday Birth<div style="font-family: Helvetica; font-size: 12px; font-stretch: normal; line-height: normal;">
<span style="font-size: 12pt;">Last night was a first for me in 12 years of being in birth work- I got to assist a family in welcoming their baby on my birthday. ❤️</span></div>
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<span style="font-size: 12pt;">I sat quietly beside the tub, with our student midwife by my side, knowing that we would soon be meeting a baby. The only light in the room was from the glowing chandelier overhead, the only sound was the breathing of the laboring woman and the quiet garble of her own mother and grandmother whispering in excitement in the background. Dad sat in nervous silence, in witness to it all. </span></div>
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<span style="font-size: 12pt;">No blinding overhead lights. No dings, bells, alarms. No repeat questions or pushed agendas. </span></div>
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<span style="font-size: 12pt;">“I feel like I have to push!” Slight panic and a hint of doubt in her voice. “What do I do? What should I do??” </span></div>
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<span style="font-size: 12pt;">Simple reassurance: “Listen to your body. If your body is pushing, then push.” </span></div>
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<span style="font-size: 12pt;">Such a basic concept, but something birth has gotten so far from. </span></div>
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<span style="font-size: 12pt;">How did we get here and why? </span></div>
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<span style="font-size: 12pt;">She takes that thought and eases more into the water with it. She bears down with guttural pressure, and then starts to creep up in the water, her butt beginning to rise to the surface. </span></div>
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<span style="font-size: 12pt;">“Keep your butt in the water.” My voice is soft and gentle, but there’s no if in what I’m saying. </span></div>
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<span style="font-size: 12pt;">She doesn’t open her eyes but her body relaxes a little.</span></div>
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<span style="font-size: 12pt;">“Ease into the water and push into your pain. You’re almost done!”</span></div>
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<span style="font-size: 12pt;">A few pushes and the baby begins to crown, head slowly emerges. Megan reaches in to get ready to help this mom bring her baby up. </span></div>
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<span style="font-size: 12pt;">A snap back from primal incoherence to once again cognizant- she asks, “Will the baby drown?!” </span></div>
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<span style="font-size: 12pt;">Her baby’s head is in between her legs, submerged under water. </span></div>
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<span style="font-size: 12pt;">Simple reassurance: “Your baby is being born from water, to water.” </span></div>
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<span style="font-size: 12pt;">Megan reminds her of the purpose of the umbilical cord- giving oxygen-rich blood to the baby throughout birth. </span></div>
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<span style="font-size: 12pt;">I sit overseeing, sitting on my hands to not interfere or disturb unless I’m needed. The baby is born and Megan slowly brings the baby up. He goes straight to his mother’s arms, onto her chest. </span></div>
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<span style="font-size: 12pt;">Silence. That’s what we hear. </span></div>
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<span style="font-size: 12pt;">The baby doesn’t cry, yet the family rejoices. </span></div>
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<span style="font-size: 12pt;">Why? </span></div>
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<span style="font-size: 12pt;">The baby has no clue he’s been born. His heart is excitedly beating. He’s breathing quietly. His lungs are clearing. He starts to open his eyes and looks at his momma. And yet he’s silent. </span></div>
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<span style="font-size: 12pt;">A birth so gentle that the baby doesn’t even recognize that he is outside of his momma’s womb. Looking around, in awe of the world. </span></div>
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<span style="font-size: 12pt;">Stop. It’s a science and an art. Imagine what would happen if you just stopped. And observed. And thought. </span></div>
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<span style="font-size: 12pt;">We don’t wipe him off. </span></div>
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<span style="font-size: 12pt;">We don’t routinely stimulate him. There’s no need. </span></div>
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<span style="font-size: 12pt;">He’s kept warm by the warm water and his mother’s body. </span></div>
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<span style="font-size: 12pt;">We don’t routinely suction him. There’s no need. </span></div>
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<span style="font-size: 12pt;">That’s the beauty of midwifery. We are there, but not. There to support, there to safeguard, there to witness, there to intervene when it’s warranted and needed. </span></div>
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<span style="font-size: 12pt;">The day before, another patient of ours had to deliver at the local hospital. She was abused, belittled, and threatened by the doctor. An episiotomy was pushed on her and she was told she was going to kill her baby for informly declining certain interventions. The stories aren’t mine to tell, but I will say this- we hear it time and time again, over and over and over. And yet, we are the crazy ones? </span></div>
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<span style="font-size: 12pt;"></span><br /></div>
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<span style="font-size: 12pt;">I think to myself of this stark contrast, two different worlds that shouldn’t be so different.</span></div>
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<span style="font-size: 12pt;"></span><br /></div>
<div style="font-family: Helvetica; font-size: 12px; font-stretch: normal; line-height: normal;">
<span style="font-size: 12pt;">How did we get here and why? </span></div>
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<span style="font-size: 12pt;"></span><br /></div>
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<span style="font-size: 12pt;">How do we bring birth back to where it belongs and what it is suppose to be? </span></div>
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<span style="font-size: 12pt;">One woman, one baby, and one birth at a time, just like this Birthday Birth. </span></div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-56899977883688908932016-09-20T19:26:00.002-07:002016-09-20T19:38:57.354-07:00Moments of a Midwife<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); color: rgba(0, 0, 0, 0.701961); font-family: UICTFontTextStyleBody; font-size: 17px; text-decoration: -webkit-letterpress;">
Water broke and hour 20 with no action. Tick tock, tick tock...if the damn clock was working, that's what it'd say. That's what is on everyone's mind, anyhow. They know what the birth center regulations say, and that hour 24 seems so near. Sent them to the mall for a walk, but they return with nothing to report. Smiles, yet underlying doubt and discouragement. My best midwife reassurance that there is still "plenty of time," and not to worry. Even if that midwife herself had doubts. An hour later and that 4th time momma labors hard, her first unmedicated birth. Sirens blazing outside in downtown Anchorage and roads surrounding us blocked off. A suspected bomb right down the road. Sirens, fireworks, people in the streets. I reminisce to myself, "This sounds like Haiti." Downtown Anchorage on a Saturday night. We ain't in Palmer anymore, Toto. </div>
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Low quiet noises and that momma repeatedly apologizes for how loud she is being. This is a real-life lesson on our individual Reality and Perception...such a funny thing. Wanting a waterbirth and realizing it ain't for you. That's ok. Pushing past that pain, and a baby boy is born. </div>
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Those parents thanking you for what you've given them, but you being thankful that there are families out there who give you the opportunity.</div>
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The very next day, in that very same room, within those 100 year old walls...</div>
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First time momma contracting every 2-3 and she means serious business. Partner like a deer in the headlights, looking at anyone, everyone, whoever for reassurance. Little does he know he is probably one of the best support I've ever seen. He asks the midwives, "Are you scared?" He's stone faced serious, but we laugh. I would hope the midwives aren't scared! A room full of strong women, supporting this first time momma. She doesn't bat an eye at the laughter and clatter in the room...she is what we call In The Zone. Mary is primarying- midwife speak for the person primarily responsible and catching the baby- she's front and center. I'm directly behind her on her left, but even more so her proverbial "Right Hand Man." The head comes out and Mary looks at me, and states matter-of-factly, so, so serious, "The.head.is.out." I'm not by any means normally witty- it's a characteristic I seem to have been born without- but it comes out without skipping a beat, "Thanks, I see that." We laugh at that she felt the need to state the obvious. We can pretty much read each others minds, so this makes it even more comical. A baby girl is born, welcomed into the world by the hands of a midwife that I trained, and the hands of her mother and father. The sun shines in through the window. It's 8:58 am and a beautiful Fall day in Alaska. </div>
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I've been up for two days straight...but all I can think is...</div>
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This. Right. Here. </div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-15636726287784319822015-10-01T20:55:00.000-07:002015-10-01T20:55:34.916-07:00PerspectivePerhaps it can be said that the last birth Glen and I attended in Haiti was the perfect birth. Perhaps I shouldn't use the word "perfect." After all, I know as a midwife and as a woman that has given birth, the word 'perfect' in reference to birth is highly subjective...and sensitive. It wasn't a glorious birth by our standards at home, by any means. If you've read even one other blog post regarding maternity care and birth in Haiti, you will understand this. A typical birth back home takes place in a pristine and beautiful birth room that is private, surrounded in candlelight, endless hot water, a walk-in glass shower, a deep soaker tub, clean instruments and supplies, and...just simply...Calm. Birth in Haiti is quite a different experience. When basic care and a trained birth attendant is the exception and not the norm, it puts all of the other "luxuries" into perspective.<br />
<br />
There had been four women all nearing delivery. The mom who had induced an abortion had just delivered. I had just held her one pound baby girl in my hands, holding her as she took her first breath and holding her as she took her last breath. My heart was sad as I processed this. I retreated to the back storage room for a clean place to rest, where I sat and thought in the still quietness. Camille was not feeling well and needed to lay down and rest. As she laid the camping mat down on the storage room floor, she questioned the rat situation. I assured her that there were no rats on the inside of the Labor & Delivery unit. I had only ever seen them on the exterior corridor. I told her I would keep an eye out and let her know if I saw any though.<br />
<br />
Awhile later, Glen had gone to make rounds on Labor & Delivery and listen to heart tones. After a bit, he hadn't returned, so I ventured out to see what he was up to. I won't ever forget what I saw and what he said. With hands on the belly of a laboring mom and a big grin on his face, he exclaimed, "Look Love, I'm a doula!" I think of it now, and I smile. The laboring woman wouldn't let him leave her. He had tried to walk away, and she had insisted that he stayed.<br />
<br />
The needs of humans are actually quite simple, when you take away the materialistic possessions and perhaps more importantly, the ego. This woman simply needed a human presence; the comfort and touch of someone who cared. The fact that he was a male obstetrician, nearly from another world, made no difference. She was in need. She didn't want to be alone.<br />
<br />
I walked over and relieved him of his new-found, slightly awkward doula duties. I placed my hands on her belly, and ever so gently, just touched her. Without hesitance, she grabbed my hands and put them exactly where she needed them to be, getting a reprieve from the pain, with my hands gently rubbing her belly as she had a contraction. As she progressed over the next hour, she would grab my hands and move them to her hips, then the small of her back, telling me with not a single spoken word, that she was having back labor. Occasionally she would look into my eyes and nod her head, as if saying to me, "Yes! That helps so much!" Isn't it fascinating, certain situations in life where spoken words are irrelevant, when the most insightful, effective form of communication is simply through the eyes and subtle, unintentional body language? Two people, two strangers, connected only by the human experience...one in pain and afraid, the other simply having understanding and compassion, and their connection not extending beyond that simple awareness.<br />
<br />
As we pushed with this woman- supporting and encouraging her in birthing her babe, I saw something out of the corner of my eye, running on the floor. "GAAAAHHH!" I nearly jumped 3 feet in the air, hardly an exaggeration. "GLEN! Do you see that?!" I pointed to the mouse that was now contently resting in the center of the L&D floor.<br />
<br />
I thought of Camille, sleeping on the floor just a few feet away. "Should we wake Camille and tell her?"<br />
<br />
We decided that it was just a mouse, not a rat, and well, I had told Camille that I would wake her if I saw a RAT. All about perspective, right? No need in waking her up unnecessarily. I got a little chuckle at that, but vowed that I would be keeping a good eye on the little guy, to ensure he didn't make his way to the storage room.<br />
<br />
The birth would be what we might call "uneventful"...except for the obvious, of course- a child, as well as a mother, was born. As Camille and Sheily (our translator) rested, Glen and I would attend this birth together. We had a language barrier that made verbal communication nearly impossible between us and our patient (without our translator), but even without a language barrier, Glen and I needed just as few words between us. Perhaps that is a benefit of a husband-midwife team. We are confident in the each other's ability; we can read each other's minds simply with subtle looks or gestures.<br />
<br />
I don't remember if the baby was a boy or a girl. I don't even remember which one of us "caught" the baby. I remember the calm. I remember the Haitian midwives quietly watching, the intact perineum, cleaning her up, placing the makeshift pad of folded cotton fabric between her legs, and helping her to slowly get dressed. There was no bed for her that night. Imagine that: a woman who just gave birth and yet there is no bed in the entire hospital for her to sleep with her new baby. In the wee hours of the morning- some time after midnight but yet still hours before dawn, freshly dressed and brand-new bundled up life in her arms, she shuffled herself to the entrance of the Labor & Delivery unit, laid down a sheet, and spent the first night with her baby on the cool concrete floor.<br />
<br />
And yet, she was beaming with happiness and pride.Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com1tag:blogger.com,1999:blog-714741860362412016.post-41969482074766986802015-09-25T14:35:00.002-07:002015-09-25T15:30:28.126-07:00Blood, Sweat, & Tears...and Love<br />
<div style="margin-bottom: 0in;">
<div style="margin-bottom: 0in;">
Often times in life, we are our biggest
critic and our own greatest set-back, allowing idealistic perceptions
define what is “good enough,” and inevitably, setting our very
own limitations. One of my favorite quotes speaks to this thought-
“If you limit your choice only to what seems possible or
reasonable, you disconnect yourself from what you truly want, and all
that is left is a compromise.” (Robert Fritz)<br />
<br />
It is not just the rare occasion in
which I feel inadequate myself...Am I good enough? Am I competent
enough? Am I worthy enough? Does any of what I'm doing matter? I'm
tired...I'm scared...I'm unsure. These are a fraction of my own
internal limitations. It is a continual effort to remove my own
limitations and push myself past these internal barriers. Yes I am
good enough. Yes I am competent enough. Yes I am worthy enough. Yes,
this matters.
</div>
<br />
<div style="margin-bottom: 0in;">
Last night we arrived on the Labor &
Delivery unit to a young woman writhing and moaning loudly in pain.
She hardly looked pregnant. When I questioned the Haitian midwife on
why the patient was there, I was told that the patient was “4
months” pregnant, and had fallen. As I spoke with the patient and
took her vitals, I suspected that the patient may be lying about
falling. She had no tenderness, no bruises or abrasions. Induced
abortions with Cytotec here are rampant- Cytotec is inexpensive and
easily obtainable. Whatever the cause- a fall or an intended
abortion- the patient's cervix was dilating and she would no doubt be
miscarrying. There was nothing we could do. Soon after our arrival,
things became more intense, with it apparent that delivery was
imminent. I looked to Glen and said, “I can't do this delivery.
Will you please do it?” He asked me why and I answered honestly.
“I'm scared. I've never seen or touched such an early baby.” I
didn't know what to expect. I didn't know what this baby was going to
look like. Would this baby come out intact? Damaged? Bloody, gory? I
was afraid I did not know how to serve her well. I had no clue, and
the unknown is frightening.
</div>
<br />
<div style="margin-bottom: 0in;">
As we were expecting an imminent
delivery, we would find out from the patient's family who accompanied
her to the hospital that she had indeed taken Cytotec. The loss of
this baby was intentional.
</div>
<br />
<div style="margin-bottom: 0in;">
Around us, all Hell breaks loose. Four
patients, all near delivery, are contained in a small room the size
of my master bathroom at home. The walls contain the yelling,
screaming, moaning, and shouts to Jesus. “Jesus, I am dying!” is
exclaimed into the air.</div>
<br />
<div style="margin-bottom: 0in;">
The patient begins pushing and in two
pushes, the baby's butt becomes visible, revealing to us that this
baby is breech. Glen delivers the butt, legs, and abdomen, and as
this limp baby girl hangs out of her mother, she suddenly wiggles and
kicks fiercely. Glen and I both startle. Glen looks at me and states
the obvious, “THIS BABY IS ALIVE.”</div>
<br />
<div style="margin-bottom: 0in;">
He delivers the baby's head, and places
her in my blanketed hands. I gently place the baby on her mother's
abdomen, gently wipe her dry, cradle her body in the blanket, and
place my stethoscope over her. Her heart rate is strong and steady at
160 beats per minute, and she is making an effort to breathe.
</div>
<br />
<div style="margin-bottom: 0in;">
Her heart pounding strongly.
</div>
<div style="margin-bottom: 0in;">
My heart racing wildly.
</div>
<div style="margin-bottom: 0in;">
I am dripping sweat and nauseous, my
stomach contorted, feeling as if it is in my throat.</div>
<div style="margin-bottom: 0in;">
The stagnant air is relieved by a
breeze coming through the window from the storm that is brewing
outside.
</div>
<div style="margin-bottom: 0in;">
“Camille, can you close the window? I
don't want her to be cold.”</div>
<div style="margin-bottom: 0in;">
Camille closes the window.</div>
<div style="margin-bottom: 0in;">
Dripping sweat, my back is aching, I'm
leaning over listening to the baby girl's heart beat.</div>
<br />
<div style="margin-bottom: 0in;">
I begin to cry and don't even try to
refrain myself. Tears are streaming down my face; big fat tears fall
to the already saturated, filthy floor beneath us, joining the mom's
blood, sweat, urine, and every other patient's blood, sweat, urine, and vomit. This floor knows my sweat well, and now, my tears
join it all. This, THIS, is the definition of Blood, Sweat, &
Tears.<br />
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</div>
<br />
<div style="margin-bottom: 0in;">
I am sweating and crying for this baby,
and my heart aches so bad for this baby girl that it could bleed for
her as well.</div>
<br />
<div style="margin-bottom: 0in;">
She wasn't just “4 months,” she was
probably about 22-23 weeks...but she didn't even have a chance. Not
here. I cried as I heard her heart beating because I knew I was the
first to hear her heart, and I would also be the last. I cried
because she was living. I cried because she was dying. I cried
because there was nothing I could do. I cried because this didn't
have to happen.</div>
<br />
<div style="margin-bottom: 0in;">
I looked to Glen, me having never done
this before and not knowing what to expect. “How long will she
live?” He says to me that it could be just a few minutes...or a
couple hours.</div>
<br />
<div style="margin-bottom: 0in;">
I look into the mother's eyes and tell
her that her baby has a heart beat, but will soon die. I ask her if I
can hold the baby up on her chest, and wait. She nods yes. This is a
big deal. I tell her that I will continue to listen to the baby's
heart and will let her know when it stops beating. I ask her to look
at her baby. I ask her to touch her baby. I tell her that I'm so, so,
so very sorry. There is so much I could say, but right here, right
now, it's not appropriate and it doesn't matter anyhow. I want to
pray but my mind is not able to assemble any coherent thoughts. I
simply say quietly, over and over, “Lord Jesus, please be with this
baby; please be with this mother.” I know The Lord doesn't need my
words. He knows my thoughts, and knows what is in my heart.<br />
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</div>
<br />
<div style="margin-bottom: 0in;">
Slowly, the baby's heart would
gradually slow...160...130...120...100...and finally, just simply
stopped. Over the course of that baby's hour here on earth, she was
against her mother, and in my hands, wrapped in not only a blanket
from Alaska, but also wrapped in prayer. I said to the patient, “Your
baby's heart has stopped.” She cried. I cried.
</div>
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<br />
<div style="margin-bottom: 0in;">
Eventually, after I had carried the
baby away, I placed the baby on the scale, looked her over, and weighed
her. I wrapped her gingerly in her blanket, and then placed her in
the box that was given to me.</div>
<br />
<div style="margin-bottom: 0in;">
In the beginning, I doubted myself and
my ability to do a good job and serve this mother and her baby well.
I was fearful. I felt I lacked the “right” words. But in the end,
my own expectations and self-imposed limitations didn't matter. In
the end, I gave my blood, sweat, & tears...and love. That
mattered.</div>
<br />
<br />
<div style="margin-bottom: 0in;">
I took my gloves off, washed my hands,
and walked away.
</div>
<br /></div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com8tag:blogger.com,1999:blog-714741860362412016.post-69679680711832693112015-09-24T16:24:00.000-07:002015-09-24T16:29:32.667-07:00Reverence for Life<div style="margin-bottom: 0in;">
Before I write the story of the last
shift, I want to first say this: There are many people who have read
this blog and who have subsequently saturated us with thanks and
praise, pouring us over with statements of what great things we are
doing, how selfless this work is, and how we are doing such
phenomenal things. While this praise does indeed lift us up and make
us feel good, I want to acknowledge that we are doing nothing
special, nothing requiring anything but a love and respect for life,
and the heart to care. The word 'altruism' comes to mind, and there
are times I wonder if true altruism exists. Don't we all do things
for a purpose of our own heart and conscience? I cannot say that
volunteering my time does not make me feel “good,” simply. That
in itself is a selfish reason.</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
I've recently finished a book that was
very insightful. It gives an understanding of early Haiti, how Haiti
came to be the Haiti that it is. Mainly, it is the story of an
ordinary man and woman, not much unlike you or me, detailing how
these two individuals did extraordinary things in Haiti. This book I
speak of is called Song of Haiti, which details the lives of Dr.
Larimer and Gwen Mellon. The recurrent theme (and purpose of Larry
Mellon and his philosophical mentor, Albert Schweitzer) speaks to
what draws me to Haiti: “Reverence for Life.”</div>
<div style="margin-bottom: 0in;">
<br /></div>
What is Reverence for Life? It is recognizing the value of all
life, with the fundamental principle of morality being that good
consists in maintaining, promoting, and enhancing life. I value my
life. I value the life of my children. There is nothing more valuable
to me than this. I see my own life and the life of my own children
here. We are not so different. I value life and the right to live
without pain and suffering- no matter in my own country, or half a
world away. I it's because of this that I cannot have a skill that I
can share and not share it, which I know will save lives and help to
ease suffering.<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJEweJH-5MkD1ggizFHkUcYX60nLzOepzAUYgX_8ByVdwGUalCB5tn7ZuIQ1YhmJw9CqQmPunlTlwT1iQc2ethXL7liTSmlYBT4dLjlQPoTbF_XjQ_b1JZ29-nsX_awSkYUsGsKYXD8Npk/s1600/GJ7A3100.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="265" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJEweJH-5MkD1ggizFHkUcYX60nLzOepzAUYgX_8ByVdwGUalCB5tn7ZuIQ1YhmJw9CqQmPunlTlwT1iQc2ethXL7liTSmlYBT4dLjlQPoTbF_XjQ_b1JZ29-nsX_awSkYUsGsKYXD8Npk/s400/GJ7A3100.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A little girl at the feeding center</td></tr>
</tbody></table>
<br />
<div style="margin-bottom: 0in;">
<br /></div>
“The fundamental fact of human awareness is this: 'I am life
that wills to live in the midst of life that wills to live.' A
thinking man feels compelled to approach all life with the same
reverence he has for his own.” -Albert Schweitzer<br />
<br />
<br />
<br />
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<br /></div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
Our evening started off rather
eventful, and not in the usual way. We rode to the hospital in the
usual fashion, riding on the back of a moto. This is something that I
fear dearly. The black and white logical thinker that I am, has
mulled over many times the various ways that we could come into harm
while in Haiti, and I've concluded that the moto is likely the #1
culprit for injury. Further add that we are most often on motos
during dark hours- going to the hospital in the evenings after the
sun has set, and returning in the morning, before the sun has fully
risen. The darkness adds the factor of limited visibility, in
addition to the dirt roads entrenched with large stones, rolling and
bumping land, that further creates an unstable journey on two wheels.
As we were riding to the hospital, I thought to myself, “I wonder
if we are going faster each time, or if I am becoming more paranoid?”
It was as if Glen read my mind because as soon as I finished my
thought, he says out loud, “It seems like the moto drivers are
going even faster than before!” Oh Lord, it wasn't just me. Not 1
minute after that, I look forward and see the single headlight of
another moto coming straight at us, both us and him going full
moto-speed, directly toward each other. I think, “Oh shit, we are
going to die,” and instinctively yell out, “SHIT!” My hands fly
up to grab the first thing they could grasp onto to brace myself-
that being the drivers neck. As I yelled, “SHIT!” I felt my nails
sink into the driver's skin. Thankfully both motos slammed on their
brakes, bringing us to a halt right before collision. I am also
thankful that SHIT wasn't my last word before I died. I apologized
profusely to the moto driver, and even though he spoke no English, I
am certain he got the gist of what I was trying to convey, as I
tapped his neck and said repeatedly, “So sorry!!!!”</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-IZRjkQGqvVU/VgSEPdAom3I/AAAAAAAAAxQ/Npfkuw2DLUU/s1600/GJ7A2987.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://1.bp.blogspot.com/-IZRjkQGqvVU/VgSEPdAom3I/AAAAAAAAAxQ/Npfkuw2DLUU/s400/GJ7A2987.jpg" width="265" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Our view from the back of a moto</td></tr>
</tbody></table>
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<br /></div>
<div style="margin-bottom: 0in;">
Planting my feet firmly on the ground,
I was relieved to get off the moto and walk the few hundred feet from
the outside gates of the hospital compound, to the entrance of the
Maternity Ward. As we walked through the hospital grounds, the sky
above was thundering and rain started to fall down on us. I stopped
just before the metal gate entrance to the ward, and stood there
under the falling water. Even in the dark night with a deep blanket
of clouds above, the air here remains thick. The cool rain felt good.</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
We began our night by making rounds on
the antepartum, postpartum, and post-op units. These are each one
room units, lined with beds on both sides of the room, each bed
numbered on the wall above. The first patients we see is a mom and
baby. The baby is about a week old and is being watched for a
low-grade fever. The first observation is that the baby is swaddled
up tightly with a thick winter blanket. It is hot as hell in here,
and no one should be using a blanket, baby included. I have no doubt
this is likely contributing to her low-grade fever. We take her
vitals and do a full assessment. I see that the baby's diaper is
full, and note that it is soft, yellow stool. Just as it should be. I
help Grandma change the baby's diaper and discover that this baby
girl dressed in all pink, actually has a penis. I laugh at my own
assumption, because really, using whatever clothing you have is
simply practical.<br />
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As we are doing our rounds, one of our
favorite Haitian midwives Carmell says to us, “I will let you know
if we have anyone in labor come in. I know you like to do
deliveries!” I smile at that. I know she likes the help, and she is
right- I do like birth.
</div>
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<br /></div>
<div style="margin-bottom: 0in;">
At 9:50pm I catch a baby- a normal
vaginal delivery, a healthy mom and healthy baby. As I am finishing
up and helping the new mom get cleaned up, Glen listens to heart
tones on another patient who is being induced with misoprostol due to
severe hypertension. This mom looks terrible and seems to be very
sick. Her whole body is extremely swollen, tight from the fluid that
is collected in her body. Her face is so swollen that even her
eyelids are puffy. I am certain she is nearly unrecognizable from
what she normally looks like. Just looking at the woman is a reminder
that hypertension in pregnancy is no joke. It may cost this woman her
life, or her baby's life. Glen puts the doppler on and we hear
clunk.........clunk..........clunk......................clunk. The
baby's heart rate is in the 80s and stays there. They reposition her
and continue to monitor baby. There's no oxygen available. The baby
continues there, sometimes skipping beats. With this mother's
hypertension and severe symptoms, along with misoprostol induction,
there is no doubt that this baby has little reserve. Glen checks her
to see if we are close to delivery and can somehow expedite it. She's
only 3 cm. We know that this baby is not going to tolerate labor much
longer. He calls a c-section. It's 9:55pm. The Haitian midwives call
the Haitian OB. He's busy and can't come. He says that Glen needs to
do the c-section. The midwives hang up and jump into action. Within
mere minutes, a foley catheter has been placed and the patient is
prepped for surgery. Honestly, I'm dumbfounded. I have never seen
anything happen so fast in Haiti. There is true urgency in the room,
and I have never before witnessed this in Haitian culture. Maybe I'm
naïve, but this is my honest observation. Glen tries to listen to
the baby again and can't find heart tones again. Is it because of a
positional issue or have we lost the baby? We are all wondering the
same thing. He continues to try, and nothing is heard. The clock is
ticking...ticking...ticking...we wait and the minutes pass by. The
Haitian OB who they previously called cannot get a hold of the
anesthesiologist, and neither can they. She isn't answering her
phone. Glen can't do a c-section without anesthesia.
Tick...tick...tick...the minutes are ticking by, and this baby is
dying with each tick. Finally, an ambulance arrives to the hospital,
and in the ambulance emerges not a patient, but the anesthesiologist
and a scrub tech. How interesting that the ambulance brought them to
us. As we would find out, this crew is Cuban and only speaks Spanish.
</div>
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<br /></div>
<div style="margin-bottom: 0in;">
So there they went, an Anesthesiologist
and scrub tech who only speak Spanish, an OB and RN who only speak
English, and a Haitian O.R. assistant who only speaks Creole. As Glen
leaves he shakes his head and tells us that it is inevitably too
late. There is no way this baby is still alive. My chest is heavy as
I think that we listened to that baby's heart slow down as it
gradually stopped beating altogether. I walk to the storage closet,
to where Shelly was, and I ask her (as if she were more insightful
than I was on the matter), “Do you think the baby is still
alive???” I feel as if I am grasping at straws, wanting some
reassurance that this little life is still in existence, that we even
have a chance. Not just the he or she has a chance, but that yes, WE,
have a chance. This life is valued. This life matters. I don't know
the swollen face of the mother from any other random face of the day,
and I might never know her baby, but in these fleeting minutes, tick,
tick, ticking away, there is Reverence for Life.</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
Shelly looked at me and answered my
question. “I don't know...probably not. But I hope so.”</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
I would walk away to another mom laying
on an exam table who was pushing. I would do this delivery by myself,
as Glen and Camille were likely just beginning the c-section. I
couldn't help but to think that as one life blazed into the world
screaming, one life was ending, coming into the world silent. That is
a profound feeling. As Glen and Camille would later tell me, Glen
would lift the blue, lifeless baby boy from his mom, hand him to
Camille. He was certain this was a lifeless baby he was handing over,
and contemplated this as he sutured this mom's very sick body back
together.
</div>
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<br /></div>
<div style="margin-bottom: 0in;">
I had just finished with this mom when
Camille entered the room with the tiny bundle in her arms, pressed
against her body. I heard her say my name, “Tara.” She called it
out firmly, not exclaiming but still, making a statement.</div>
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<br /></div>
<div style="margin-bottom: 0in;">
I knew when I heard her that the baby
was alive. I asked her, “Is the baby breathing?” The baby was
trying to breathe, though not very effectively. The conversation
between Camille and I is a blur. I took Camille's stethoscope and
placed it over the baby's heart and was surprised to hear a heart
galloping away; 140 beats per minute. A couple breathes of PPV and
some stimulation and this baby was breathing on his own. My fingers
remember what that limp body felt like under my fingers. This baby
was not even two pounds. So delicate, so frail. We wrapped up this
tiny, flopping body who was now making an effort to breathe, and
carried him down the hall to the NICU. A pulse ox was placed and
showed that his heart rate was 160 bpm and oxygen saturation was 87%.
Astounding. We would leave the baby there, under the care of the
NICU team. We walked away having done what we could, leaving him in
the care of others who will hopefully do what the can.</div>
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<br /></div>
<div style="margin-bottom: 0in;">
Meanwhile, we do an intake assessment
on a young and very tiny mom whose water has broken. She is a first
time mom, looks to be about 100 pounds, and is about 28 weeks
pregnant. There is amniotic fluid everywhere- the exam table is
drenched, and as Camille and I speak to her, our shoes are in a sea
of in her amniotic fluid. She lays on the exam table, without
underwear, her legs spread. Her vulva and legs are dripping with
fluid, smeared with mucous and blood. I place my hands on her belly,
and see that her abdomen hardly looks pregnant. The untrained eye
would likely not suspect this naked abdomen to be a pregnant belly.
My sweaty, gloved hands could hardly palpate a baby. Her muscles were
taut and solid, her skin and muscles from not having held a baby
before. Her vitals were normal and her baby sounded fine. She was not
contracting. The Haitian midwife had already completed a vaginal exam
and said she was 1cm dilated. I went over to the Haitian midwife and
asked if we were staring steroids, to help mature the baby's lungs.
She shook her head no. I asked why. She said because the patient was
already dilated and it was too late, steroids would not be useful. I
felt the need to clarify how dilated this mom was, and asked again.
She said 1cm. I had so much to say but recalled a good piece of
advice that I had just read in the Midwives for Haiti volunteer
manual...the best place for questioning something and to correct or
teach, isn't in real time, in the clinical setting. This is, after
all, their territory, we are just here to help, and teach by example,
or when otherwise appropriate. I walked to the back room where Glen
was and explained the situation. He agreed that the mom should get
steroids and antibiotics. I asked Shelly how I might say this, to let
the midwife know, “This is what we would do at home...” Shelly
ended up doing a great job with translating this, and in the end, the
midwife was very receptive to it, asked Glen the appropriate medicine
and dose, and then said she would do it. [The next day we would find
out that this mom would subsequently deliver her 28 week breech baby
into the hands of another midwife volunteer with Midwives for Haiti.
No one knew if the baby was dead or alive, and when the baby's legs
were delivered. Jamie was surprised when they started to move. As I
write this, the baby is alive and well in the NICU. I hope those
steroids got to where they needed to go.]</div>
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<div style="margin-bottom: 0in;">
We would have another delivery later in
the night, and this one wouldn't be easy on use either. I wouldn't
have expected anything less. The Haitian midwives were taking care of
a mom in labor. I had previously told them to just let us know what
we could do to help, that we were available if need be. While pushing
with the mom, the midwife heard that the baby's heart rate was having
decelerations. It would go from 140 to 80...70...and then slowly
recover back to baseline. That's not something that we don't
sometimes see. Except then she noticed that the baby began to have
repetitive decels that were taking longer and longer to recover, now
staying a good bit of time in the 70s and then not recovering. She
asked for “Dr. Glen” to come help. At this point we were seeing
baby's head at the peak of the push, but not crowning. The Haitian
midwife asks if Glen can do an episiotomy, but he explains that this
will be useless because the baby isn't to the perineum yet. The
midwife nods in undertsanding. I see her contemplating something, and
as I open my mouth to offer a suggestion, she says the same thing,
but in Creole. “What about a vacuum,” we both ask? Glen looks
surprised and says, “Oh, do we even HAVE a vacuum?” Why yes, yes
we do. I had seen them in the storage closet. He says ok, and a
vacuum is retrieved. He puts it on, mom pushes, and he assists her
pushing with the traction of the vacuum. A baby girl is born,
screaming.
</div>
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All in all, a busy two days...reminding
us and revealing to us in new ways, how delicately precious life is.<br />
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-83984110647957897112015-09-22T19:06:00.003-07:002022-03-11T09:42:32.631-08:00A Pot to Piss In...and So Much More<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
Welcome everyone. If it doesn't become obvious momentarily, I (Glen) have been handed the reigns for today's blog. Thankfully, I have had a bit of help with the editing to give it a bit more of a writer's flare. Never fear, I'll make sure Tara picks back up tomorrow! <br />
<br /></div>
<div style="margin-bottom: 0in;">
I'm glad our first day started off so
quickly- it gave Camille a taste of what it could be like. But, this
last shift would allow us to sit back and take it all in...and that
might not be all good. We started the day off nice and slow, such a
difference from yesterday, when we literally walked into two
simultaneous deliveries. This shift, we were able to help take care
of some of the tasks of a busy ward. Tara and Camille set off with
our translator to do vitals. Certainly an eclectic mix of
antepartum, postpartum, and post-op moms to be seen. One of the most
interesting was a mom admitted from mobile clinic for suspected early
labor. (Because she lives so far away, she may end up staying there
until she delivers.) On exam, Tara noticed something odd about her
lower belly. It was obvious she was pregnant, but her bladder was so
protruding that it was noticeable with her laying on her back. Tara
expressed concern to me; dare I admit Tara's perplexed concern was
somewhat comical. She wasn't quite sure what the problem was, as I
don't think she had ever seen a bladder so obviously distended. Upon
questioning, the patient stated that she did not feel the need to
urinate. Tara palpated her abdomen and felt her bladder. The patient
didn't flinch, and appeared to not have any discomfort. Clearly
though, she had to pee. But where? In what? There are no restroom
facilities anywhere. Remember the saying your mom always used to
say...'she ain't got a pot to piss in.' I laugh at this...perhaps
that was just MY mom, growing up in rural Kentucky. But, I
remember hearing it and it never was quite as vivid as here. We found
her 'pot,' which was a large bucket that the family had brought with
them. Camille held it under the mom as she stood at the side of her
bed (not 2 feet from a postpartum mom and baby couplet) and peed.
Nearly filled the bucket. You look around and everyone has their pot
to piss in...well, everyone except the birth team. Thankfully Tara
and Camille somehow have the capacity to hold their bladders for 12
hours. But...that's a different story.</div>
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<br /></div>
<div style="margin-bottom: 0in;">
Just when you think that we have
everything, or that you can do anything, you're thrown a curveball.
Dr. Celestin had apparently seen this young, first-time mom in his
outside office and sent her to L&D to get a D&C due to a
miscarriage that had not passed. This patient had had consistent
bleeding for 8 days that was not slowing down. D&Cs aren't the
most glamorous procedures to do here as they are typically done
without much in the way of anesthesia and such an invasive procedure
which is normally (back home) done in private, is done here in plain view of everyone. Tonight would be no different, except for one
twist. As I'm preparing myself for the procedure, I go to the stand
beside the patient and look over my instruments. I expect to see all
the usual: speculum, tenaculum, dilators, and a currette. Instead, I
see no currette and a plastic iPas device. I've seen this manual
suction device before, even thought of buying one for use in the
office for miscarriages, but this is not my typical go-to device.
And here it is in front of me.Thankfully, it wasn't very difficult
and all things considered, the D&C went pretty well. Tara stood
by the patient's side, holding her hand and caressing her face to
help her relax through it, while Camille assisted with holding a leg.
One of the Haitian midwives oversaw, and hopefully now could use the
iPas device, should she need to. The best part for me was that at the
end, the patient looked to Tara, took her hand, and said (in clear
English), “Thank You,” for helping get her through it.
</div>
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<tr><td class="tr-caption" style="text-align: center;">Something is brewing in those clouds</td></tr>
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<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
It's never fails to amaze me that women
come and go in Labor and Delivery here. Somehow, the midwives keep
all of these women straight. One such woman had apparently been
there all day. When I asked what her status was, the midwife says,
'Dr. Celestin is coming in to section her at some point.' “Why,”
I ask? “Transverse lie and her water is broken.”
</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
I decided to examine the mom myself
and confirm that the baby is now vertex! The baby is “Cephalique”
and shouldn't need a cesarean section. A few hours later, Dr.
Celestin comes in and does a vaginal exam and doesn't feel a
presenting part and finds the head is the right lower quadrant.
</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
In our discussion about abnormal lie
(breech, transverse), I ask if anyone there does versions. A
'version' is a procedure where a baby is manually turned to get it to
head down. A fairly common procedure in the states, but not here. I
ask why they don't at least try- certainly an attempted version is
safer than a potential cesarean section- and am told by Dr Jean
Baptiste that they learned in training that versions will cause the
placenta to pull away and harm the baby. This just goes to show that
you just never know what is common sense and commonplace in one
place, may be literally a foreign concept somewhere else.</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
Eventually, we take the patient back
for section. Dr. Celestin jokes in Kreyol that I am the primary and
HE will be assisting me. Apparently, not only am I the primary
surgeon, but the scrub tech as well. I stock the Mayo stand, prep
and drape the patient. Everything, except the sharps, eventually
winds up between the mom's legs...placenta, retractors, scissors,
blood clots...everything. It isn't exactly the prettiest, but it did
get the job done. Camille would join Dr. Celestin and I for the
cesarean and be responsible for the baby. After delivery, Camille
would take the baby to Tara, who was awaiting in Labor &
Delivery. I can't say that the protocol for having an assistant in
charge of baby's care has been implemented, but as Tara reminded me,
we did get to model this. An assigned care
provider for baby to company during the surgery, and someone waiting,
prepared to assist with care on the ward.
</div>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqS74xxUknHjSaw5oMvZNYXznuCzAlV98x-05DexeQvRSYGfTp-KKwfxQYZauhpRAvFBKzxoQ9X6cgloLqGnOXREEbBCZJX2yuOt2fPjBrSWU8eeXA22aXI9HkCkGDmfOl2fBQjZFacoLe/s1600/IMG_8729.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqS74xxUknHjSaw5oMvZNYXznuCzAlV98x-05DexeQvRSYGfTp-KKwfxQYZauhpRAvFBKzxoQ9X6cgloLqGnOXREEbBCZJX2yuOt2fPjBrSWU8eeXA22aXI9HkCkGDmfOl2fBQjZFacoLe/s400/IMG_8729.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Preparation for the c-section baby</td></tr>
</tbody></table>
<div style="margin-bottom: 0in;">
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<div style="margin-bottom: 0in;">
As our 4 year old Adria would say, this
baby was a 'fat man' (this is her term of endearment for Callen), at
a whopping 8lb 13 oz. Except, apparently it is a curse in Haiti to
call a baby 'fat' because those 'fat' babies will then lose weight
and not thrive or do well. In doing postpartum rounds, Tara proudly
exclaimed, “The baby is so fat!” Our translator had to inform her
that she should not say this, since it is not a good thing for he
family to be told. Lesson learned regarding the importance of cultural appropriateness. No “fat garcon” or “fat
tifi” here!</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
One of the things about birth that we
take for granted back home is that women, and our culture as a whole,
value and celebrate the 'birth experience' when the baby is born. It
has been my experience that moms and dads often cry when their new
baby is born. Emotions are abundant with birth in our own culture.
However, birth is not typically a time when Haitian women express
emotion. Nor are babies often named at birth. We often get asked
regarding this by friends, why it seems as though Haitians seem
irreverent during birth. While it may appear this way superficially
without understanding Haitian culture, we slowly understand that this
is not the case. At the very basis, we need to consider and remember
that if a baby is born alive, BIRTH is the first of many hurdles that
the baby has to cross to get to adulthood. Enough babies die after
birth that it seems recognized that the newborn's life may be
short-lived.
</div>
<div style="margin-bottom: 0in;">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-XqRhGjZdIkI/VgH_vupxBiI/AAAAAAAAAuw/OxvHGqa0ltw/s1600/IMG_8733.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-XqRhGjZdIkI/VgH_vupxBiI/AAAAAAAAAuw/OxvHGqa0ltw/s400/IMG_8733.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A baby girl we assisted with...photo with permission. </td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoPNCwondDEP2TaXzCCPFePa2xWe_0gKRne-crTta2wopTilZWjmIZ5nPt_rGRLijhF6BWVbpE3rYrRxWKy8ThMcEgzl63KmuyGNdshAG346T-TgbuF5fFCHwK_3PougS3WP_X4OGM5LVs/s1600/IMG_8735.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoPNCwondDEP2TaXzCCPFePa2xWe_0gKRne-crTta2wopTilZWjmIZ5nPt_rGRLijhF6BWVbpE3rYrRxWKy8ThMcEgzl63KmuyGNdshAG346T-TgbuF5fFCHwK_3PougS3WP_X4OGM5LVs/s400/IMG_8735.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">2 kilo budle of love</td></tr>
</tbody></table>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3DYjDk0fH2yPf0yzEvb8kSB80UmT6bK1DaTaIXle-5V-KRnnVn0FBccEubJm9Jh0fObedzAFbN6jn6LS9Y6SLY2oQ1x1eKxD9h6zjiSuMA01oN2mX6KynCWlEA4hLZR22BpBUSJMLBCBn/s1600/IMG_8737.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3DYjDk0fH2yPf0yzEvb8kSB80UmT6bK1DaTaIXle-5V-KRnnVn0FBccEubJm9Jh0fObedzAFbN6jn6LS9Y6SLY2oQ1x1eKxD9h6zjiSuMA01oN2mX6KynCWlEA4hLZR22BpBUSJMLBCBn/s400/IMG_8737.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">#clothdiapering</td></tr>
</tbody></table>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
I will admit that I was once perplexed
over a total lack of emotion in Haitian people, in birth and in
death. But last night changed that. In the overall quietness of the
night, a spontaneous commotion erupted within the hospital compound.
A woman sprung from the dark, exclaiming, yelping, and wailing,
making us question whether she was having a mental breakdown. The
exterior hallways within the hospital are as pitch black as the night
sky, making visibility in trying to visualize the happenings hardly
possibility. In the wee hours of the morning, with wards overflowing
with admitted patients and no where but the outside for some patients
and their families to sleep, the halls are lined with sleeping
bodies. The shrill hysteric outcries of this woman startled all of
these slumbered bodies, resulting in a scattering of the people that
laid surrounding her. What is going on? What is happening? I am sure
these were the questions in everyone's mind, us and Haitian alike.
The woman's hysterical screams and outcries continue, as random
voices yell to her in the dark. Though we had no idea the specifics
of the situation, it was obvious that this woman was grieving. One
thing is certain, the translation of loss and grief transcends
cultural and language differences. As we would learn from our
translator, someone had just died in the ICU. The yelling sounded
despaired and grieved, and that it was. This was the first overt
display of emotion that I had witnessed in Haiti. Through the pain of
labor, the separation of family, the death of a child, nothing we had
previously seen provided a glimpse into one's personal feelings of
their pain and suffering.</div>
<div style="margin-bottom: 0in;">
<br /></div>
<div style="margin-bottom: 0in;">
As those of this blog would know,
hypertension in Haiti has been rampant in our previous trips. As we
take vitals in labor I'm amazed that more often than not, the women
have had normal blood pressures. Obviously there has not been a
dramatic change in diet, but perhaps an increase in prenatal and
intrapartum care availability? This of course is anecdotal... I don't
know the answer, but it is very apparent that something is changing. </div>
<div style="margin-bottom: 0in;">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1wkR-1eB7Gi73s-vdHsGP50IJmc1C6VITM-Q2tbpB61TxKDU43icoOgDyjACxKvHmcOsmVk59kmWlGznaZAZvDvjRvF_VetfjlWEa63UrFGrw_IjDHT7tanleF3Qq0rOXn0aZ1Z7z_-pk/s1600/IMG_1950.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="224" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1wkR-1eB7Gi73s-vdHsGP50IJmc1C6VITM-Q2tbpB61TxKDU43icoOgDyjACxKvHmcOsmVk59kmWlGznaZAZvDvjRvF_VetfjlWEa63UrFGrw_IjDHT7tanleF3Qq0rOXn0aZ1Z7z_-pk/s640/IMG_1950.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sunrise behind the Midwives for Haiti compound.</td></tr>
</tbody></table>
<div style="margin-bottom: 0in;">
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<div style="margin-bottom: 0in;">
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<div style="margin-bottom: 0in;">
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-43115727455204670722015-09-21T14:34:00.001-07:002015-09-21T14:34:45.489-07:00Haiti 2015: Day 1 & 2<br />
We arrived into Port-Au-Prince on Saturday afternoon and made the long, winding journey to Hinche by way of the Midwives for Haiti Land Cruiser. I will admit that I was a bit excited about the travel accomodations, as we have always received transportation in the classic, "Pink Jeep." The enclosed air conditioned vehicle was a welcome repreive from our 20 hours of travel from Alaska, and especially knowing how I get with motion sickness. We would, however, find out that the air conditioner isn't functional. Ha! We packed into the back of the Land Cruiser and within about 20 minutes the first passenger was feeling sick. Thankfully, it wasn't me (yet). I got out the peppermint oil from my purse and Glen got out a rag, which we wet and put on the back of the other volunteer's neck. The rest of us rubbed peppermint on the backs of our necks to help us cool down. The cooling sensation felt amazing in the dense heat we were sitting in. Of course not long after that, I was the next victim of the trecherous journey. The constant swerves, bumps, and horns ablaze from other vehicles flashing by was taxing on my senses and internal stamina. I quickly turned 'green,' earning myself a front seat accomodation, right alongside our driver. I laid back in my seat, splashed water on my face, closed my eyes, and let the wind blow in my face. 2 1/2 hours from that point, we had made it safely to Hinche, and I had made it without vomitting...as did Lea, my partner in sickness<br />
<br />
Sunday was our first full day here, and the beginning of a night shift at St. Therese. A group of us rode on motos into town and attended church service.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-9stKkyG0Xog/VgBpyT20HkI/AAAAAAAAArs/2R7yohrdwNA/s1600/image1.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-9stKkyG0Xog/VgBpyT20HkI/AAAAAAAAArs/2R7yohrdwNA/s400/image1.jpeg" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Volunteers Lea and Shelly</td></tr>
</tbody></table>
<br />
After church Glen and Camille (our clinic RN back at home, who joined us this trip) took a tour of Hinche. I stayed behind to rest and gear up for night shift. Camille would return, slightly aghast, telling stories of the food she saw in the open market- fruits, meats, fish, all swarming with flies. She held serious concern for Glen, and made sure to report back that he had been eating these items, without concern for what might subsequently happen from ingesting flies and larvae. Glen assured us that it was delicious and he was fine. 20 minutes later I was downstairs eating a late lunch and Camille came flying into the dining area, wide-eyed, as if she had just seen a ghost. She said to me, very much an exclamation rather than a question (because she already knew the answer), "Tara! WHERE IS DR. ELROD!?" (It's funny to me that more times than not, she still refers to him as 'Doctor Elrod,' rather than Glen.)<br />
<br />
Amusingly, I had already heard him from downstairs and knew exactly where he was. He is, afterall, the world's loudest puker. I responded with, "Oh, he's upstairs puking." Camille's eyes were as wide as saucers, and just like that, it pretty much validated Camille's hesitance to consume anything out of the ordinary. But don't worry about Glen...it was delicious...and he's fine. ;-)<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-yYqIhIDwTek/VgBnQXRm9YI/AAAAAAAAArE/TOSPZXb6IYs/s1600/IMG_1922.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="http://2.bp.blogspot.com/-yYqIhIDwTek/VgBnQXRm9YI/AAAAAAAAArE/TOSPZXb6IYs/s640/IMG_1922.JPG" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Glen trying some dried herring in the marketplace.</td></tr>
</tbody></table>
<br />
We arrived to the hospital shortly after 7:00pm, and within minutes had assisted with two deliveries. The first baby the Haitian midwife delivered, Camille and I would assist, and Glen would subsequently suture the mom's laceration. Camille helped to stimulate the baby and I tied the cord with string. Camille would do the newborn exam and dress the baby, all while Glen and I pushed with the mom 5 feet in front of the first mom who delivered. As Camille was doing the newborn exam, she noticed that it was oozing and had to re-tie it, tighter than what I had tied. Good catch, Camille.<br />
<br />
The postpartum mom would lay there on her own delivery table, legs sprawled and perineum torn, raw from just having given birth, quitely observing the other woman preparing to do the same. I stepped over to her and made sure she understood, "We don't want to start to suture you right now, so that we are prepared for this baby. As soon as this baby is born, we will get you sutured and dressed." She smiled and nodded, appreciating the explanation. Camille took her vitals and tended to the baby while Glen and I assisted the other mom. The Haitian midwife charted, and attended to the other packed room of laboring women.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCZFhVE3yMrSR5ZvmGurvmaxPNtH6fgMgt-GgKR2nbkAVJlF8JhpoWNrgyagD2Sl2-lqXAvXw_UJeewWO75_1ca53qQJ5lzNu6MUpVHSiJ7lVM3-aCWoSyrP-Om_bBOpw2Wy2KVrF_Nrz4/s1600/image6.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCZFhVE3yMrSR5ZvmGurvmaxPNtH6fgMgt-GgKR2nbkAVJlF8JhpoWNrgyagD2Sl2-lqXAvXw_UJeewWO75_1ca53qQJ5lzNu6MUpVHSiJ7lVM3-aCWoSyrP-Om_bBOpw2Wy2KVrF_Nrz4/s640/image6.jpeg" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Camille and a new Haitian life</td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-fzArQa3QAyg/VgBp6DZ2W4I/AAAAAAAAAsQ/5ZvAwV8l9H0/s1600/image7.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="http://4.bp.blogspot.com/-fzArQa3QAyg/VgBp6DZ2W4I/AAAAAAAAAsQ/5ZvAwV8l9H0/s640/image7.jpeg" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A healthy baby girl</td></tr>
</tbody></table>
<br />
The mom who was pushing had fetal heart tones in the 60s, telling us that baby was not doing well. Glen ruptured the bag of water (and as amnihooks are a luxury, the tool that the Haitian's use to AROM (artificial rupture of membranes) is a needle or the back of the needle cap). The Haitian midwife, Carmelle, joined us in telling the patient to push as hard as she could. "PUSH HARD! KEEP PUSHING, GO ON, PUSH! YES, JUST LIKE THAT...KEEP GOING...GO, GO, GO...PUSH!" These were the sounds now coming from the Maternity Ward. A 2.9 kg baby boy was born, needing stimulation and a couple cuffs of PPV. Mom was expecting a girl and had only brought a girl outfit to put baby in. Not that it would have been the end of the world to dress him up in a pink outfit, but I thought it a better idea to use a baby gift pack. This particular mom had brought a cloth pad but did not have any underwear to put that pad in and keep it in place. I was wishing I had thought to bring a stash of underwear. I think that would be a great addition to our packs next time.<br />
<br />
After these two deliveries, we realized that there were no more syringes for Pitocin or Lidocaine, as well as no more Vitamin K. We searched everywhere, and ended up having to resort to putting Pitocin in the 1mL syringes that are typically used for Vitamin K.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwUhgjq9CkC6oxgeYDsY1ygKG-YsqYUIAjgqlBNJTtcci1mxbHwAXR-LURqnOVrXCDuNvmt_-oc4vYg7STf7Yrcr4Xs6TsDcOuESG6XMEMqI52ZU44NjmByzsDAcRst0gY6x-Zo0-5xjKE/s1600/image5.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwUhgjq9CkC6oxgeYDsY1ygKG-YsqYUIAjgqlBNJTtcci1mxbHwAXR-LURqnOVrXCDuNvmt_-oc4vYg7STf7Yrcr4Xs6TsDcOuESG6XMEMqI52ZU44NjmByzsDAcRst0gY6x-Zo0-5xjKE/s640/image5.jpeg" width="640" /></a></div>
<br />
7 hours into our shift and it was a bit quiet, with 4 babies delivered and no one imminitently delivering. We all retreated to the storage room, which also doubles as a break room for the midwives and volunteers. We intermittently talked, rested, and checked on the women who remained in Labor & Delivery. Over the course of the night we participated in 4 deliveries, with the Haitian midwife doing another delivery as we rested.<br />
<br />
As an outsider coming to Haiti, it is so easy to feel sadness, despair, frustration, and helplessness. Nights like tonight are a welcomed blessing, showing us the good, the life, the hope...A competent and compassionate skilled birth attendant that is the product of Midwives for Haiti. Healthy, term babies. Perhaps it was a smooth initiation to preserve Camille. Either way, it was good to see the good.<br />
<br />
In my time here and life since my first trip to Haiti, it seems that the feelings of sadness, despair, frustration, and helplessness are necessary: they are catalysts for change, afterall. Can you imagine a world in which we turn a blind eye and guarded heart to the pain and suffering that exists? Just because it is not happening where we are, does not mean it is not happening. I type that from my laptop and you read that from your computer screen or iphone. Human pain and suffering can be mentally comprehended, but to really GET IT, and act on it...that's a different challenge. More on that later.<br />
<br />
Until next time...<br />
<br />
Tara<br />
<br />
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<br />Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com2tag:blogger.com,1999:blog-714741860362412016.post-57314764756092680292015-08-01T18:55:00.001-07:002015-08-03T12:09:05.652-07:00Haiti 2015: How Can You Help?<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); color: rgba(0, 0, 0, 0.701961); font-family: UICTFontTextStyleBody; font-size: 17px; text-decoration: -webkit-letterpress;">
Glen and I will be leaving for Haiti in 7 short weeks, and are in need of your support! Our trip to Haiti is one we look forward to but seems to financially add up so quickly for us...the snacks, medical supplies, airfare, the cost of checking our baggage and the cost of volunteer accommodations with Midwives for Haiti. It is something we are able to do, but not without challenge.</div>
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So we ask...</div>
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Are you able to help? In the next few weeks we will have various ways we will ask for your help and support. </div>
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One of my favorite gifts to take to Haiti has become what I call "Newborn Gift Packs." The packs are ziplock freezer bags which typically consist of a newborn onesie, pair of socks, hat, light blanket, cloth diaper, and cloth pad for Mom. (Note: The cloth diaper and cloth pad do not need to be anything expensive, but even just a thick, absorbent fabric such as cotton or flannel.)<br />
These gift packs have been handed out at mobile clinics throughout Haiti as a way to encourage moms to keep returning for prenatal care. Glen and I have also kept some on hand when we work shifts at the hospital. Inevitably, there are moms who have no clean sheet to deliver on, nor anything for their new babies. </div>
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If you are interested in making some "Newborn Gift Packs," please message me. We will be collecting them, as well as additional supplies, up <a href="x-apple-data-detectors://0/" x-apple-data-detectors-result="0" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">until September 16th.</a> </div>
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Items do not need to be brand new, but simply in clean, like-new condition. </div>
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If you are interested in purchasing clothing items to be put into gift packs, all L'oved Baby clothing items which are purchased for this cause will be 50% off at Betula Baby (the baby boutique located inside Integrated Women's Wellness & Center for Birth). Simply let us know that your purchase will be donated to our Haiti 2015 trip, and all clothing items purchased for the trip will be 50% off. This would be a great and EASY way to help. If you do not have supplies or the time to put together gift packs, you can purchase items from Betula Baby that we will then put into gift packs and take with us to Haiti. </div>
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Thank you, for whatever support you can give!<br />
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[Be sure to follow along our journey by checking the blog, our facebook pages, and @tara_elrod and @thecenterforbirth on Instagram.]</div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-80057806865787108132015-07-22T20:33:00.002-07:002022-03-11T09:02:29.171-08:00#lifeofamidwife: To Teach<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); color: rgba(0, 0, 0, 0.7); font-family: UICTFontTextStyleBody; font-size: 17px; text-decoration: -webkit-letterpress;">
Perhaps one of the most oxymoronic aspects of my career as a midwife is my role as a preceptor. It is challenging- outright maddening quite often- but also a source of great inner learning and reward. I try to keep this in mind on the particularly rough, frustrating days when I feel as though I am barreling down a one-way street called Give.</div>
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I'm a midwife yet very rarely do I catch a baby. My hands are often not the first hands to touch a fresh new life- they guide and meld the hands of two student midwives as they create and hone their own skill. </div>
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We had a mom recovering from delivery in one birth room, when another mom came in. This patient was a repeat patient of mine, who had had her first baby under mine and Glen's care. When her baby was crowning, I switched places with Mary, moving from between the patient's legs, taking the Doppler in my hand, and switching to the role of monitoring baby. Mary moved in to "catch."</div>
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The baby's head is at a full crown and mom's perineum at a full stretch. The student is nervously touching the baby's head, as if giving a head massage, obviously feeling the need to do something with her hands. We (midwives) often speak of the importance of "sitting on our hands." It's easier said than done for some. </div>
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"Stop," I quietly say, nearly inaudible. </div>
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The baby's head delivers, direct OA. The student midwife starts to apply pressure to the baby, gently downward on the baby's head as if to facilitate delivery. </div>
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"Don’t do that," I gently and discreetly say. </div>
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She reminds me of the many physicians (and yes, even midwives), I have witnessed who apply traction immediately after the delivery of the head, expediting delivery even long before the woman has the next contraction. So many practitioners do this as a means to actively manage (the threat of) a shoulder dystocia, but what it inevitably ends up doing is the opposite. Facilitating delivery prematurely only increases the likelihood of an impaction, as the baby's Cardinal Movements and specific, intricate movements to maneuver through the pelvis are not allowed to be completed, with the baby being brought down into a non-ideal position. Further, it's common for downward traction to be applied while verbally instructing the mother to push even in the absence of a contraction, which is not nearly as powerful as when she pushes with a contraction. </div>
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I see the student in her I-feel-like-I-should-be-doing-something nervousness, and I think of this. I briefly make eye contact with the other student and she cocks an eyebrow at me. We can read each other's minds without saying a word. "What in the world is she doing?" I know exactly what she is wondering. </div>
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"Stop touching the baby." I outright, very matter-of-factly say. She catches herself and retracts her hands as if she has laid hands on fire. </div>
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The baby restitutes to the maternal left leg, and with the next contraction, is born. </div>
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These women are legit. It takes a special person to be a student midwife, yet an even more special one to work under Glen and myself. Our expectations are incredibly high, we don't allow room for excuses, and we don't hesitate to say what could be and should be better. If they stick with it, these women have the potential to be two of the very best midwives. </div>
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Later we debrief from the birth- how it went, how we did, what could have been done differently...and we teasingly make fun of the shenanigans. She’s good sport. Before we know it, these student midwives will be licensed and catching babies as midwives. I'm thankful that so far neither of them have flushed a placenta down a toilet or flooded a birth room. I can't think of any student midwife that would do that. ;-) [Reminiscing back to my apprenticeship...]</div>
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I think and laugh to myself that an apprenticeship is a special sort of hazing. </div>
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-4693119860784736782015-06-27T14:08:00.002-07:002015-06-27T14:08:44.036-07:00Haiti 2015It's official! Glen and I have set the date for our third trip to Haiti, in support of Midwives for Haiti. We will be in Haiti September 19th-26th.<br />
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As with our previous two trips, we need and value the support of our family, friends, and community. We appreciate all forms of support- encouraging words, prayer, monetary gifts to help purchase supplies, gifts of comfort items for ourselves to use while volunteering (hand sanitizer, snacks), medical supplies, and basic baby items made into gift packs to hand out during mobile clinic (well as for the families who come to the hospital with nothing) including: a onesie, hat, pair of socks, baby blanket, and cloth diaper.<br />
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The single most important factor in ensuring a safe birth for both mother and baby is having a access to care with a skilled birth attendant. While we struggle here in the United States with decreasing the rate of (unnecessary) intervention, there are women and babies dying due to that they do not have the most basic of intervention- a skilled birth attendant.<br />
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Please support us as we support Midwives for Haiti in their work to end preventable maternal and infant mortality. All donations may be brought to Integrated Women's Wellness & Center for Birth, now through September 14th. A list of specific needs will be posted and kept updated on a separate blog entry.<br />
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With Thankfulness,<br />
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Tara ElrodTarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-38890274263818808322015-06-19T11:21:00.002-07:002015-06-19T15:41:15.426-07:00Humility <span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); color: rgba(0, 0, 0, 0.701961); font-family: UICTFontTextStyleBody; font-size: 17px; text-decoration: -webkit-letterpress;">Last night after a birth- like after most births I attend- my husband sent me a text that read, "Good job." We had just had a calm, gentle waterbirth, and welcomed a new baby boy.</span><br />
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I'm not sure if my husband's words of praise are a thoughtful effort on his part to lift me or encourage me (no matter how 'easy,' uncomplicated, normal, or short a birth may be, the demands of what it is to be a midwife never change), but he makes sure to share this small praise with me often.<br />
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"I didn't do anything," I responded. Truly, this woman required very little of me. I was with her in my simple presence of just Being. My work included monitoring her baby and ensuring the normalcy of what was already naturally occurring.<br />
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A conversation stemming from his "good job" ensued. </div>
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"You obviously did do something. She got there at a great time in her labor, she had a good birth, no complications...You obviously had some part in orchestrating that." Yes, yes I did. But I know that we both already know that. And I recognize who did the most important work (not I). Should I be boastful? Should I be prideful? There is a difference with having pride and being prideful.</div>
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I drove home at 2:30 am, the Alaskan sky still glowing with light like the smoldering hot embers of a campfire that continues to persist. I marveled in the beauty of "summer birth" in Alaska, how easy it is compared to the dead darkness of the desolate winter. Tiredness doesn't cohabitate with Alaskan Summer, and at 2:30 am, it might as well have been 2:30 in the afternoon. I drove marveling over Pioneer Peak, while mulling over the value of Humility. When I got home, I quietly crept into my house, still light from the Midnight Sun and without need of turning on a light, devoured two cold pieces of pizza right out of the box that had sat there all afternoon and night. I crawled into bed beside my sleeping husband and baby, and further contemplated humility; what it means to be humble.<br />
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<span style="background-color: rgba(255, 255, 255, 0); text-indent: -30px;">"Humility has nothing to do with depreciating ourselves and our gifts in ways we know to be untrue. Even 'humble' attitudes can be masks of pride. Humility is that freedom from our self which enables us to be in positions in which we have neither recognition nor importance, neither power nor visibility, and even experience deprivation, and yet have joy and delight. It is the freedom of knowing that we are not in the center of the universe, not even in the center of our own private universe." -David Wells</span></div>
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<span style="background-color: rgba(255, 255, 255, 0); text-indent: -30px;">This speaks to midwifery and what I value in my heart. </span></div>
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-7757542506406637472015-01-27T22:00:00.000-08:002015-01-27T22:00:37.518-08:00Miss Perception<span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); color: rgba(0, 0, 0, 0.701961); font-family: UICTFontTextStyleBody; font-size: 17px; text-decoration: -webkit-letterpress;">When we first broke ground on our new office and birth center, we were called several times by people in what seemed to be going toward a community uproar. Why? Because we were building an abortion clinic, that's why. Or so, that was the word on the street. People in our neighborhood called our office. The church across the street called our office. Another midwife in our community was approached about us by inquiring minds in her own church. </span><br />
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The interesting thing with living in a small community, is that we are all connected. This, for the most part, is a strength and why I love living in a small community. I go on to have repeat clients and help them welcome all of their babies, I take care of friends and family members of previous clients, and we all continue to be further enriched by being deeply and strongly interweaved. However, sometimes- as in the case of the abortion clinic- living in a small community turns comparable to a bad case of The Telephone Game: information is shared, misconstrued, added, subtracted, twisted, contorted, misinterpreted, and passed on as factual truth. </div>
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In the case of the abortion clinic, the truth was: we were- and are- anything but. We take care of women. We help families become families. </div>
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Fast forward to today and on a completely different topic, our office received a phone call from a very upset, and not-so-nice woman. Her phone call really upset one of our receptionists. The woman felt the need to randomly call and speak of "things she had heard." In speaking with our employees about the incident, I contemplated the idea of calling this anonymous woman back to address her statements and provide her with accurate, factual information. Would it do any good? Would it be welcomed? Would it/could it make a difference to this apparent raging-mad woman? Would it just upset me? One of our employees pointed out: if I didn't call- if I just left it as it was- this woman would remain with her inaccurate misunderstandings. Thankfully for caller ID and a thoughtful receptionist, I had her phone number. </div>
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I picked up the phone and called this woman, not knowing what to expect but knowing that my heart was open and I was coming from a place where I wanted to rectify any misinformation. </div>
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<span style="background-color: rgba(255, 255, 255, 0);">The Telephone Game teaches us the power of perception and individual interpretation...stories morph as they go from individual to individual, each unique in perception and interpretation. </span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">For the anonymous caller, I hope our talk helped- and put this lesson into perspective. </span></div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-14787310239520949142015-01-13T23:12:00.000-08:002015-01-14T00:32:43.955-08:00The Birth Center OptionEvery week it seems we get more and more calls and emails inquiring about what our care consists of and what exactly a birth center can offer. It is wonderful to see more and more women and families actively researching and wanting to know more about this option. So, I got to thinking I should write a little bit about what we offer and why we are the best. Here goes...<br />
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In a time when healthcare consumers are becoming more and more involved in their care and decision-making, an increasing number of families are choosing to give birth not in the hospital, but rather, within a birth center- a homelike facility that revolves around the wellness model of pregnancy and birth.<br />
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The increasing number of families choosing to deliver at birth centers may largely be attributed to the increasing number of women desiring to have a natural, unmedicated birth, free of unnecessary intervention. Rather than policies of routine intervention, birth centers are guided by principles of <i><b>support</b></i> and <b><i>prevention</i></b>.<br />
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So you know you want a natural birth? Maybe you don't even know that for sure and are bordering on thinking that it is a wild and crazy idea! The best thing you can do- for yourself and your baby- is to know your options and learn more about what a birth center can offer. As we say around Integrated Women's Wellness...if you don't know your options, then you have none!<br />
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Here is what you can expect from a birth center birth with us:<br />
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<b>Us</b><br />
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We are a small, intimate practice whose primary focus is providing evidence-based, family-centered care, and truly getting to know each individual person. Unless planned well in advance, you know you will have the same care providers you have seen throughout your pregnancy attending you at your birth. Our patients have the benefit of an integrated model of care, which marries the personalized, wellness model that is midwifery care, with the science of obstetrics.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUapz2_QL9vFK3lkvRFDBn6uKdAjO4D-vIBvPTNPO1klcByxqwlUH50TBfQYB4z99ZQ2ftJ8xYjrADd_m2ouc1fp2ft9LYxlB-CK0yWc3G8ZoUjpOrOT_wdVlUP9YE_m3wUQHdOy2cwKaM/s1600/image.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUapz2_QL9vFK3lkvRFDBn6uKdAjO4D-vIBvPTNPO1klcByxqwlUH50TBfQYB4z99ZQ2ftJ8xYjrADd_m2ouc1fp2ft9LYxlB-CK0yWc3G8ZoUjpOrOT_wdVlUP9YE_m3wUQHdOy2cwKaM/s1600/image.jpg" height="212" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Tara Elrod, CDM</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRTAwEE6HbpYnC3gGnMM2diSkqpb4t-GuIGBq3qf2bO2Bbw_Sad2PJUgJ70_Goz1kwWm_py5TK9WxsVQR5VZjSexVRhA8di0bi7VXp-VdU8h-jiUQJuM6CrH6vQ9RnIQUqlQ2hbDmvRsdS/s1600/image.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRTAwEE6HbpYnC3gGnMM2diSkqpb4t-GuIGBq3qf2bO2Bbw_Sad2PJUgJ70_Goz1kwWm_py5TK9WxsVQR5VZjSexVRhA8di0bi7VXp-VdU8h-jiUQJuM6CrH6vQ9RnIQUqlQ2hbDmvRsdS/s1600/image.jpg" height="234" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Glen Elrod, OB/Gyn</td></tr>
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<b>Our Rooms</b><br />
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We have two beautiful rooms that we specifically designed to be a cross between the comfort of home and the relaxing space of a luxury hotel. Both birth rooms showcase the scenic photographic art of our local Alaska surroundings (done by a local photographer, Calvin Hall), though each with different decor and its own distinct 'feel.' Both rooms offer a queen-sized family bed, an open-concept shower, and a large tub- both for hydrotherapy as well as the option for waterbirth.<br />
There is no separation from partner, the barricade of a bed rail on a hospital bed, nor a hospital bed that gets "broken down" for a lithotomy-positioned turtle-back delivery.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-7SyScwfmlmWsMiJLKdfIy-qbFeugATpXXS84dwJtznK4mCgrduRN-CBaThhnANsPiZfOL7KoZXAT-8bxmL-2l0aYdKyoQmnhqkOwdsfff1H9AN-eMAhqbOooUZ-PfhZSauAkaTHdlHXd/s1600/image.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-7SyScwfmlmWsMiJLKdfIy-qbFeugATpXXS84dwJtznK4mCgrduRN-CBaThhnANsPiZfOL7KoZXAT-8bxmL-2l0aYdKyoQmnhqkOwdsfff1H9AN-eMAhqbOooUZ-PfhZSauAkaTHdlHXd/s1600/image.jpg" height="300" width="400" /></a></div>
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<b>Support People</b><br />
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Our model of care is that of evidence-based, family-centered care. There is no limit on the number of people allowed to be with you as you give birth or how involved they can be. It is entirely up to the patient. Family members, doulas, and siblings are welcome, as mom so chooses. Siblings and dads are welcomed and encouraged to be active participants in the birth. Also, at Integrated Women's Wellness & Center for Birth, we have two Apprentice Midwives who are also both Certified Doulas, who are able to provide wonderful additional support.<br />
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<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-00psTGNooIk/VLYbwN8ePKI/AAAAAAAAAnU/yrQp16ozOK0/s1600/image.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-00psTGNooIk/VLYbwN8ePKI/AAAAAAAAAnU/yrQp16ozOK0/s1600/image.jpg" height="320" width="213" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Shelby Larson, Apprentice Midwife and Doula</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Mary Yanagawa, Apprentice Midwife and Doula</td></tr>
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<b>IVs and Medication</b><br />
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While birth centers are guided by principles of prevention and only appropriate medical intervention, some interventions are available, when indicated. At The Center for Birth, most women do not need to be hooked up to an IV, as they are low-risk and able to eat and drink freely. IVs are available as needed- for hydration, antibiotic administration for GBS, and for blood loss management. While IV pain medications are not available, antibiotics, Pitocin, Methergine, and Cytotec (for the management of a retained placenta or postpartum hemorrhage) are readily available and given as needed. If there is a laceration that needs to be repaired, lidocaine is able to be used for numbing.<br />
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<b>Pain Management and Relaxation</b><br />
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Due to possible side effects for mom and baby, analgesic drugs (like IV pain medications) aren't given at The Center for Birth. However, the best kind of pain management comes from the encouragement and freedom of movement, aromatherapy, physical and emotional support, musical therapy, the supportive and calming surroundings, and the use of hydrotherapy in our large walk-in showers, and large tubs. Nearly 90% of the births with Integrated Women's Wellness and Center for Birth are waterbirths, and 99% of moms use water as a means of pain management and relaxation at some point during labor.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBSnfmbtoPxrG1Kk-m_McB81M2uWsi2XEJ3W0davGGRlTLmPu9sqhYjsF5-4jtU0MdbK1FFn-bvnnSwcDgKZUNxIS9yMKvtFDvnC30VE4rkyrS1XheZqc8Kl3F55YgqR2-IZC6McZKyUOA/s1600/JY3A2550-Edit.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBSnfmbtoPxrG1Kk-m_McB81M2uWsi2XEJ3W0davGGRlTLmPu9sqhYjsF5-4jtU0MdbK1FFn-bvnnSwcDgKZUNxIS9yMKvtFDvnC30VE4rkyrS1XheZqc8Kl3F55YgqR2-IZC6McZKyUOA/s1600/JY3A2550-Edit.jpg" height="213" width="320" /></a></div>
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<b>A Higher Level of Care (Hospital)</b><br />
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Emergencies are not expected but always anticipated and prepared for. Every clinical person- providers as well as support people- are trained and certified in Neonatal Resuscitation, the treatment of postpartum hemorrhage is possible, and we are located less than one mile from Mat-Su Regional Medical Center, should a hospital transport be necessary.<br />
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The birth of a baby- a new life- is a sacred event and a momentous occasion for a family. Consider having your baby in a welcoming, family-centered, and safe environment- our birth center!<br />
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AKbirth.com<br />
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<br />Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-56744388316534752982014-12-15T20:12:00.000-08:002014-12-15T20:20:52.492-08:00A Record HolderA wonderful part about being a midwife is creating long-term relationships with people. Maybe not the kind of relationship in which I see past patients often or even keep in touch on a daily or weekly or monthly basis, but the kind of relationship that perseveres through time, with meaning that does not diminish as years go by or as people move away. I speak of a relationship that very often consists of keeping in touch to hear about birthdays and milestones, and mostly, simply remembering. Most anyone who has had a midwife that they loved during their pregnancy and birth will never forget that midwife. Most midwives who have had a patient who they have connected with, gotten to know well, or served in a particularly meaningful way will never forget that patient...or that birth. <br />
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<br />
Today I received this message from a past patient who has since moved away:<br />
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">"Hey Tara! Our sweet Asher turned one today and we are reminded of your (and Dr. Elrods )help and support during this special day. We made a mad dash and nearly had him in our car, but you were my voice of reason and strength on the phone. I can not even express to you the comfort you brought me and that I much needed on that drive over. You guys make a great team! Thank you for being a part of our special day!"</span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">I read this short message and it brought a smile to my face. I won't ever forget Ginni's labor. It was fast and furious! She had called me in labor, letting me know that she was contracting every 2 minutes. I told her to head to the birth center. I won't ever forget literally running out the front door of my house- which I do often, but not quite like this- yelling behind at Glen to come with me and HURRY UP!</span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">Minutes later Ginni called to let me know that her water had just broke on her way out the door in heading to the birth center. I asked her the usual questions, assessing that everything was 'normal' and well. I told her not to panic but to simply get in the car and get to the birth center. I hung up the phone and as I was driving said to Glen, "She is going to call back in a couple minutes and tell me that she's pushing." Two minutes later my phone rings and it's Ginni- in control but scared- telling me that she was pushing. I'm on the phone, holding it with one hand and conservatively navigating the precarious roads with my left hand on the steering wheel. Ginni is crying. The roads are crisp white, blanketed in freshly fallen snow. There is no such thing as driving fast and rushing in the Alaskan winter of gentle snowfall. Ginni is trying not to push and doesn't know what to do. I tell her that it's ok. If she has to push, then don't panic...just relax and let your body push if you need to. I tell her to have her husband turn the heat on to get the car warm and to get something ready to wrap the baby in. I tell her, calmly but yet firmly to tell her husband to NOT STOP. "Tell him that if you are pushing or if the baby starts to come, do not stop driving. Do not pull over. Keep driving to the birth center, no matter what." A baby born inside a car certainly wasn't ideal for anyone, but a baby born in a stationary car on the side of the road was even worse. </span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">We stayed on the phone together- her driving one direction and me driving another, both toward the birth center from equal distances. As she was pushing something dawned on me..."Ginni, do you have your pants on?" I envisioned a baby crowning into pants. Yes, she said. "If you are going to push then you have to pull your pants down. The baby can't be born in your pants." In such a situation, this is not at the forefront of anyone's mind.</span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">We were just a couple minutes from the birth center. "Oh heck," I thought, "But what if the baby isn't born yet when we arrive to the birth center? Then she will have to get into the birth center with no pants on." It's amazing how even when things are happening relatively furiously and your brain is firing a million times at once, one is still capable of having long, detailed thought processes. I wasn't sure which was worse, the baby being born in her pants, or having to get her from the van to the birth center with no pants on. </span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span></div>
<div data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0">
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">We pulled up to the birth center at the same time. As we were pulling in, Glen took off his seat belt, in preparation of jumping out to help. He flew out one way and I the other- him to assist Ginni's husband in helping her and I to unlock the birth center door. We got into the birth center, pulled down the bed coverings, and 2 minutes after arrival, a beautiful, healthy baby boy was born.</span></span></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzv147l23rRkZI8qv3ip6_CLa7mUgM4JO4YZXQewiqjmROHhrG7-fcP5Uhm4kmnoXp0YO8pRgHQK_qeBMyt-BNtr9_dNWTXJ7aNGaEhLChXilK5qSGSBblCVk3ivOd9eSM5COSeKMDACBP/s1600/Taylor+Birth.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzv147l23rRkZI8qv3ip6_CLa7mUgM4JO4YZXQewiqjmROHhrG7-fcP5Uhm4kmnoXp0YO8pRgHQK_qeBMyt-BNtr9_dNWTXJ7aNGaEhLChXilK5qSGSBblCVk3ivOd9eSM5COSeKMDACBP/s1600/Taylor+Birth.jpg" height="352" width="400" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicUDj5YzXGz_jgyieWGXwQwS49ktVjubj4qK8wD7cIfX7T7zVi58CsAgw9iGQYs96GoI0Bx_CwyirVkylI44s7Y-6okxSl4XT_fTMh622cehQ6yZdCs3dNprr7p0cM8Jk3AWcBFUoV-uio/s1600/Taylor+Newborn+exam.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicUDj5YzXGz_jgyieWGXwQwS49ktVjubj4qK8wD7cIfX7T7zVi58CsAgw9iGQYs96GoI0Bx_CwyirVkylI44s7Y-6okxSl4XT_fTMh622cehQ6yZdCs3dNprr7p0cM8Jk3AWcBFUoV-uio/s1600/Taylor+Newborn+exam.jpg" height="400" width="265" /></a></div>
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<br />
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">To this day, Ginni holds the record for shortest time from arrival to birth. I won't ever forget the birth of Asher, nor will I forget how strong Ginni was while being within the eye of the storm!</span></span></span><br />
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0"><br /></span></span></span>
<span class="_5yl5" data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0"><span data-reactid=".7o.$mid=11418651423249=262b7dc48d2fc321a20.2:0.0.0.0.0.0.$end:0:$0:0">Happy Birth Day to the both of you, Ginni and Asher.</span></span></span></div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com1tag:blogger.com,1999:blog-714741860362412016.post-53344961026476536802014-11-19T22:53:00.003-08:002022-03-11T08:59:00.669-08:00Another Day<span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;">My day began shortly after </span><a href="x-apple-data-detectors://0" style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;" x-apple-data-detectors-result="0" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">6:00am</a><span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;">. A call from a patient in labor. The answering service patched her through and the voice on the end is a long, steady moan, which trails along for a full minute. I look at the clock to register what time it is: </span><a href="x-apple-data-detectors://1" style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;" x-apple-data-detectors-result="1" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">6:05</a><span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;">, my phone says. "Let's meet at the birth center </span><a href="x-apple-data-detectors://2" style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;" x-apple-data-detectors-result="2" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">at 7:00</a><span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 18px; font-weight: bold; line-height: 24px;">. That will allow me time to get there before you and set up," I tell her. We hang up and I call our two apprentices. They will be on their way.</span><br />
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I get up and as I'm getting dressed, Glen gets Callen changed, dressed, and ready to go along with me. Baby Callen and I head to the birth center. </div>
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As I pull up I see the laboring mom standing outside. I told her <a href="x-apple-data-detectors://3" x-apple-data-detectors-result="3" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">7:00</a> and yet she's there early. She's standing outside at the birth center entrance, laboring in the crisp Alaska cold. Thankfully it's a mild morning at 40 degrees. </div>
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I jump out of the car, apologize that she beat me there (hey, I did say 7!), grab Callen in the carseat and run to the door to let us in. I punch in the code. The door doesn't unlock. I punch it in again. It doesn't unlock. I enter the code yet again, this time slow and methodical. No luck. I try a few more times for good measure and to make sure I'm not losing my mind. Nope. </div>
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I run to the car and put Callen back in. 40 degrees may be mild but it is cold for a baby. I run to the front of the building- mom laboring, leaning against her car- and enter the code on the front door. It doesn't unlock. I try again. Still, it doesn't unlock. I call Glen as I run back around to the birth center door, I'm sure waking him from a dead sleep. "Where the heck are the apprentices?! I can't get in! Why isn't the door working?! Can you call Vivint right now?!" I don't even give the poor man a second to answer any of it and I'm pretty sure I hang up on him. I go back to the side door to try again. I'm contemplating in my mind which stone I'm going to pick up and whether it will be best to break the glass on the door or the window. </div>
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<br />
I enter the code again, making sure- again- that I'm getting it right. It should be unlocking the damn door and it's not. The definition of insanity crosses me mind. "I'm doing the same thing over and over again, expecting a different result." I enter it again, one final try before I shatter some glass and crawl through a window. And it works. We're in. </div>
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Thankfully the rest of the birth is unlike our entrance and goes smoothly- a first time mom has a beautiful, calm, unmedicated birth, and meets her baby girl. </div>
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The relationships I form with my clients vary widely in their degree, depth, and meaning. Most clients I bond with, but some more than others- with a handful developing into relationships I know I will have and treasure for years to come. Birth unfolds a new level of understanding that wasn't present prior. It's one thing to see and know a woman during pregnancy, spending 30 minutes, sometimes an hour, with her. It's another to be with her during birth. </div>
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I looked at this mom today and had such a better, deeper understanding of her and for her. </div>
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You get to know someone on a different level when you see them outside of their normal comfort zone- whether it be within the parameters of pain, anxiety, excitement, or anticipation that you witness.</div>
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During the postpartum course, I figure I can wear Callen. Shantel and I attempt to configure Callen in a side-carry using the Ergo, since I can't find my ring sling. I say configure because that's what it felt like...along with some guestimation. I walk into the birth room looking ridiculous and one of the apprentices, Shelby, takes one look at me and we bust up laughing. I’m informed by the other apprentice, Mary, me that I should probably refrain from posting my picture on the Babywearers Page because I'm in the midst of a baby wearing fail. Shelby takes Callen and wears him while I do vitals. </div>
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The new mom and her family oooh and ahhh over Callen. Mom is amazed that her baby will likely be about Callen's size in a mere 7 weeks. Oh, the time flies with these sweet babes. </div>
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The feeling in the room is happy...happy and proud. </div>
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I'm proud of this mom- not just for accomplishing Birth, but for being such a beautiful, positive person even with some not-ideal circumstances. I'm proud to now know her that much deeper and I'm proud to be her midwife. </div>
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It's a good day. </div>
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com1tag:blogger.com,1999:blog-714741860362412016.post-17659242715544992812014-10-19T19:18:00.001-07:002014-10-19T19:28:17.075-07:00The Birth of Callen GreyBirth for me is very vulnerable...though, vulnerable not in the sense of being broken down and susceptible, exposed and weak (because in labor and birth I know and feel I am anything but these things). Birth for me is feeling vulnerable to the world...vulnerable in cognizance and coherence of how fragile life is, how powerful yet also how delicate the body is, and, perhaps the most physically, emotionally, and mentally possessive- the awareness of how very little control we truly have.<br />
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I knew going into this birth that my support people mattered very much to me. I knew I likely wouldn't need much from them, only their presence and perhaps reassuring words, but that these two things mattered greatly to me. We planned to have our midwife, Peggy, our doula, Mary (who is also our student midwife that works alongside us), and my cousin, Melissa, as support.<br />
<br />
Melissa flew in from California and planned to stay two weeks. When she arrived I was 39+2 weeks. Having had Aubrey at 38 weeks, Ethan at 39, and Adria at 40+4, the running joke was that I would likely continue this trend and go slightly longer with this pregnancy. Of course, labor and birth are unpredictable, so we surely didn't know for certain. Just over 39 weeks seemed like a safe time for her to arrive- unlikely that I would deliver before then, and unlikely that two weeks later- at 41+2 weeks- I would still be pregnant.<br />
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No surprise to any though, my due date came and went...and the days ticked by, with Melissa and Glen getting more anxious. I felt so good and so not as if my body were ready (literally no signs of anything), I began wondering if my dates were correct. Ha! Perhaps a bit of "nearing-41-week-denial!"<br />
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On the Sunday before 41 weeks (40+6) we awoke to a beautiful day. The air was cool with just a slight Autumn crisp to it, the sky was a perfect blue and sparred of the presence of even the slightest speckle of cloud. This beautiful day could not go unused- and so we set off for a day trip to Talkeetna.<br />
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We ate at the local brewery, perused the small, eclectic gift shops, and made our way to the river bank, where Denali was clearly exposed, in all her glory. There remained not a cloud in the sky, and both Glen and I repeatedly marveled and remarked at how we had never before seen Denali so clear and unobscured. Even with our repetitious awe, I am not quite sure Melissa understood what a rare presence we had. The world around us was glorious.<br />
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As the next day I would officially be 41 weeks, on the way home from Talkeetna we stopped at the office and did an NST and an AFI. All was well. With Melissa set to leave on Wednesday, both her and Glen were getting anxious. But, it was what it was- I felt great, and baby was active and still doing well.<br />
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The next day, we met with our midwife, Peggy, for a prenatal appointment. I am not one for vaginal exams (and am quite a baby when it comes to them, apparently), but I felt it wouldn't be unreasonable to have Peggy check me, and if possible, "strip my membranes" to see if it would help to get things going. She checked me at the end of our appointment and I was 3cm, 50% effaced, and -2 station. She was able to strip my membranes and then left, knowing that she might be hearing from me later that night. Or...it could do nothing.<br />
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The kids went to bed, and then Melissa went to bed...both not without being adamant that I was to wake them up should anything start happening.<br />
<br />
10:30pm and my contractions were regular but not very close together. As I would advise any of my own patients to do- I ignored them as best as I could and didn't time them. If I had to guess, I would say they were about 10 minutes apart. Glen and I laid there for nearly 2 hours- just together in the quiet, dark room, side-lying together with him holding me from behind. I remember whispering to him how much I liked laboring with him, quietly, just the two of us. No fuss, no noise, just us.<br />
<br />
A little after midnight, I needed a change of position. The contractions still were spaced out but when they were happening, they were much stronger. I got in the shower for a bit. Not long after that, at about 12:30am, I told Glen that though it might be on the early side, he should text Mary (our doula) and tell her to head over. She too had been adamant about me not waiting until the last minute to call her (for fear that she would miss the birth), and so I was taking this into consideration. It dawned on me that we hadn't even mentioned to Peggy that I was in labor. I all of a sudden had my midwife hat on, thinking of how much I would not like it if a patient of mine was in communication with her birth team but not keeping me in the loop as well. I verbalized this to Glen and told him he should text Peggy and tell her that maybe she should head over too. I then changed my mind and said nevermind- I didn't want her to come over and just be sitting at the house for hours. "Maybe you should check me first." He had already sent her a text by this point but went ahead and checked me. I was 5cm, 90% effaced, and 0 station. "It's too early to have her come. Tell her nevermind, we'll call her when I'm closer." He went to tell her nevermind but she was already on her way. "Ok," I said, "Then she can just get comfortable on the couch and get some sleep until I'm further along." I was so worried about her being here for hours and hours unnecessarily. I felt bad thinking that she would be at our house for hours in the middle of the night.<br />
<br />
Mary arrived, Peggy arrived, and we let Melissa get her beauty rest. I got out of the shower and went downstairs to walk around. My contractions were still quite spaced apart, but again, when they happened, they were certainly getting my attention. Peggy sat on the living room sofa and I walked around the kitchen island, taking big, wide steps and swaying my hips. Eventually my feet were hurting from standing in the shower and the numerous kitchen island laps. I told Peggy and Mary, "I don't know what I should do- keep moving to get these contractions going, or go lay down and rest." Mary started laughing and said, "I know what you would tell a patient." "Yeah? What's that," I asked? "Keep moving," she said! "Nah...I think I would say 'listen to your body.'" With that, I decided to go upstairs to rest. Laying down wasn't an option, so I sat on the birth ball and leaned over on pillows on the bed, as Mary rubbed my back. Glen laid a couple feet away on his side of the bed still sleeping. Eventually I became less aware of his obnoxious snoring and began to float in and out of sleep as Mary caressed my back. There was no sense of time for how long I stayed that way, but 30 minutes would be my guess. My contractions did indeed pick up, now feeling as if they were 2 minutes apart. The next memory I have is the shower being turned on for me and me now on my hands and knees, beside my bed. Mary walks in and asks loudly, "Are you having ANOTHER contraction?!" I think to myself, "ARE YOU REALLY ASKING THIS?! A little bit of observation goes a long way." I kept the thought to myself and kept my mouth shut. I got up and got back in the shower. At some point, Melissa woke up on her own and joined us.<br />
<br />
I would intermittently try to sit on the toilet. That wasn't comfortable. I would stand for a contraction. That wasn't comfortable. I would sit back down, stand back up, sit back down. I would literally go up and down throughout my contraction, and this repetitive motion was a coping mechanism in itself.<br />
<br />
I look at Mary and ask her, "Will you say some bible verses?" She says the first one that comes to mind:<br />
<br />
"Fear not, for I am with you."<br />
<br />
I nod. That's a good one.<br />
<br />
Mary goes and gets her phone and searches for more applicable bible verses, as she seems to be stumped. She comes back reading them. I look at Melissa and matter-of-factly say, "Tell Mary her bible versus aren't very good."<br />
<br />
We laugh at it now but at the time I was dead serious. Her bible versus weren't good enough.<br />
<br />
Transition at its finest.<br />
<br />
I get in the tub. My contractions were now 2 minutes apart and strong, transition contractions. It was quiet- myself included. Shortly thereafter I was getting the urge to push and began bearing down, silently, at the peak of each contraction. I never announced it to the room and I remember thinking to myself, "I wonder if they can tell that I'm pushing?" At this point the pain was intense and there were three things that made it better: silence, swaying my head, and having Glen close. I ask him if he would get in the tub with me. I needed the comfort of having him there, beside me. It is amazing how you can be in such intense pain that you are incapable of verbalizing, but yet your mind is still sharply aware and processing. I remember assessing, thinking of how I was so quiet and also thinking to myself how I was certain everyone in the room thought I looked like a crazy person, with my head swaying back and forth and my eyes rolling in the back of my head. I remember thinking, "If I had the energy to laugh, I would laugh at myself."<br />
I would continue pushing for nearly 40 minutes, and at some point in the midst of that I had the realization that what I was doing was not working. Callen felt bigger than Adria and I felt like I was trying to push a 10 lb. brick out of my rear that was not budging, despite my best efforts. The midwife in me told me that I needed to change positions, get out of the tub, and go sit on the toilet. Oh, but everyone hates the toilet. The mom in me adamantly said hell no, that is going to hurt more. And so, true to the ways of being human, I stayed where I was. Eventually, probably 5 minutes before birth, I had a come-to-Jesus moment where I thought to myself, "Enough of this. You have got to just push and push HARD, as hard as you can, and get this baby OUT." I started pushing like I had never before in my life done, with any of my other babies, and for the first time in my labor, became vocal. For the first time ever, I felt the "ring of fire"- the burning sensation of my perineum stretching as the baby's head was crowning.<br />
<br />
"It burns," I said.<br />
"You're doing great," someone said. "Keep pushing."<br />
<br />
I continue pushing, long, strong, as hard as I think is possible...<br />
<br />
"Is his head out," I ask?<br />
<br />
"No...keep pushing...," I'm told.<br />
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RAWWWWRRRR!!!!! I'm pushing like a multip shouldn't have to push...<br />
<br />
"You're to his eyebrows, keep pushing..."<br />
<br />
I roar and keep pushing, as hard as I can. I picture what usually happens with a multip, pushing this hard- the baby usually flies out. WHY IS THIS KID NOT FLYING OUT?!<br />
<br />
"Top of the ears...keep going..." someone says.<br />
<br />
"RAWWWRRR!!!!!!" Pushing as hard as I can...<br />
<br />
"To his nose now..."<br />
<br />
"Is his chin out," I ask?<br />
<br />
"Keep going, give another push." It's Glen that says this.<br />
<br />
I am pushing so hard...<br />
<br />
Callen's head comes out. I have relief knowing that I'm almost done. Glen sees that Callen doesn't restitute and tells me to push to get the rest of him delivered. I give one last, long push and Callen is born into his Dad's hands. Peggy says, "Reach down and get your baby" and I reach down and lift Callen out of the water, onto me. It's 5:19am on September 30th, 2014.<br />
<br />
I thank and praise The Lord, "Thank you Lord, thank you Lord, thank you Lord..." this is all I'm verbalizing, but in my heart and mind I know what I am saying...Thank you for giving me the capability, thank you for giving me the strength, and thank you for blessing me with this life.<br />
<br />
It feels good to be done and to have my baby in my arms.<br />
<br />
I get out of the tub, walk to my bed, and get tucked in with our new baby. The newborn exam is done with all of us watching, and Callen Grey weighs in at 9 lbs. 8 oz.<br />
<br />
At 2 hours postpartum, Glen gets called in for another mom who would have her baby shortly thereafter, and Peggy stays for another hour, leaving Melissa, and Callen & I tucked in bed. Nicole, our nanny, arrives as Peggy is leaving, and I nap all morning off and on, with the big kids playing happily and excitedly downstairs.<br />
<br />
Glen arrives home, happy to be back home with his wife, kids, and new son, and basking in how wonderful it feels to have also helped another family welcome their own son on the same day.<br />
<br />
<br />
We are so blessed.<br />
<br />
<br />Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-53603053273674251512014-09-10T21:22:00.002-07:002014-09-10T21:25:41.621-07:00If These Walls Could Talk<br />
If these walls could talk, perhaps they'd be speechless anyhow<br />
they'd say it's sometimes all for nothing<br />
the nods and smiles and pretense of love,<br />
sometimes he's just bluffing<br />
<br />
Growing bellies equate to growing life and not just cell division<br />
tides changing, life enveloping<br />
it's not all that was envisioned<br />
<br />
If these walls could talk, they'd share of disintegrated love gushing out of red-rimmed eyes,<br />
a life-full belly pushed against an empty heart,<br />
a liar, a cheater, a leaver<br />
his mind and body miles apart<br />
<br />
If these walls could talk, they'd rejoice in happiness and victory,<br />
victorious, glorious, ecstatic<br />
not just a baby born, but a mother<br />
oxytocin drenched, wholly climactic<br />
<br />
If these walls could talk, what is it that they'd say<br />
would they tell these stories justly<br />
the excitement, the fear, the love, the betray?<br />
<br />
Oh the stories...<br />
<br />
Veins of flowing heroin, waking up beside death,<br />
the sun shined bright but she was always in the dark<br />
in the darkness of addiction<br />
she was the prey, and the predator had its mark<br />
<br />
A two vessel cord and a fall down the stairs<br />
life is oh so fragile<br />
living on our prayers<br />
<br />
Warm midwife hands and a smile to the soul<br />
These walls could tell of our laughs and our cries<br />
You'll be ok...<br />
don't you know?<br />
<br />
If these walls could talk perhaps they'd imitate guttural moans in the night<br />
grasping swaying rocking,<br />
bone on bone in the dark, the most challenging mental fight<br />
<br />
If these walls could talk, what is it that they'd say?<br />
They'd share the life of a midwife- LIFE-<br />
excitement, fear, love, and betray.<br />
<br />
<br />Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-10660792431896488472014-09-05T18:51:00.002-07:002014-09-05T19:03:14.464-07:00The Waterbirth of Riley DawnI often speak of the importance of a strong and trusting patient-provider relationship- what it entails, what it means, and why it is absolutely necessary. Specifically, I often speak of how it's even more so pertinent to our Out-Of-Hospital birth patients.<br />
<br />
Out-Of-Hospital birth is an entirely different beast than hospital birth. For the patient, the family, and the providers alike. There are no epidurals, no pain medications- not even the comfort of having it as an easily accessible, immediate option. To do Out-Of-Hospital birth means to have a strong desire and a determined commitment- again, not just for the woman and her family, but her care providers as well. And trust...trust is the cornerstone. To have trust in each other is to know that everything is out on the table- concerns, fears, desires, expectations- and that we can mutually work together through it and for it. Trust is when the shit hits the fan and you think you may very well be dying because you are in the thick of it, but we look at you with guidance and reassurance and well, you ARE reassured that yes, it's ok, and yes, you CAN do this.<br />
<br />
This morning was a perfect example of trust and commitment and how the patient-provider relationship carries that.<br />
<br />
I helped support a family in welcoming their 3rd baby; not only their first Out-Of-Hospital birth, but their first unmedicated birth. I didn't see them at all throughout their pregnancy and therefore didn't (and don't) really know them in the way that I know my own patients. But what made them special is that they have been long-time patients of Glen's.<br />
<br />
I remember first meeting Randi- at a childbirth class I taught at the office. Afterward we stood and chatted briefly. She hadn't previously considered a birth center birth, but after learning of her options and wanting the same doctor- her doctor- she changed her plans for birth. She looked at me and said, very matter-of-factly, "We've had two babies with Dr. Elrod. I'm not having a baby without him. If I need to have a birth center birth to guarantee that he'll be there, then I'm having my baby here. I'll go wherever he is."<br />
<br />
I remember going home and being amazed, repeating those words to Glen. Yes, a relationship and trust are very strong things.<br />
<br />
Just like any woman experiencing natural childbirth- there were a few- but brief- intense moments. It may have been her 3rd baby, but Randi had never felt THIS before. In the small birth room, in the corner tub, surrounded by the decor I myself love and deliberately selected, with her husband by the side of the tub, and Glen and myself kneeling in front, with the urge to push and not knowing what to do she exclaimed, "Dr. Elrod, please help me!"<br />
<br />
The room was dimly lit by the sconces that light up on each side of the bed. The same sconces we have in our home. The wood headboard that was made locally. A room that not only has what is needed to practice evidence-based care and safely have a baby, but that also feels like the kind of environment that is conducive to a family actively working together and welcoming their new baby.<br />
<br />
Glen looked at her and reassured her that her baby's head was right there. She pushed 3 times and the baby's head was out. She looked at me- directly and intentionally- and said entirely calm and collected, yet every bit as intense as the words she spoke,<br />
<br />
"Tara, I'm scared. I'm so scared."<br />
<br />
Her eyes were wide and intensely locked on mine.<br />
<br />
"You're ok. It's just your baby's head. Everything is ok, " I reassured her.<br />
<br />
And with that, one more push and she delivered her baby girl- into the water, into Glen's hands and then immediately up to her chest. Even though she was admittedly scared, she was strong, and SHE DID IT!<br />
<br />
Riley Dawn was born today- an uncomplicated, unmedicated, beautiful waterbirth. Mom and baby are doing great, and Dr. Elrod is pretty proud too!<br />
<br />
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<img src="webkit-fake-url://7737A44D-17B3-427D-AFCF-E95F229185C6/imagejpeg" />Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-75317466381145338482014-07-21T17:28:00.002-07:002022-03-11T09:03:07.842-08:00Baby, Bloom, and Beyond<br />
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">We
don’t usually update this blog with events of our life- specifically, our
personal life and daily adventures, but I thought it would be a nice change to
give such an update. Life has been busy, with a lot of excitement and good
around us!</span></div>
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<span face="Arial, Helvetica, sans-serif"><span style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">The
weather in Alaska has been beautiful- mostly warm days and not too much rain.
With our long, sunny and mild days, it leaves the world buzzing. We have our
work days but still seem to have plenty of time to enjoy our “down time.”
Parades, festivals, markets, fishing, outside lunches at our local brewhouse,
and the various classes and meet-ups that we have at our office have left us
busy and enjoying our summer. </span></span></div>
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";"> </span><span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">I’m
now 31 weeks pregnant and feeling excited about the upcoming addition to our
family. This baby boy has yet to get a name, but I’m sure that will come in
time. Afterall, I have yet to meet a person with no name. ;) We have been
blessed so far to have had a healthy and uneventful pregnancy and have enjoyed
having a midwife for our prenatal care, including the home visits that she does
for us. It’s been amazing for us to see how much Adria (our 2 year old) has
really seemed to understand. She certainly seems to understand that a baby is growing
inside of me and that we will soon have a baby join us, to feed and to care
for. Though it’s been awhile since she herself nursed, she seems to be familiar
with the idea that mom will be breastfeeding the new baby, as shown by her
demonstrations. Perhaps it’s a testament to her exposure of pregnant and
nursing women that she sees in the office.</span></div>
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";"> </span><span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">As
for birth, we are looking forward to another homebirth, in the company of our
midwife, Peggy, the bigger kids (minus Candice who will still be finishing up the
Fall semester), and our two other support people- my cousin Melissa, and our
friend Mary. I can’t honestly say that I look forward to the challenge that
labor brings (yes, even if it is my 4<sup>th</sup> time around, it’s still the
biggest challenge!), but I do take comfort in knowing that I’ll be surrounded
by these very special people.</span></div>
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";"><span face="Arial, Helvetica, sans-serif">Last
week we celebrated a milestone for our practice- the beginning of offering
medical spa services. Glen has wanted to venture into medical esthetics for
some time now, but with being a solo practitioner for so long and focusing on
building the practice, there was little extra time to focus on anything else.
Now, with various changes in our practice and in life in general, now was the
time. It has been such an interesting and fun time to develop this aspect of
the practice, and one I’m happy to see become a reality- for Glen as well as
for the women who will utilize it.</span></span></div>
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";"> </span><span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">When
this practice was a fledging practice and when we first began planning the
building we are now in, we envisioned that it would be a mecca for women- a
place for health and wellness, encompassing preventative care, treatment,
education, beauty, and other complimentary services. We still have so much that
we envision, but to think that much of what was only a vision 3 years ago is
now a reality, is a beautiful thing.</span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiP_ulF0vbthfmyEM4iRAj7JUX4ipfg4RqgE9gnS73jbGxDzQwQaV-1xHv1k1QShlrnM7yRU_X2O6OrTNUq5TQe3wBUvLgQpCpmcPhVqMAgAwdiOX4HShMpu0bdN3ZYj6-c0AQzGA98xsYD/s1600/Property+view.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiP_ulF0vbthfmyEM4iRAj7JUX4ipfg4RqgE9gnS73jbGxDzQwQaV-1xHv1k1QShlrnM7yRU_X2O6OrTNUq5TQe3wBUvLgQpCpmcPhVqMAgAwdiOX4HShMpu0bdN3ZYj6-c0AQzGA98xsYD/s1600/Property+view.jpg" width="299" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">June 2012- the view from our property, which had yet to be cleared.</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxNDvS_1Fl1H2HBOHSoF25VPhABGe1z4g8mha3uDmRaBFKqAVTO2f9CC34G4BUfL2b7peelvSQt-eDiaa5HnjpgG8jGbr09tsjP_8FNCua3kGtgcf_FZESWuQFJ8q7kEdVtg7CV7tRcBqZ/s1600/IWW+2013.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxNDvS_1Fl1H2HBOHSoF25VPhABGe1z4g8mha3uDmRaBFKqAVTO2f9CC34G4BUfL2b7peelvSQt-eDiaa5HnjpgG8jGbr09tsjP_8FNCua3kGtgcf_FZESWuQFJ8q7kEdVtg7CV7tRcBqZ/s1600/IWW+2013.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">July 2013</td></tr>
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">The
open house for Bloom, the Medical Spa at Integrated Women’s Wellness, was a
huge success. HUGE. So many women from our community came out to enjoy a night
out and learn about the services that the medical spa is offering. Even though
technically us and our staff were working, we all truly had fun. We dressed up,
ate, drank, got to show off our Integrated Women’s Wellness home, and talk
about esthetics. In just two short hours, we booked about $10,000 in services.
Amazing to me, because in the back of my mind I always wondered how successful
a medical spa would be in Alaska. Afterall, we are not in San Diego or Los
Angeles! It’s a bit of a different climate...literally and figuratively. At the
end of the day, however, Californian or Alaskan, women are women, and to feel
good on the inside as well as the out seems to be universal. While to be
financially successful is of desire and benefit to us, at the end of the day,
the most satisfaction comes from offering a service that will make a difference
in the lives of women…and to be the best at doing so. ;) This concept is a cornerstone
of Integrated Women’s Wellness.</span><br />
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">So,
what’s next? We will continue to build up the esthetic aspect of the practice,
continue to add various classes to our class offerings, countdown the days
until we meet our new baby, prepare for our upcoming birth center inspection,
host a Betula Baby table at the Alaska State Fair, and bid farewell to Dr.
Wayman as she relocates back home, at the end of next month. In September I’ll
celebrate my two year anniversary of being a licensed midwife. I have several
repeat clients right now, and to have the experience of being a woman’s midwife
throughout more than one pregnancy is truly special. </span></div>
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<span face="Arial, Helvetica, sans-serif" style="font-size: 10pt; mso-fareast-font-family: "Times New Roman";">There
is plenty to come- both personally and professionally- and we are excited about
it all! </span></div>
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-28516467959734582052014-06-27T00:24:00.001-07:002014-06-27T10:49:22.553-07:00My Cloth Diapering 101While cloth diapering seems to be growing more and more in popularity, it seems there are no shortage of people who are still scratching their heads and mind.blown. when they find out that we cloth diaper. [Insert the Whats?! and the Whys? And the 'That is disgusting!'] I mean really, why WOULD any sane parent want to subject themselves to not only more contact with pee and poop, but also...more work? Well, read on.<br />
<br />
We haven't always cloth diapered. In fact, prior to my last baby (Adria, now 2 1/2) when I envisioned cloth diapers, I seriously envisioned a prefold with metal safety pins, all held in to place by good ol' rubber pants. And, I'm not even sure I've ever seen a pair of real-life rubber pants, but that's what I had in my mind. Leave It To Beaver days.<br />
<br />
Little did I know that these aren't the days of my momma's cloth diaper. Things have changed. Cloth diapers are not only <i><b>not</b></i> scary...they are wonderful. And cute. And addictive.<br />
<br />
One day, in the earlier part of my pregnancy with Adria while I was meandering through a baby fair, I came upon the display of a diaper service business. The lady was nice and the information was profound. I took the information and then I went home and researched it. I knew soon thereafter that we were going to be cloth diapering. My husband- the doctor and also a man of convenience- surprisingly didn't bat an eye...once it was explained to him that he would not have to wash them.<br />
<br />
<br />
THE BENEFITS OF CLOTH DIAPERING<br />
<br />
- <b><span style="font-size: large;">Avoidance of the chemicals</span></b> that are found in most disposable diapers...Bleach, chlorine, 'superabsorbent' gel, dyes, and fragrance.<br />
<br />
-<b><span style="font-size: large;"> Environmentally friendly</span></b>:<br />
<span class="Apple-tab-span" style="white-space: pre;"> </span>Cloth dipes are much less of a strain on Mother Earth than disposable dipes. If you do a bit of research, you'll find the more than 200,000 trees each year are lost due to the manufacturing of disposable diapers for babies (in the U.S. alone!). In addition, it takes 3.4 billion gallons of fuel oil every year to make diapers. It's estimated that disposable diapers require 20 times more raw materials, two times more water and three times more energy to make than cloth diapers. Pure cotton, bamboo, or hemp are much friendlier for Earth Momma!<br />
<br />
<span class="Apple-tab-span" style="white-space: pre;"> </span>Also, cloth diapers equate to reduced waste in our landfills. It's thought that disposable diapers take hundreds of years to decompose in our landfills (though we don't know how long, exactly). Think of all of the diapers your little one goes through each day...now each week...each month...and each year. Yep, that's a lot of diapers. Cloth stays out of the landfills!<br />
<br />
- <b><span style="font-size: large;">Less diaper rash</span></b>.<br />
<span class="Apple-tab-span" style="white-space: pre;"> </span>Why? Refer back to the first benefit discussed. Yep...no artifical chemicals and dyes means nothing to irritate baby. Also, because cloth diapers have none of those 'superabsorbent' gel beads or lining to soak up urine for hours, it does require more frequent changing. <i>This is a good thing, I swear! </i>This also attributes to less incidence of diaper rash.<br />
<br />
- <b><span style="font-size: large;">Fashion</span></b>.<br />
If you haven't already checked out some styles and prints of cloth diapers, do it. But prepared to become obsessed. There are many different styles, colors, sizes, and prints. At my shop, Betula Baby (who I run alongside the Tidy Tush, a local diaper service), we keep it simple and carry Thirties, Rumparooz, and Alva.<br />
<br />
LET'S TALK <b><span style="font-size: large;">MONEY</span></b><br />
<br />
Being the owner of a baby boutique, I of course love to help out moms and dads support their cloth diaper addiction. But even with all the fun and funky prints and accessories taken into consideration, cloth diapering can equate to SAVING money! I did a quick online store price eval and found that it's pretty average for mid-range diapers in a value pack to be about .25 cents each. If you cloth diaper and choose to wash your own, the yearly cost of diapering can be significantly less than those disposables. If you're like me and choose to use a a diaper service, it still ends up being slightly cheaper (though, depending on where you live and the price of your service, it could end up being about the same or slightly more. BUT- refer back to the aforementioned benefits of cloth diapering. My vote is- it's still worth it.)<br />
<br />
Our local diaper service is Tidy Tush and the yearly fee is $900. For $900 you get all the pre-folds that you need, tote bags for pick up and drop off, and the luxury of getting your diapers freshly and beautifully laundered and delivered right back to your door. And, if you're blessed like me, your very own lovely Tidy Tush diaper lady is also included and at your disposal for all of your diapering and baby questions. ;-)<br />
<br />
<br />
THE HOW TO'S (Let's not make mountains out of molehills...it's pretty uncomplicated. Really.)<br />
<br />
Remove diaper from baby.<br />
Put the diaper in the diaper pail or wet bag. Yes. Nastiness and all. (No worries, you have a get out of jail free card until about 6 months or whenever you begin solids. Then the turds come.)<br />
Put pre-fold diaper insert into diaper cover. Snap (or velco) shut.<br />
Put dirties out on porch on diaper day.<br />
<br />
Ok...there's my regimen. That was easy!<br />
<br />
But what if you choose to wash them yourself? Then continue on.<br />
<br />
4. Throw diapers (and wet bag, if you use one) into wash. Wash twice on Heavy Duty (some choose to use a bit of bleach, some don't and just use a basic detergent), and if all is well and no ammonia smell is present (then that calls for a simple vinegar soak, if so), then put through another cycle, but with no detergent or bleach. This is the in-depth rinse cycle, getting the diapers agitated, spinning, and rinsing in just plain water. Repeat again.<br />
<br />
5. Dry. (Some hang dry, our 'diaper lady' puts them in the dryer.)<br />
<br />
And lastly...<br />
<br />
ISN'T IT COMPLICATED TO CLOTH DIAPER?<br />
(Yeah...no. If we can do it, so can you!)<br />
<br />
There are many options when it comes to brands and types of cloth diapers, but we keep it simple and use two things: A waterproof cover (Thirsties, Rumparooz) and a cotton pre-fold. Put the pre-fold inside the liner and wa-la! You've done it.<br />
<br />
Why do I personally prefer covers and prefolds? Well, because it's less bulk for the wet bag and less wash (even if I don't technically wash them myself, I still care.). Unless the baby has pooped or seriously messed up the cover, it is easily wipeable and then made new by a fresh pre-fold.<br />
<br />
So...for all the moms and dads who are shocked or fascinated or even curious about cloth diapering, now you know. We aren't the most 'crunchy granola', we don't exactly have oodles of spare time on our hands (if you know us, this statement is funny...), and we don't particularly like extra poop exposure or extra work...but, WE LOVE CLOTH DIAPERING, for oh so many reasons!<br />
<br />
<3<br />
<br />
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Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-60869040954821894242014-03-21T12:03:00.003-07:002022-03-11T11:22:02.251-08:00Beauty Is EverywhereThe night before last we worked a night shift at St. Therese. Glen and I were accompanied by Keri, the doula from Connecticut who we have been blessed to meet and share this trip with, and our translator Shelly.<br />
<br />
<br />
<br />
When the sun sets over St. Therese, the vibe noticeably changes. The unrelenting heat that beats upon the dirt and the concrete, and the thick, heavy stench of dehydrated urine, feces, amniotic fluid, blood, and unbathed, moist bodies give way to the night sky. The scorching sun departs, and the Haitian sky welcomes the moon, which brings a yet still warm night, but one that gives the comfort of an intermittent cool breeze.<br />
<br />
The hustle and bustle slowly dissipate as the hours draw by, consistent with the slow but steady drop in temperature. We can feel the difference in the air even in just a couple degrees, and for that, we are thankful. The patients who are here to stay retreat to their beds for not only the comfort of a soft place to lay and potential sleep, but for the protection that the mosquito net brings. Each ward closes its doors, guests and family retreat for the night, and the metal gate to the hospital is shut to the outside world. The moans, yells, and shouts to Jesus of the day no longer occur, but are now replaced with cries that are coming from the new Haitian lives residing in the postpartum unit- the babies that were born today and yesterday.<br />
<br />
What I notice for the first time in this sanctuary lull, is the sweet aroma that fills the air. Gone is the invasion of bodily fluids, but now the air is filled with the presence of sweet flowers. It is Heaven on earth. I take deep breaths of the fresh air and I speak to Glen of how beautiful it smells. I wonder why we have never noticed it? Funny how when darkness falls, when your world and heart are quiet, you become more aware of what surrounds you. Beauty is in the little things, yet so often we fail to see them through the busy or the bad of everything else that is occurring. But it's still there.<br />
<br />
<br />
Earlier today, at about 1pm, a woman in labor walked into the maternity unit. I took one look at her and said to my translator, "That is a big belly for a Haitian belly! She has to have twins." I would bask in my observation skills, as minutes later we would find that she was indeed carrying twins. And term twins at that. Glen did an ultrasound and confirmed that Baby A was vertex and Baby B was breech. She would be 5cm then, and when we returned for the night shift, she had not yet delivered. At about midnight, I asked if I could check her and found that she was 8cm, Baby A was nearly +3 station, and a tight bulging bag right inside her introitus. I told Glen and the midwife to prepare for delivery, as once that bag broke, we would be having babies. While Glen made sure Pitocin was drawn up, clean instruments were out, and the PPV mask was out, I geared up in the makeshift delivery garb, to help wherever needed. I stood there, feeling how I imagine new Haitian babies must feel- hot in the stagnant heat, yet swaddled in layers of non-breathable clothing. Within minutes a pop and explosion, a powerful burst of amniotic fluid ruptured 3 feet across the room, followed immediately by Baby A's head. I was the only one gowned and gloved. I stepped over and immediately caught Baby A. Glen garbed up in the protective gown and gloves and stepped in for Baby B, as we knew this baby was frank breech. Just a few minutes later, this second baby made her way into the world, rump first, to join her sister. Mom would go on to have a postpartum hemorrhage, which would be controlled with Pitocin and Cytotec. She, and her two new girls, would do just fine.<br />
<br />
After mom was stable and moved to the postpartum unit, Glen and I would go to lay down to get some rest. Two hours later, we would hear commotion outside in the corridor. Glen said to me, "We better go out there. I think I heard someone say something about a mom pushing in the car." I grabbed my supplies and ran out to the exterior of the building, Keri and Shelly already two beats ahead of me.<br />
<br />
What I see is gut wrenching. There are men lifting a woman from the van, trying to get her into a wheelchair. She is contorting, bucking, violently thrashing, in the black abyss of seizure after seizure. I throw gloves on as I yell over the commotion, "Is she pushing? Did she deliver?!" Shelly says to me that she has already delivered. I yell, "Where is the baby? Is the baby alive?!" I have no idea if she is 24 weeks or 40. IS THE BABY ALIVE?!" I must yell it three more times, as no one hears me, there is such commotion and attention on the violently seizing mom. Finally Shelly says, "Yes, the baby is alive." She is so calm, almost too calm. She talks and moves in slow motion, and I know that this is because her eyes and ears are acclimated to scenes such as this. Shelly points to a man, still in the van, and I see he has a bundle of miscellaneous cloth in his arms- shirts, scarves, I am sure anything they could find to keep the baby warm. I step to the open door of the van- as mom continues to thrash like a wild animal that the men are trying to tame- and I see the blood. There is a sea of red blood on the floor of this van, spilling onto the dry dirt ground that I am standing on. I grab the cloth bundle and prepare in my mind for what I might see. I have no idea what the condition of this baby will be. I take the bundle and immediately something falls down out of the cloth- the placenta hits the filthy, bloody floor of the van, acting as an anchor in this Red Sea. I have no extra hands to pick it up, and I we are tethered to the van. Keri instinctually steps forward as if to grab it for me, but immediately halts, as if in line with the shout in my head that has exclaimed, NO! She realizes, as I realize, that she has no gloves on and has broken fbe cardinal rule of universal precautions. She sees a clean, dry towel sitting on the seat, and uses that to pick up the placenta. Together, stride for stride, we walk as quickly as we can back to the maternity unit. The baby is alive and breathing well, has good color, but feels as cool as I imagine a cadaver must feel.<br />
<br />
We remove the baby from the sopping wet garments and clamp and cut the cord, detaching the placenta. I look to see what this baby is...she is a girl. It is the least of my concerns, but as I dress her in what I have brought in my backpack, I am sad that all I have are boy clothes. The scene is stark in my mind- a new Haitian baby, whose mother continues to seize in the background, is getting cared for and dressed for the first time by a disheveled, hot mess of an American who is dressing her in boy clothes.<br />
<br />
Keri and I would take turns holding her up against ourselves, with an electric warming pad pressed up against her back. This is how we kept her warm, bringing her temperature up from the 95 degrees it was on arrival.<br />
<br />
The following day, the mom would be stable, conscious, and alert. Keri and I would go visit with her and help to get her baby girl latched to the breast. The importance of breastfeeding...it can be the difference between life or death here. To see a woman who I thought may very well die just the night before, now alive and nursing her baby, this was amazing. Even in a room overflowing with sadness and terrible things, this was a beautiful, wonderful thing to see and to be a part of.<br />
<br />
There is beauty everywhere. Even when we are in the midst of bad, even when we are too overwhelmed or busy to take notice.Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com0tag:blogger.com,1999:blog-714741860362412016.post-34322724414188253102014-03-20T11:06:00.001-07:002022-03-11T09:08:29.820-08:00Priority of LifeIt started like any other morning in
Hiche; cereal, coffee, some quiet banter about what everyone was
going to do for the day. Tara and I were not supposed to be headed
to the hospital until the PM shift-2 to 8pm. We took our time in the
morning, getting some relaxation and ultimately looking for something
to do to pass the time.<br />
<br />
<div style="margin-bottom: 0in;">
We found out they needed cord ties made. Once 100 were
made, they would autoclave them to sterilize them. These cord ties
consisted of 3 pieces of string, each 7-8 inches long, rolled up into
a ball, then wrapped in paper. Tedious work, but it was keeping us
occupied for a few hours.</div>
<br />
Suddenly, Nadene comes down with an
urgent phone call from Wendy. There was an ectopic on the unit and
she was headed to surgery soon and the Haitian OB wanted my help. I
took about 2 seconds for me to hop up, gather my gear for the day and
head out. My only mistake was forgetting to fill up my water bottle.
In this heat, that wasn't a good mistake to make.<br />
<br />
<div style="margin-bottom: 0in;">
The moto ride is usually a casual,
leisurely ride from the house. This ride was no different, although I
was imagining this mom having a ruptured ectopic and bleeding out as
I was taking a gentle stroll though town. I need to go faster!!!</div>
<br />
<div style="margin-bottom: 0in;">
I get to the unit and things seem
relatively calm. The OR is on hold because of a general surgery
case. I learn later that it is a radical mastectomy being done.
Recurrent breast cancer, apparently. I'm shocked to see such a
surgery done here. But, I digress. The mom with the ectopic is
stable, thankfully. She is obviously in pain, but vitals seem normal
and no immediate distress. And due to the delay, it's a good thing
she is stable.</div>
<br />
<div style="margin-bottom: 0in;">
I sit and wait for the OR to come get
this mom for surgery. I turn my head toward the door because there
seems to be some commotion. A mom was being helped in to L&D by
two men. She's in pain and sounds like she is in labor. She takes a
few steps and blood is pouring from her onto the floor. Flowing from
her, steadily running down her legs and onto the already filthy
floor...it is truly a horrifying sight to see. Regardless of the
cause, she most likely needs to be delivered quickly. First, I find
heart tones...baby was alive. Next, I use the crude ultrasound and
rule out a previa. I her IV fluids that she walked over with- two
IVs hanging- LR and magnesium. Her blood pressure was 170/120.
Imagine that...another preeclamptic. Another complication from
preeclampsia. There was no doubt she was abrupting and urgently
needed to be delivered. But...so did the ectopic. And there was
still that pesky mastectomy going on.</div>
<br />
<div style="margin-bottom: 0in;">
I looked at Wendy and said, “This
might be very bad. With the delay, we could easily lose all three
(meaning the ectopic mom, the pregnant mom and the baby.)” And it
could be quickly.</div>
<br />
<div style="margin-bottom: 0in;">
I thought of this were my decision to
make, who would be the first priority? The ectopic could go bad
quickly, but it also would be a relatively quick surgery. The
abruption, though stable at the current moment, had both the lives of
mother and baby at stake. There is a prioritization of life being contemplated...and the Haitian OB makes the call that the
ectopic gets to go first.</div>
<br />
<div style="margin-bottom: 0in;">
A bubbly, Hispanic guy named 'Romero'
came bounding into L&D and introduced himself. It turns our
Romero is our anesthesiologist. He has come to see the ectopic. I
assumed at this point that the general surgery case is done. I was
wrong! Romero left the OR, came to see the ectopic, got her back to
the OR and placed her spinal, all while the mastectomy was taking
place. As crazy as it sounds, that is exactly what needed to happen
here. Time was ticking and there was none to be spared if a life was
not to be lost.</div>
<br />
I am caring for the ectopic with Jean
Baptiste, the only other Haitian OB that I had not yet met. He is a
very nice man. You can tell he cares about his work and his
patients. As we prepare to begin the case, he reaches over and
firmly grabs my hands...holding hands with a man I have just met and
whom I do not understand his language, he says a prayer in Creole.
This work and situations such as these, transcend the expertise and
skill of any surgeon. We need all the help we can get.<br />
<br />
<div style="margin-bottom: 0in;">
We start and as soon as we open her
belly we know that it is a ruptured ectopic, blood fills her belly.
The right tube was distended and ruptured. We take it out. The left
tube was severely damaged and we both agree she may never have kids.
My guess is that she had an STD at some point that has ruined her
tubes. Sad, but it is the reality.</div>
<div style="margin-bottom: 0in;">
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjg6esxA-7S1IS3YIYXl-0eGP-Ien0ltw0IGjI-olscUGmlYY8cPcAhypxtXzcjmW19ajo0_Bcl6BMlKhyphenhyphenKnNgvAja2YaRe2DO632humhbG33Gl2_A5SKEVpAhqUcSzAiM6Y-6dkmh1hlet/s1600/ectopic.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjg6esxA-7S1IS3YIYXl-0eGP-Ien0ltw0IGjI-olscUGmlYY8cPcAhypxtXzcjmW19ajo0_Bcl6BMlKhyphenhyphenKnNgvAja2YaRe2DO632humhbG33Gl2_A5SKEVpAhqUcSzAiM6Y-6dkmh1hlet/s1600/ectopic.jpg" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Ruptured right fallopian tube.</td></tr>
</tbody></table>
<br />
<div class="separator" style="clear: both; text-align: center;">
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<br /></div>
<br />
<div style="margin-bottom: 0in;">
Headed back to L&D I'm hopeful that
the patient with the abruption is still stable. She is, only now we still wait
for her turn. This time we do wait for the mastectomy to finish,
probably another hour at this point. All together it was nearly 4
hours between when she came in with an 'emergent' reason for delivery
and when she actually delivered. Lucky for her, she maintained
stabilty for the duration.</div>
<br />
<div style="margin-bottom: 0in;">
Surgery was uneventful. Dr. Celestin
let me do the case and it was like any other c-section. Baby did
great and mom did great. Her placenta didn't exactly look like an
abruption, but her uterus had ecchymosis (bruising) that appeared to
be a classic Couvelaire uterus with bleeding into the uterus. A good
call to deliver by section.</div>
<br />
<div style="margin-bottom: 0in;">
By this time, Tara and Kerri (a doula
from Connecticut) had arrived to work the PM shift. Things were
oddly quiet for a while. As it usually happens, more commotion.
This time it is several men and one tiny woman carrying in a mom on a
stretcher. It was her first baby. She was 30 weeks by their
discussion, but looked more close to term. She had been in labor and
had been under the care of a Matron (a local, traditional birth
attendant) and she had apparently seized several times prior to
being brought to the hospital.</div>
<br />
<div style="margin-bottom: 0in;">
Matrons are traditional birth
attendants. These are both men and women that have grown up watching
others in their village attend births. They have learned their
skills by observation, being taught by matrons before them.
Matrons often have had no formal training in birth at all. Yet,
because of the long history of using matrons, these women are very
much a trusted part of the community. (Midwives for Haiti has begun
a series of classes to teach the basic medical skills needed to
provide safer care to the women in these remote village without
access to midwives.)</div>
<br />
<div style="margin-bottom: 0in;">
On first evaluation, her blood pressure
was 140/120, baby's heart beat was 120 and she was complete and plus
2. All in all, she was pretty stable. She continues to labor as the
midwives work to start her IV, hang magnesium, and wait for her to
deliver. Over the next hour or so, it becomes clear that her
seizures have left her exhausted and her pushing efforts are
non-existent. Tara wonders and questions o the Haitian midwife
whether a section would be in order at this point. She unobtrusively
asks how long they will wait before making that decision. Of course she is too wanting an uncomplicated vaginal delivery for this patient, but I can see the reasoning behind questioning for a cesarean. A first-time mom who has knowingly
seized several times and while now arguably relatively stable, she is
not coherent and hardly conscious. I can tell she feels this should
be happening. One of the Haitian OB doctors checks the patient and
says that he will give her a bit more time before ordering pitocin.</div>
<br />
<div style="margin-bottom: 0in;">
I can't say that listening to heart
tones is a regular thing here. There doesn't seem to be a protocol.
We tried as best as possible to listen consistently every 20-30
minutes, but in an environment of chaos and a lack of staff, it is
difficult. In this case, we listen and find the heart rate in the
70s! It stays in the 70s. We set in motion the means to get a
section done. I notify the anesthesiologist, the midwives call the
Haitian OB. The heart tones have come up a bit to the 100s, but are
still low. I was very surprised, pleasantly surprised, that things
went very quickly towards section. Within minutes of my notification
the OR was in the room to get her. Within a few more minutes she was
off to the OR. In the OR, she had a spinal placed mostly on her
side, but I'm fairly certain that he nearly put it in with her on her
belly. For those that know OB anesthesia, you'll know this is no
easy task when they can't sit straight up or lie still on their side.</div>
<br />
<div style="margin-bottom: 0in;">
The only thing missing was the Haitian
OB. Once her spinal was in, the anesthesiologist and scrub tech yell
at me and motion for me to just start. “You...go!!!' Hesitantly,
not wanting to break any rules we agreed on at the beginning of the
week, I decide to scrub. It is either that, or we might lose this
baby. Just as I'm prepping the belly, the Haitian OB walks in and
motions for me to continue. It looks like I'm on my own. He doesn't
scrub.</div>
<br />
<div style="margin-bottom: 0in;">
I quickly get to the uterus and open
it. Mec...lots and lots of thick meconium. Not terribly unexpected,
but also not a great indicator of what I'll find. The baby was limp
and apparently lifeless. I knew, however, that there was a set up
for resucitation handy, just in another room. I quickly hand the
baby off and finish the section. All is well with the mom. I find
out that the baby has actually done well. Initial heart rate was 130
and only needed bag mask to get started.</div>
<br />
<div style="margin-bottom: 0in;">
All in all, a busy day. I have found
that the willingness to call for a pediatric nurse and have them
called for every birth has truly been a life saver. There is no
doubt in my mind that without a skilled pediatric nurse for this last
baby, she would have died. For that one change since we were
here last, I am grateful, as well as proud of this program. There is
change being made.</div>
<br />
<div style="margin-bottom: 0in;">
Until tomorrow.</div>
<br />
<div style="margin-bottom: 0in;">
Glen</div>
Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com1tag:blogger.com,1999:blog-714741860362412016.post-91885709808196787532014-03-18T01:08:00.002-07:002014-03-18T01:11:31.556-07:00Sweat, Dirt, and Love<br />
The room Glen and are staying in while here with Midwives for Haiti is a small room that, on our arrival, had a twin bed and a single mosquito net canopy above it. Acknowledging that Glen and I are two people- husband and wife, it was offered that another twin size bed be carried into the room and placed beside the existing twin bed. The first night we arrived, this is what was done. Glen and Steve moved an entire bed from one room to the other, all so that we would have a comfortable place to sleep, together. I joked to Glen that having a bed big enough to share was the least of my concerns. I came to Haiti to work, not to make love or to cuddle. And besides, the idea of being pressed up against a hot, sticky body was not appealing to me.<br />
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I thought about this as we drove through the streets of Hinche. Riding on a moto or in the back of a jeep through the unforgiving, unpaved dirt roads, you see the rickety, tattered shacks that are the homes to the people in this town. I found myself wondering about the lives of the men and women and families that live there. I thought of my own relationship and life with my husband and wondered if those personal, intimate moments in life could possibly be the same here? Does the woman and her husband lay in bed and discuss their life? Do they hope and dream and plan for the future? Do they make love to purposely make a baby? Or is the prospect of adding another baby scary? Is it a burden...is it another mouth to feed? What does that life look like from within those dilapidated walls? A home that is not even a glorified shack. A home made of wood scraps, branches, dirt, metal, or if you have more than most, cement. Do they lay beside each other in the hot darkness...cloaked in sweat, dirt, and love? Does he whisper to her that she is the most beautiful thing in the world and that he loves her? Do they lay against each other and make love in their one-room windowless hut as their other kids or family members sleep just feet away? Do they have any idea how different life is for so many people...<br />
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It is simple to look at Haiti this way, to compare it to what we have back home, and inaccurately conclude that families must feel this way. But the reality is, we are all the same in basic ways, are we not? We put stake in the future by way of hope, we work hard to survive but also to improve and rise above from where we are, and we all make plans for the future. Why would Haitians be any different? Our life's treasures are not what we own, nor what we hold of monetary value and possession, but the family we create, the relationships we form, and the lessons we pass on to these people and in turn, the world. I suppose even in a country as Haiti, where access to the seemingly simple, basic necessities of life are not guaranteed, where pregnancy and birth carry the very real potential of death, the magnificent reprieve is that of Life and Love.<br />
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Today was our first day of work. Glen went to the hospital to help the Haitian OBs and midwives wherever needed, and I went on a mobile clinic to a town about an hour outside of Hinche. The mobile clinic goes to this particular location once a month. This enables the women and babies in this particular area to have access to quality care once a month, when before Midwives For Haiti came here, most went without. Without transportation and expendable money to be used on a 'tap-tap,' women simply could not reach a doctor or midwife.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0jvu9ZG_JWb_g4WqaPWiCsp3UBp8fCwYNJHpfVnrJlVdRh5hsJnFhEjc-j83D9s-d8KqjJR0PMWX9e7K0H_O0h8-gCrSCrzD6BaPYyR213217D5S_xIb3tm3ixKZKIBpKLFhdy0hvD1Gl/s1600/image.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0jvu9ZG_JWb_g4WqaPWiCsp3UBp8fCwYNJHpfVnrJlVdRh5hsJnFhEjc-j83D9s-d8KqjJR0PMWX9e7K0H_O0h8-gCrSCrzD6BaPYyR213217D5S_xIb3tm3ixKZKIBpKLFhdy0hvD1Gl/s1600/image.jpeg" height="300" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The new Midwives for Haiti Landcruiser, which we donated toward. </td></tr>
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We arrived to find that the house and church which was to be used as the mobile clinic site was locked up, with no way to access it. Women and babies had already lined up, waiting on our arrival and anticipating to be seen. Something so trivial as having no access to the building was not going to make us skip a beat. These women and babies needed to be seen. A couple midwives walked around the property and found a wooden picnic bench. This would be where the women would sit and wait for their turn to be seen. There was a permanent, cement table placed in the center of the shaded veranda, where the midwives would then make a makeshift pharmacy and urine dipping station. Meanwhile, someone set up the portable exam table that we had brought along with us. A backpack strapped to my back, a doppler on my waistband, stethoscope around my neck, I placed my measuring tape, doppler gel, and blood pressure cuff on the exam table to make my "exam room." A basic set up with minimal supplies, out in the middle of nowhere Haiti, and we were equipped to save a life by way of preventative care, education, and screening.<br />
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<tr><td class="tr-caption" style="text-align: center;">Keri and I. She's an American doula.</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCbuvMPFPDFoVMDEnKmvLwp2j4p0amj0lwXgdsnSUbHhQCxvu4-shFaBi4zJCdvEoK3xfRxbHQJKJpbZ2Lmpy7ywJgAhxxOypqeGh5vRcI7bhqpAUQEjhrveSDhqz7tsLPqlkE0i3J_yC1/s1600/image+%25283%2529.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCbuvMPFPDFoVMDEnKmvLwp2j4p0amj0lwXgdsnSUbHhQCxvu4-shFaBi4zJCdvEoK3xfRxbHQJKJpbZ2Lmpy7ywJgAhxxOypqeGh5vRcI7bhqpAUQEjhrveSDhqz7tsLPqlkE0i3J_yC1/s1600/image+%25283%2529.jpeg" height="640" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">This is where we hosted our clinic.</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdB-Rd4dXIgZ7jiaSpo9J1A8xDa08swrQrwKxGrcDtbdXL4OLDpY1xU9pBBrfkSM5pGXsQ_pR0q8h7NPqUXhnQdne8ekFebU8ILX_RJDEaVNONudgHqveALPRB5jXIGIyajchuCCvm33a4/s1600/image+%25284%2529.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdB-Rd4dXIgZ7jiaSpo9J1A8xDa08swrQrwKxGrcDtbdXL4OLDpY1xU9pBBrfkSM5pGXsQ_pR0q8h7NPqUXhnQdne8ekFebU8ILX_RJDEaVNONudgHqveALPRB5jXIGIyajchuCCvm33a4/s1600/image+%25284%2529.jpeg" height="300" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">My 'exam room.'</td></tr>
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The morning proved to be uneventful. I went from woman to woman sitting on the wooden bench and took each woman's blood pressure. I was honestly astounded by the beauty of each reading...105/60, 110/60...I'm not sure I had seen such great (normal!) blood pressures during our last trip. I made it a point to tell each of these women how great their blood pressure was, how their baby palpated head down, how wonderfully and completely normal they were measuring. Throughout the late morning patients, a young boy would come up to me, eagerly searching for conversation in his broken English. "Allo, what is your name," he asked me? "My name is Tara," I told him.<br />
"How old are you?" He answered that he was 15. "How old are YOU," he asked me? I smiled at that. "I'm 30." I thought about it more and laughed. "Ha! I'm twice your age...15x2!" He laughed with me at that. I was puzzled at his presence. "Why are you here? Obviously you are not pregnant." (He laughed at this.) He responded saying, "I am here to be a guest!" Okaaaay. I wondered why in the world a 15 year old boy would come here to hang out...to watch pregnant women and busy midwives meander around in the hot sun, as if it were entertaining? Very puzzling to me, but I shrugged and went about my business, smiling at the oddity.<br />
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The mild morning warmth quickly stretched into the blazing afternoon, and the steady stream of patients became just a few remaining. One of the last remaining patients got up on the exam table.<br />
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"Bonjou! My name is Tara, I'm a midwife. As I began to talk, I instinctively put my hands on her belly feeling as I spoke. Her soft, stretched, gravid belly reminds me of a momma who has carried 10 babies within her throughout her life.<br />
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"What baby is this for you?"<br />
"It is my 4th."<br />
It creeps into my mind...she is expecting her 4th baby, just like me. We are two women, in the same phase of life. She is like me. I am like her. Yet so far...<br />
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"How are you feeling?"<br />
"OK", she responds, after my translator has translated what I have said to her.<br />
"When are you due," I ask?<br />
"April," she says.<br />
"Is your baby active?"<br />
"Yes."<br />
"Do you have any complaints...headaches?"<br />
"Yes," she says, I have had a headache for 3 weeks."<br />
Hmmm.<br />
"Are you having any visual disturbances?"<br />
"Yes, I have been seeing spots for 3 weeks," she tells me.<br />
"What was her blood pressure," I ask Pleasure, my interpreter?<br />
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He rummages through the paperwork I've just been given by one of the midwives, who took her blood pressure a few moments ago, with an automatic cuff.<br />
Pleasure points to a number, and even though I shouldn't be surprised, I am.<br />
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It says 210/110.<br />
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I quickly finish examining her...I note no edema, I measure her and she measures appropriately, I palpate and the baby is head down...and then I listen, hesitating in my mind because blood pressure like that makes me wonder if baby is even still alive. It is. I tell her that her blood pressure was very high and that I would like to take it again, myself, and manually this time. She sits up and I put the cuff on. When I hear the first beat and when I hear the last, I am yet again surprised. There is NO WAY her blood pressure is what I think it is. I have to take it again.<br />
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I take it again and get the same reading. I have never in my life, even in Haiti, seen a blood pressure this high. I switch arms and I repeat it yet again. It is indeed the same.<br />
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240/140. I type those numbers and I honestly cannot wrap my mind around it. If someone would have told me that there was a person with a blood pressure this high, I likely would not believe it. I looked her in the eye and I said to her, "You must go to the hospital." She stared back at me, expression unchanged. I knew she did not understand the severity of the situation. I am sure that is the venom of hypertension...it is silent. It does not hurt. It creeps up and up and up, unbeknownst to the invader, silently destructing and wearing down the body from the inside.<br />
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I sat down beside her and my translator translated quickly as I went. I looked her in the eyes, just inches from her face, and this time, I recognize those sweet eyes. They belong to that boy. The 15 year old who wants to be a doctor, who was half my age, who was talkative and silly. He belongs to her. She is his mother.<br />
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"You MUST go to the hospital, right away. Blood pressure this high can cause you to have a stroke, can cause you to lose the baby, and can kill you. I know it is far, I know nobody wants to go to the hospital...but it is better than dying. Do you understand?"<br />
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She looked at me and nodded, and I felt she truly understood. I said to the Haitian midwives, "She needs blood pressure medication right away. Do we have anything?" One midwife brings over some pills, and before she gives them to the woman, she asks her if she has had anything to eat today. The woman says yes, that she had a cracker this morning. A cracker. Nothing more.<br />
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I remember the snacks in my bag and I tell her that I have some peanuts in my bag. Would she like some? She eagerly says yes, yes please. I give her the peanuts, brought from Alaska, gifted to me from my dear friend Mary. She sits there like a silent ticking time-bomb, quietly and happily popping honey roasted peanuts into her mouth, and I wonder to myself if she and her baby will make it.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjU5DQgiXS9Dg370WAcLTPVG1uc5ALQO5AiGjYX9z6g3ayATUnUpXIaDigFQaeIQ-D6-sLUTEwSk7RtsvUY1A6spvM_OyCdCRIgcQGI4X1SCXt6wOGXG-jDSYTQkfvSsICxDVPZKT6liIUo/s1600/image+%25286%2529.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjU5DQgiXS9Dg370WAcLTPVG1uc5ALQO5AiGjYX9z6g3ayATUnUpXIaDigFQaeIQ-D6-sLUTEwSk7RtsvUY1A6spvM_OyCdCRIgcQGI4X1SCXt6wOGXG-jDSYTQkfvSsICxDVPZKT6liIUo/s1600/image+%25286%2529.jpeg" height="640" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The writing on the tag says, "I do not give lectures or charity. When I give- I give myself." Walt Whitman</td></tr>
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I wanted her, so badly, to ride back with us. I wanted to see her arrive to the hospital safely. But, she insisted that she go home to tell her husband where she was going and to get the items she would need for delivery (a sheet, a towel, a bucket, baby clothes). I wondered what all this truly mattered, if it meant further putting her life at risk. What does a baby outfit and a diaper do for a dead baby? My heart sank as we loaded up. I walked over to her, one last time and spoke with her, "I want to see you and your baby healthy. Please do not delay in getting to the hospital. I will be looking for you." She smiled, and we said goodbye- all of us headed down the rugged dirt road, cloaked in sweat and dirt, yet filled with love for this work.<br />
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I don't know if she made it to the hospital. I don't know if she will be ok. I don't know if I will ever see her again. But I hope...<br />
<span class="Apple-tab-span" style="white-space: pre;"> </span>Tarahttp://www.blogger.com/profile/01407282839039709665noreply@blogger.com3