Sunday, September 28, 2008
Fall birth
I was in my second birth this morning. It was beautiful and surreal, dappled fall light coming in through the open door and church bells chiming in the background. My body helped support the mama's and when the baby came out I was christened with vernix. She scooped him up into her arms and studied him with wonderment and astonishment covering her face in vernix and laughing as she met her little boy.
Friday, September 26, 2008
Nacimiento
I drifted off to sleep after writing that last post, joking with the other girls that a woman would come in complete and pushing. As I am still in orientation in the clinic we are "shadowing" the interns and watching the roles that each of them play in the birth. I had shadowed Olympia as primary a few nights before and we spent the whole night with a young girl having her first baby. At around five in the morning she and her mom decided to go to the hospital, I suspect there was some strong persuasion going on from grandma as she had difficult obstetrical history. It had been a long night with a bit of a sad ending so I was hoping that perhaps on this shift Olympia and I could complete the circle in a sense.
We both thought it was a joke when we got woken up an hour or so later being told we had a complete and pushing mama! I took the role on as documenter recording each new progression of the labor. For example: head born @ 11:57 am. Baby born at 11:59am, September 25th and so on. In retrospect I was a little shaken by the power I had simply as a documenter, especially in this birth. I made the call that it was 11:59pm when I could have seen the clock as 12:00am which would have made her birthday September 26, a date that she will be used to identify for the rest of her life. Part of being a student at MLL requires that we write a birth report after each birth with our reflections on that birth. Here is mine.
First and thousandth birth....
Allisson’s birth was the first and the thousandth for me. It simply was, as I am, and seemed less of a mystery then I had anticipated. Birth. Beautiful and complete, yes I know this, yes this is familiar. More familiar then anything has ever has been. I am struggling to find the words to describe it. My emotions and thought process seem slow and glitchy. Attempting to find the end of my thoughts to be picked up and examined seems fruitless. It is complete, a full circle with no ending and no beginning to it. I don’t think anything else in life has ever felt so whole and so completely satisfying.
After Allisson was born I lay on the on the bed beside her while her mama was taken care of.
As I listened to to her breath, the thump of her heart and the gurgles of her tummy I was struck with how defined and perfect she was, this creation of woman’s womb. Her skin was so soft, vernix tucked into the roles of her neck, her eyes closed tight against the bright light and her tongue and mouth rooting. She represented to me the beginning and as I looked at her I also saw the end and I found bliss in both.
We both thought it was a joke when we got woken up an hour or so later being told we had a complete and pushing mama! I took the role on as documenter recording each new progression of the labor. For example: head born @ 11:57 am. Baby born at 11:59am, September 25th and so on. In retrospect I was a little shaken by the power I had simply as a documenter, especially in this birth. I made the call that it was 11:59pm when I could have seen the clock as 12:00am which would have made her birthday September 26, a date that she will be used to identify for the rest of her life. Part of being a student at MLL requires that we write a birth report after each birth with our reflections on that birth. Here is mine.
First and thousandth birth....
Allisson’s birth was the first and the thousandth for me. It simply was, as I am, and seemed less of a mystery then I had anticipated. Birth. Beautiful and complete, yes I know this, yes this is familiar. More familiar then anything has ever has been. I am struggling to find the words to describe it. My emotions and thought process seem slow and glitchy. Attempting to find the end of my thoughts to be picked up and examined seems fruitless. It is complete, a full circle with no ending and no beginning to it. I don’t think anything else in life has ever felt so whole and so completely satisfying.
After Allisson was born I lay on the on the bed beside her while her mama was taken care of.
As I listened to to her breath, the thump of her heart and the gurgles of her tummy I was struck with how defined and perfect she was, this creation of woman’s womb. Her skin was so soft, vernix tucked into the roles of her neck, her eyes closed tight against the bright light and her tongue and mouth rooting. She represented to me the beginning and as I looked at her I also saw the end and I found bliss in both.
Thursday, September 25, 2008
clinic
Another day almost done at the clinic....its 10pm and my second full shift here. Its been another crazy/wonderful/mad/super tiring day. I did my first breast exam, another initial (which takes a few hours of interviewing in Spanish) watched a pap, attempted to draw blood, and another gazillion things I can think of right now. My last shift here I was up all night following another student in a labor sit. They ended up going to the hospital so I still haven’t seen a birth but am getting the hand of listening to fetal heart tones and feelings bellies. Its so amazing how much can be learned in 24 hours....Off to try and get some sleep in case a laboring mama comes in, I’m up for the birth again...
Wednesday, September 24, 2008
some more pictures....
Juarez at night
The food bridge bride into Juarez
The view from my bedroom
window in the morning
The food bridge bride into Juarez
The view from my bedroom
window in the morning
Saturday, September 20, 2008
Shocked at deaths, Guatemala trains midwives
The Associated Press Published: September 19, 2008 
Guatemala is trying to reduce the number of women who die during childbirth by providing basic medical training to some 15,000 lay midwives in villages around the country.
More than 600 women die from complications of child birth each year in Guatemala, where midwives deliver six out of every 10 babies. These lay midwives are often the only help available to rural women, and most have no formal medical background.
President Alvaro Colom has announced a five-month program to provide them with training in the basics of gynecology and obstetrics, including how to identify complicated pregnancies and avoid preventable deaths.
"One of our biggest challenges is solving the problem of limited access to health services, and the shortage of qualified midwives in rural areas," Colom said.
For each high-risk pregnancy the midwives refer to a doctor, the government will pay them US$20.
"If we're able to get these women to see a doctor, high-risk cases could be identified and we could take steps to prevent them," said Jackeline Lavidali, who directs Guatemala's reproductive health program.
Guatemala plans to enlist non-governmental organizations already in the field to do the training, using financial support from the United Nations and the U.S. Agency for International Development.
But many obstacles remain — including roads and transportation that are so poor, it is nearly impossible for women to quickly reach a doctor even if their midwives have identified problems. That's why the government is trying to create maternity houses near bigger hospitals where rural women with high-risk pregnancies can arrive days before giving birth.
Francisca Raqueq, a 65-year-old midwife, has helped deliver babies for 50 families in the last 25 years in the village of El Llano, 40 miles (65 kilometers) northwest of Guatemala City.
She said the nearest clinic is 15 miles (25 kilometers) away and it would cost US$70 to rent a pickup truck to get there in an emergency during labor. That's a small fortune for farmers who make US$4 a day.
Sited from:
www.iht.com
Guatemala is trying to reduce the number of women who die during childbirth by providing basic medical training to some 15,000 lay midwives in villages around the country.
More than 600 women die from complications of child birth each year in Guatemala, where midwives deliver six out of every 10 babies. These lay midwives are often the only help available to rural women, and most have no formal medical background.
President Alvaro Colom has announced a five-month program to provide them with training in the basics of gynecology and obstetrics, including how to identify complicated pregnancies and avoid preventable deaths.
"One of our biggest challenges is solving the problem of limited access to health services, and the shortage of qualified midwives in rural areas," Colom said.
For each high-risk pregnancy the midwives refer to a doctor, the government will pay them US$20.
"If we're able to get these women to see a doctor, high-risk cases could be identified and we could take steps to prevent them," said Jackeline Lavidali, who directs Guatemala's reproductive health program.
Guatemala plans to enlist non-governmental organizations already in the field to do the training, using financial support from the United Nations and the U.S. Agency for International Development.
But many obstacles remain — including roads and transportation that are so poor, it is nearly impossible for women to quickly reach a doctor even if their midwives have identified problems. That's why the government is trying to create maternity houses near bigger hospitals where rural women with high-risk pregnancies can arrive days before giving birth.
Francisca Raqueq, a 65-year-old midwife, has helped deliver babies for 50 families in the last 25 years in the village of El Llano, 40 miles (65 kilometers) northwest of Guatemala City.
She said the nearest clinic is 15 miles (25 kilometers) away and it would cost US$70 to rent a pickup truck to get there in an emergency during labor. That's a small fortune for farmers who make US$4 a day.
Sited from:
www.iht.com
Friday, September 19, 2008
Mole
We are now done orientation and will begin integrating into the clinic and working 24 hour shifts. Its been an intense three weeks and more information was crammed into my brain then I thought possible. We all went out for mole (a mexican sauce made out of chocolate and 17 different spices apparently). The restaurant we went to was supposed to be the best on this side of the border. I was certainly not disappointed with my first experience....
Tuesday, September 16, 2008
Becoming
I have come to accept the fact that the only way to make it through this program is to surrender. It is all consuming. At times it feels as though some great external gravitational force is pulling at every cell in my body. It takes a sense of organization, not just for the stacks of papers and hand outs but organization of the mind. This program is seasoning us as Midwives, we are Midwives. We are gaining our experience and our knowledge through assignments, creating folders, information and protocols that we will use in our own practice. We are defining ourselves and what mid [with] + wife (in the archaic sense [woman] ) means to each of us.
Monday, September 15, 2008
Transition
This morning we went to the hospital to familiarize ourselves with the facility so when a woman transports due to complications of labor we know where to go. After we went to the best place in town to get tamales and ate them from a view point above El Paso. On friday orientation ends and we begin working 24 hour shifts in the clinic. I am starting to see a weariness in the group and in myself. The learning has been intense and I’m starting to wonder just how much more information I can absorb. Each class is so important and even missing five minutes can set you back as the information is so vital. Things are going to be more emotionally intense when we start working in the clinic. I have been speaking little to no Spanish and feeling a need to start exercising that muscle in my brain so that I am able to work with the clients in appointments and help them labor. The only way I feel like I can really prep is reminding myself to breath breath breath for the moments that I know are going to come. These past weeks have been all consuming with my time off usually spent trying to make the apartment more homey or studying. I’ve gotten a lot of homework done which feels great. The information that I learn from doing it feels so important to know and I am so interested in it it rarely feelings a chore. All of it is to help me become a better Midwife and to expand my knowledge which I am hungry for. Right now the 18th months ahead of me seem like forever. I’m looking forward to settling into my life here a bit more. I love it here and want to feel like my life is balanced and complete which it doesn’t feel like right now but its getting there. Its a real blessing to have a home that feels as good as it does and to have such a great roommate.
Sunday, September 14, 2008
An El Paso evening
Driving along the highway in the evenings is really amazing. The desert sunsets mixed with the city scape make a strange but beautiful site.....
Venipuncture class
Taking blood is something that I have always been a bit scared of. Something about pushing that needle into the skin has always made me a bit panicky. Whenever I've had blood taken for testing I've never been able to watch it happen and still wasn't able to in class. Pushing the needle in wasn't as bad as I was expecting. The tricky part was stabilizing the barrel and inserting the tube into the barrel to collect blood without letting the needle go in deeper and through the vein or accidentally pulling it out. By the end of class I successfully filled four containers in a series of two punctures. We also tested blood sugar levels and hemoglobin by quickly pricking each others fingers will small sterile dart like tools. It was an emotional day for all of us though some of us held it together better then others.
Thursday, September 11, 2008
Saturday, September 6, 2008
A lesson in Spanish....
A SPANISH Teacher was explaining to her class that, in Spanish, unlike English, nouns are designated as either masculine or feminine.
'House' for instance, is feminine: 'la casa.'
'Pencil,' however, is masculine: 'el lapiz.'
So, a student asked, 'What gender is 'computer'?'
Instead of giving the answer, the teacher split the class into two groups, male and female, and asked them to decide for themselves whether 'computer' should be a masculine or a feminine noun. Each group was asked to give four reasons for its recommendation.
The men's group decided that 'computer' should definitely be of the feminine gender ('la Computadora'), because:
1. No one but their creator understands their internal logic;
2. The native language they use to communicate with other computers is incomprehensible to everyone else;
3. Even the smallest mistakes are stored in long term memory for possible later retrieval; and
4. As soon as you make a commitment to one, you find yourself spending half your paycheck on accessories for it.
The women's group, however, concluded that computers should be Masculine ('el computador'), because:
1. In order to do anything with them, you have to turn them on.
2. They have a lot of data but still can't think for themselves.
3. They are supposed to help you solve problems, but half the time they ARE the problem; and
4. As soon as you commit to one, you realize that if you had waited a little longer, you could have gotten a better model.
The women won.
'House' for instance, is feminine: 'la casa.'
'Pencil,' however, is masculine: 'el lapiz.'
So, a student asked, 'What gender is 'computer'?'
Instead of giving the answer, the teacher split the class into two groups, male and female, and asked them to decide for themselves whether 'computer' should be a masculine or a feminine noun. Each group was asked to give four reasons for its recommendation.
The men's group decided that 'computer' should definitely be of the feminine gender ('la Computadora'), because:
1. No one but their creator understands their internal logic;
2. The native language they use to communicate with other computers is incomprehensible to everyone else;
3. Even the smallest mistakes are stored in long term memory for possible later retrieval; and
4. As soon as you make a commitment to one, you find yourself spending half your paycheck on accessories for it.
The women's group, however, concluded that computers should be Masculine ('el computador'), because:
1. In order to do anything with them, you have to turn them on.
2. They have a lot of data but still can't think for themselves.
3. They are supposed to help you solve problems, but half the time they ARE the problem; and
4. As soon as you commit to one, you realize that if you had waited a little longer, you could have gotten a better model.
The women won.
Friday, September 5, 2008
Placenta
Last night I had my first clinical shift (just 3 hours) and was able to examine a placenta. Holding something that I have been reading about and studying for such a long time not to mention something that creates life felt pretty emotional. My moment was interrupted by another student jumping in and I felt a bit shaken. Later at home when I told Jessica I started to cry over my "interrupted" moment and then started to laugh realizing I really must be an MLL Midwife if I get so excited over a placenta and tired and emotional enough that it evokes tears!
Thursday, September 4, 2008
Settling in
Writing this from the glow of my computer and candles. Jessica and I are about to spend our second night in the apartment, my first night alone in my own bed and room! We had it set up that our beds would be delivered last night but only one came. This afternoon after school we cleaned the apartment like mad women and started to make the place feel like home. We still don’t have electricity so when it gets dark we spend our evenings strolling the isles of K-Mart eating Taco Time or devouring cereal and warm milk in bed.
Tomorrow is our fourth day of our three week orientation. So much has happened in the past three days I don’t even know where to begin or end. By 9pm my eyes are watering and I am so ready for bed. Tomorrow after a full day of classes I have my first clinical shifts. Its just three hours of following an “intern” (a student that has completed 6 months) and getting a feel of the clinic. I’m looking forward to it.
Classes have been amazing and beyond what I expected. Everybody is so kind and supportive and always checking in and assuring that they will be there every step of the way holding our hands until we are confidant. As the program is excellerated things move fast, really fast. In five and half weeks we will be catching babies. In two and a half we have a long list of things that we must be proficient at and be signed off by the licensed Midwife on duty who overseas the whole clinic.
I know in retrospect I will realize just how much I am absorbing and learning. Right now its all about getting up in the morning, spending all day in class and then rushing around trying to get all the little nitty gritty things taken care of. I’m so thankful that I have Jessica, my partner in crime to make jokes about the “El Pasonian” driving (ITS HORRIBLE) and talk through the moments of panic when we realize how many assignments we have. Were both so happy to be here but also hanging on by our finger nails, trying to stay on top of everything.
Tomorrow is our fourth day of our three week orientation. So much has happened in the past three days I don’t even know where to begin or end. By 9pm my eyes are watering and I am so ready for bed. Tomorrow after a full day of classes I have my first clinical shifts. Its just three hours of following an “intern” (a student that has completed 6 months) and getting a feel of the clinic. I’m looking forward to it.
Classes have been amazing and beyond what I expected. Everybody is so kind and supportive and always checking in and assuring that they will be there every step of the way holding our hands until we are confidant. As the program is excellerated things move fast, really fast. In five and half weeks we will be catching babies. In two and a half we have a long list of things that we must be proficient at and be signed off by the licensed Midwife on duty who overseas the whole clinic.
I know in retrospect I will realize just how much I am absorbing and learning. Right now its all about getting up in the morning, spending all day in class and then rushing around trying to get all the little nitty gritty things taken care of. I’m so thankful that I have Jessica, my partner in crime to make jokes about the “El Pasonian” driving (ITS HORRIBLE) and talk through the moments of panic when we realize how many assignments we have. Were both so happy to be here but also hanging on by our finger nails, trying to stay on top of everything.
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