A birth

I actually got to attend a live birth this week! It was a pretty incredible experience, I’d have to say.

I was in Concepción, a town about 30min outside of Xela where PIES has a clinic. The clinic has a doctor who is there 2 days a week and a nurse full time, but the midwife, Dona Angela, is the primary attender of the pregnant women who come in. Women come into the clinic for their prenatal checks and to give birth. I was in Concepción with the director of the Domestic Violence program Marta, and 2 other women from the office. They were gathering information at the justice office and police station on how many cases of domestic violence had been reported, what the follow-up had been, etc… At around mid-morning break time (refraccion) we stopped in at the clinic to have our bread and coffee. When we got there, we found out that there was a woman in labor in the 2-room clinic. Wanting to see a birth, and thinking that this might be my only chance I asked if I could stay, and I did. For the sake of this blog, I will call the woman giving birth Maria and the father of the child Jose. I don´t actually know their names.

Maria was 31 and having her 5th child. She had started to go into labor at around 9am, and her water had still not completely broken when I got there around noon. She was walking around the room trying to get her water to completely break. I learned from Dona Angela that this is normal for women who have had many children. Apparently, the water can fully break hours into labor - for women with many children the child often comes soon after the water breaks. At about 2 (2 hours after thinking that the baby would be arriving soon), Dona Angela was getting impatient. Therefore, it was not unusual that Dona Angela, fully broke Maria´s water herself by sticking her index finger up the birth canal.

The staff at the clinic was very laid back about the whole thing. At noon, Dona Esperanza went into the room to see how Maria was doing. The staff was trying to figure out when to eat lunch. If Dona Angela thought that the baby would come soon, we would eat lunch afterwards. If not, we would eat now. Dona Angela decided that we should go ahead and it as she said - a phrase I hear a lot that day - "Falta un poquito" (a little more time).

I entered the room with Maria, her mother and a friend at around 1pm. We spent the time in between contractions talking and chit-chatting. Dona Angela and Maria´s family would speak in Mam and I would listen, not understanding a word, but enjoy watching their grand hand motions and animated speech. I gathered that they weren´t talking about much. At one point they started looking at Maria´s mother´s shoes and I think were talking about prices and where she bought them. I would speak with the nurse who was in the room too - only to provide back up. She would explain things to me and help me get a sense of what was going on.

Maria was almost totally silent through out the other births. While I heard that many women scream from the pain, yell "no, no, i don´t want it" and other things of the sort, Maria did not say a word. You could tell she was in pain, because as each contraction came, she would tap on the bed post, calling over her mother or husband and then have an extremely pained looked on her face.

Around 2:30, Dona Angela and the nurse started to express their concern about the birth. Maria´s contractions weren´t getting closer together, at times it even seemed like they were getting farther apart. For a while Dona Angela had been thinking that the baby was close, but was now starting to get worried. Her stomach was soft, while during the end of labor, it should be hard to show it´s contracting. You could see the black of the baby´s head, but for some reason it didn´t want to come out. Dona Angela and the nurse knew that taking her to the hospital would be a bigger risk then keeping her at the clinic, given how close she was. They decided that she needed to be in a better position to push. Her mother and husband who came to her side during her contractions were pushing her down, rather than keeping her in a position where she could use all her force to push. Maria had refused to lay on the bed with stir-ups, which didn´t help. To help give Maria sustenance and to get rid of all the bad blood before the baby is born, Maria drank a fruit nectar and raw egg concoction. Yum!

Dona Angela sent the family of the room and took matters into her own hands. We moved the bed, propped Maria up, and the nurse stood behind her. The entire time I am standing right at the end of the bed, so that I can get a good view of the birth, they tell me. This helped and soon after progress was being made and a 3:20 a baby girl was born. She weighed 9lbs 12oz, which is why they think Maria had so much trouble.

There were a lot of things I didn´t realize about birth. One, once most of the head comes out, the entire body follows in what feels like one second. Secondly, it´s not really over for the mom who now has to push the placenta out too (which takes anywhere from 10-30 min). The umbilical cord is really long and Dona Angela spent some good time looking at it. She said that you could see all the children Maria had in it. I´m still not really sure what she meant by that. It was really incredible to be a few inches away from Dona Angela as she cut the cord, cleaned the baby and handled the placenta.

The placenta - by the way - is given to the family who then buries it. Dona Angela put it in a plastic bag and the family threw it into the sacks they had brought. As if it were a t-shirt. I found that a little disturbing.

After the placenta came out, the baby girl was cleaned and placed in crib while Dona Angela dressed Maria. Then, Dona Angela blessed the baby with a candle, followed by the grandmother, and the baby was dressed. I have never seen a newborn in so many clothes! She looked like a little sausage when Dona Angela was done with her. 3 sweaters and a fleece blanket as a diaper, plus being wrapped in another fleece blanket. The baby was then handed to the mother for the first time, about 40 min after birth. It was interesting to me that she wasn´t handed over sooner to the mother. Other people in the room (at this point, other relatives had arrived too) and they had had a chance to hold the baby before the mother. Even when Maria left, she went in a separate car then the child.

The family asked me where I was from and told me what an honor it was to have me there. Dona Angela had been telling them that I was going to be a woman´s doctor (not really sure where she got that from, but she is a bit old). I told them it was for me as well and thanked them for the opportunity. They then asked me my name, and said how much they liked it. Maybe they would name their daughter Laura Estefanie. In Guatemala, you don´t have to name your child for a month. So, who knows, maybe Concepcion will have a new Laura.