Saturday, October 11, 2014

Micaiah

A midwife's life is often filled with unpredictable events. One never knows when baby will come or how long labor will be. This past weekend I was blessed to attend the labor and birth of a dear friend.

I awoke with a start to my phone ringing. As I answered, I glanced at my watch and noted that it was 3:20am. On the other end was my friend Karolyne. I had been blessed to attend the birth of her first son in 2012 and was invited to also attend for her second son's birth. She informed me that her waters had ruptured but that contractions were still not so regular. As we talked, I grabbed my birth bag, and threw in my water bottle and an apple. We finished and I quickly readied myself and put Beau (my puppy) in a dog crate. It was not even 3:25am and I was off.

The drive up was quiet and dark. There was no traffic. I passed a total of 5 vehicles along the way. I smiled to myself and prayed that the gas I had would last the ride as I had forgotten to throw in the spare gas can and our gauge can be finicky. A light rain was falling as I pulled into their driveway an hour or so later.

As I entered their home, I saw Karolyne walking back and forth. She expressed her desire to head to the hospital once her mother-in-law came to watch her son. She was ready and excited to have this baby. The contractions were still spaced out and it was apparent that active labor was not present. A little before 5 am her mother-in-law arrived and after a changing of the guard we headed to the hospital.

Upon arrival to the hospital, we to the OB ward. Karolyne preferred the stairs as it helped bring on regular contractions. Up we went (it was only the 2nd floor anyway)! When we arrived she was checked in and we discovered that she was only 1cm dilated.

As the morning moved on we did what we could to encourage contractions to pick up. I lost track of how many laps we walked through the halls of the hospital. At one point we enjoyed a time of softly singing hymns together while her husband Jonathan rested up for the long haul ahead.

Four hours later, the doctor arrived and checked for progress. Unfortunately there was no progress. The contractions were still coming but seemed ineffective. The decision was made to start a pitocin drip to help encourage the contraction pattern to pick up. It seemed to help and slowly the contractions came with more regularity.

Per policy though, along with pitocin came the electronic fetal monitoring. Thankfully, after talking with the doctor, he agreed to allow her to still walk around as long as intermittent monitoring was used. So labor continued on. Jonathan and I supported her as best we could.

Around 5:30 pm the doctor again checked for progress. Now she was only 2-3cm dilated. The doctor noted that the bag of waters was present (meaning the afore mentioned gushes probably came from a high leak) and promptly "broke" them again with an amnihook and little explanation as to what he was doing. As the head applied more pressure, the contractions picked up with a greatly renewed force. So much so that the doctor agreed that the pitocin could be discontinued for the time being.

Labor continued. Breathing, moving as much as possible and lots of back pain. Around 8pm the nurse checked again. Only 4-5cm dilated. I asked if baby was asynclytic but the nurse informed me that she did not know how to check baby's sutures. We continued to labor and Karolyne used various positions to help her labor progress. The doctor came in two hours later for another exam.

I could tell that at this point the doctor was becoming a little wary of the situation. She was approaching 20 hours past initial SROM and still no baby. He determined she was 7cm and was going to leave it at that. I asked if the baby was at all asynclytic. He seemed slightly startled that I would ask such a question and said in fact baby was. I encouraged Karolyne to lay on her side to rest and help baby to rotate into the correct position. I continued to pray that the Lord would help this labor to proceed normally.

Contractions began to once again space out. I explained to Karolyne and Jonathan that this was a normal occurrence in labor and may actually indicate progress. I coached and encouraged Karolyne to relax with each contraction. After almost an hour they began once again to pick up. I saw the familiar look and told them that I must go talk with the nurse for a moment.

Outside at the nurses station I quietly informed our kind nurse that Karolyne was seeming to be ready to push. She glanced at her watch and noted that it had only been an hour. I explained what I saw and she readily agreed and did not question my judgement. Instead she checked and called the doctor to confirm. At 11:25pm she was declared to be "fully".

I was blessed to be able to help support Karolyne and coach her through the next 20 minutes. At 11:45pm adorable little Micaiah was born. He was 7lbs 0.03oz (3185g). I was so happy to witness such a beautiful birth. It was a long and hard labor, but the end result was priceless!

Baby had a 36cm head and was 52cm long. It was different getting used to seeing a puti (white) baby again! What an amazing family! I truly enjoyed watching the strength of this couple during the long haul! There were a number of times I caught myself wanting to talk to them in Visayan. Thankfully the Lord helped to give me the English words that I needed to say!

A few hours later at 3am I walked out of the room for the last time and towards the nurses station. The new family was stable and finally tucked into bed to sleep for a few hours. Our kind nurse beckoned me to follow her. I did and she led me down the hall to the storage room where she retrieved blankets from the warmer. I continued to follow her to a storage room where she had a bed made up. She turned down the sheets and told me to rest as long as I needed before my drive home. I was thankful for her thoughtfulness as the warmth of the blankets enveloped me and I drifted off to sleep.

About 3 hours later I awoke, packed up and headed home. As I drove, I enjoyed the colors of fall and watched the sun peak out as the morning sky brightened. I thanked the Lord for his protection and safety and for the precious new life I had left behind. I drove homeward knowing that the loving arms of my family awaited and that in a few short hours I could sleep once more.


Wednesday, October 8, 2014

Back to Blogging

Hello Friends!

It has been a while since I last posted here on my blog. Part of this is due to the busyness that followed my return home. I have been BUSY!

First, There was the NARM exam.... PRAISE THE LORD I PASSED! It was a super stressful time for me, but God is ever faithful! I am still awaiting my official certification to arrive in the mail, but I have been told that it is currently being processed and I am hopeful to receive it within the next month or so!

Next, there was my little sister's wedding (a BEAUTIFUL event!). I may post more on this once I receive photos. Unfortunately, this maid of honor was a little to busy to think of taking any for herself! I am so happy for my sister and now brother-in-law! They truly are a wonderful couple!

Then there is cultural adjustments. I feel like I am doing much better now, but it is still hard at times. There are the random things that come up such as speaking Visayan words/phrases and forgetting that people around me do not understand. Or pointing with facial expressions. Or forgetting that you actually CAN flush toilet paper.... There are the deeper aspects of adjustment too. Learning to once again live with a family. Learning to not feel such frustration with the common selfish American mindset. Learning to adjust to a life that has changed much in the past two years.

So much has changed. It is still home and a family I love, but I now have a niece, sister-in-law and a brother-in-law. Friends have changed, married, moved away. I have changed in ways too. It is a lot of adjustment to take in and process.

I had been seeming to go through what I termed "birth withdrawals". I miss birth! I miss being in an environment where I lived and breathed midwifery. It was an integral part of my life for the past two years. Being out of that environment has made me feel at times like a fish out of water. However, the Lord knows and has been helping me in that.

This past week I was blessed with the privilege of attending a dear friend of mine's birth. (Post coming soon!) I was honored to be her doula and witness the miracle of birth once again. God is so good!

So what comes next?- you may ask. Thanks for asking! I am excited to see what the Lord has in store! Right now, He seems to be leading for me to start serving here as a midwife! I have had a number of meetings with various midwives here and some have encouraged me to just start where I am at. I have been overwhelmed by the support and acceptance I am receiving. Stay tuned! There may soon be a blog post introducing a new name in the midwifery practice world!

Besides trying to get everything in order for that, I have been busy with life in general. I have gotten back to helping on my family's farm (Shear Pleasure Farm) and have been excited to see how that is blossoming. Back in September I was able to show my French Angora buck's fleece and won 3rd place from the Common Ground Fair! Anyway, I found it to be very exciting!

Well.... That is a brief update of what I have been up to! I will TRY to be a bit better about blogging, but there is no guarantee! Until Next time!

Wednesday, August 6, 2014

Transition Time

Today another chapter of my journey comes to a close. Tomorrow, another opens.

In a few short hours (August 6th am for those EST or pm for those here in the Philippines) I will be boarding my first flight on my journey home. It is a great time of transition and mixed emotions. I am leaving my home of 2 years, a place I have come to know and love.

More than the place, I will miss the people. I will miss the many friends I have made. I will miss the women I have served. I will miss the midwives who have taught me. I will miss the people!

I have greatly enjoyed my last few days in the Philippines! I have been so very thankful for my time here! I am not sure words can describe all that I feel right now. I am trying to prepare myself for this transition, yet I do not know how to.

The one thing I do know is that I can rely upon the Lord and that He alone will provide the strength I need for this time in my life! Please keep me in your prayers!

Friday, August 1, 2014

Worth more than a thousand words....

It is said that a picture is worth a thousand words. To me, millions could be said about these pictures. Each of these women are dear to my heart. Together we have learned, grown, and served. Together we began this journey to become midwives. We have laughed together and cried together. We have prayed together and supported one another. It has not been an easy journey to get to this point, but it has been an amazing one!




I am so very thankful for each one of these magnificent midwives! There is much that could be said about each of them... but I will just say this-You are wicked awesome and I am glad to have had the privilege to walk this road with you! Though we may be parting ways soon, the memories we have made will last a lifetime! Let the pictures speak for themselves... Enough said.


Sunday, July 27, 2014

One year and 3 months later...

The other I had the amazing opportunity to see a little boy who I welcomed into this world in April of 2013. His mother recently delivered again at the clinic. Thankfully, I was able to be there and also witness the sweet birth of his younger sister. You can read about it here.

Here is a photo of Zhel John then.....


Here are pictures from our visit yesterday-
Baby Mhelsie Sarah, Zhel John and I

Precious little Mhelsie Sarah

Happy big brother

Look at those adorable little faces!

Such a wonderfully amazing opportunity! I was glad to share in this precious time before I leave in a few short days! God is so very good!


A Labor of Love

The day started off with the ring on my alarm. I quickly got up and ready for the day. As I walked to the clinic, I wondered what the Lord had in store. I prayed that it would include welcoming a little baby into  the world.

I arrived and noticed that the clinic was very busy. There were numerous postpartum patients and one laboring mother. This was her 3rd baby in under 4 years. She was only 22! I received care of this young mother and noticed right away that she was exhausted. "Yan-yan" told me that she had not slept a moment all night. She labored very quietly and rarely spoke, however, when she did it was in perfect English.

I had evaluated her a few hours later and determined that she was progressing in her labor, though by conventional estimation she may still have a few hours of labor left. She desired to be alone, so I went to assist with other activities. About 40 minutes later, a midwife who was at the clinic for a baby postpartum check came and said that "Yan-yan" was looking for help.

As the supervising midwife and I entered the cubicle, I saw her bag of waters had broken and 3cm of thick black hair was visible. We moved into position and moments later welcomed a little girl with a healthy set of lungs. Jamara was born at 10:04am and weighed 3200g.


"Yan-yan" did hemorrhage, but with a little help, the bleeding quickly subsided and mother was stabilized. A few hours later, I helped the new family settle in the postpartum area. Little Jamara was quite adorable and her parents were so happy. After endorsing her care to the next shift, I left the clinic.

I had no sooner walked out the clinic door than  my cellphone alert noted that I had a text message. I guessed who it was and was correct. My continuity patient "Nene" (whose last baby I welcomed in 2013) was having regular contractions 20-30 minutes apart. I asked how she was and if she would be able to labor at home. She areed that would be best and would text me later with an update. This was her 3rd baby. I was pretty sure that I would be back at the clinic later.

I returned to the dorm and decided to shower and make dinner for my house. Some of the visiting girls would be leaving soon and had requested for me to make the meal I had cooked upon their arrival. I was happy to help and soon the meal was simmering on the stove. (A recipe the Hedgehog balls is here- do note the name is due to the spiny appearance, not to meat content ;) ).

After having some dinner, I went to rest. I knew that the night could be long. My phone had been plugged in and charging. I had the feeling I should check it again before I slept. For some strange reason, until I unplugged it, messages had not come through. Suddenly, I saw that "Nene" was at clinic and the guard was on his way. I quickly threw on the scrubs I had laid out, grabbed my backpack and raced down the stairs. Then I rushed back, grabbed my glasses and hurried back down. Once in the ambulance, I put my hair up and prepared myself for what I may find.

Once at the clinic, "Nene" was so excited to see me. We soon found that she was very actively in labor. I prayed with her and helped her breathe through the hard contractions. She smiled and hummed her own tune softly between contractions. I rubbed her back as she swayed back and forth, slowly working baby's head lower into the pelvis with each contraction.

A little while later, she was ready to push. Her breathing became grunts and the supervising midwife entered the cubicle along with other supporting midwives. After talking with "Nene" one midwife was chosen to photograph the birth. As I asked "Nene" if she would want this she very animatedly told me yes, that would be wonderful.

With the next contraction, her bag of waters burst. Try as I may, there was no escaping the huge gush of warm fluid. Despite "Nene" having the urge to push, we encouraged her to breathe. One of the midwives grabbed a clean scrub shirt and helped me change in the next cubicle so I could rapidly return to be with "Nene".

A few minutes later, baby slowly emerged. The cord was wrapped very tightly around baby's neck. After a little struggle, baby was somersaulted, untangled and placed on mother's abdomen. Baby was pale and floppy. One midwife suctioned baby, another provided oxygen. I explained to frantic "Nene" what was going on. Then baby cried and Momma cried.

A moment later I encouraged "Nene" to see if this was a boy or girl. After having 2 previous boys, she had hoped and prayed for a daughter. As the midwife lifted the baby, I watched "Nene's" priceless reaction. She was beyond thrilled! It was an amazing blessing! She finally had her baby girl! I was very honored when she shared with me baby's name- Mhelsie Sarah. My first Filipino namesake!

A few hours later after being stabilized from her hemorrhage and being sutured (it was a somewhat complicated tear) mother and baby were moved to postpartum. It was after 11pm. When paper work was finished and the new midwife informed, it was time for me to return to the dorm.

The guard brought me back in the ambulance. I unpacked my bag, showered, and prepared for bed. It had been over 20 hours since my head had touched my pillow. Sleep was welcome. Tired as I was, while I was dozing off, this thought kept coming to mind- "the miracle of birth is so beautiful! I love what I do! I am so blessed!"







Wednesday, July 16, 2014

He took my breath away

Birth- It is such a beautiful and amazing miracle! I know I say that often, but it is so true. Let me share with you the story of this little guy who I greeted this morning.

It had been 3 weeks and one day since I had personally been able to welcome a little one into the world. I had seen many transports and sent home many mothers who were early in labor during that time. Yet I had not been able to welcome a tiny baby and be one of the first to touch a little life.

I came on day shift wondering what the Lord had in store. I knew that whether it was busy or slow, it would be a good time. If it was to be slow, I figured I would read more of my "Heart and Hands" (by Elizabeth Davis). If it was busy--- I was ready!

Thus,  I was ready when I met the first woman who came into the birth room. She was here for help with labor stimulation. After receiving some help, encouragement, care and support, I prayed with her and she headed home. I decided to read some and wait for what would come next...

Around 9am a laboring mother came into the clinic. She did not appear to be actively in labor but this was her 5th baby. "Hazel" told me she felt it was time to come and she proceeded to smile while rubbing her contracting abdomen. I directed her to a bed and in no time check in was completed. Further examination showed that she was indeed 5cm dilated and that the contractions were coming every 4-5 minutes as opposed to the 10-15minute interval "Hazel" reported upon arrival.

I stayed close by "Hazel's" side as I knew her husband would return as soon as he could. Her bana was a taxi driver. He had to return the taxi after driving her to the clinic or else he would pay a fine for not using it for work. I encouraged him to hurry. Mother's expecting their 5th baby can be unpredictable at times.

About an hour later I noticed signs that "Hazel" was becoming more active in labor. Her contractions came more frequently and though she breathed well, the pain was much more intense. I alerted the supervising midwives.  We would continue to monitor and wait.

 A little after 10am  "Hazel" could hardly breathe through a contraction. The uncontrollable urge to push came. Though it was only one hour later, she was ready. I called and a midwife came into the cubicle. Her bana had not yet returned. "Hazel" asked me if it was time. I nodded to her and watched as she gathered her strength to focus on the task at hand.

Moments later there was a gush of warm amniotic fluid and baby's head slowly emerged. "Hazel" remained in complete control, cool, calm and collected. She breathed and focused on her precious baby. With another contraction and a slight push, her new son entered into the world.  A large flood of fluid followed him.

His birth was so simple, beautiful and uncomplicated. His mother so strong, magnificent and stunning. As I followed their care, I watched her tenderly hold her son. This may have been her 5th baby, but she treasured him like he was her first.

About an hour later father arrived. I led him to the cubicle and announced his presence. Tears came to his eyes as he saw his son for the first time. "Salamat, Salamat" (thank you, thank you) he kept repeating to me. I assured him that the thanks should go to the Lord. He leaned over and examined his precious baby. I slowly backed out of the cubicle to leave this new family alone.

Two hours later as "Hazel" transferred to the postpartum area one could hardly tell that she had just given birth. She and her bana were bantering back and forth in a beautiful expression of their love. He was sorry he missed his son's birth, but he would take pride in his duty and care for his wife. I cannot express how wonderful it was to watch this couple and their interactions. The love between them was visible. The extension of this love to their child was immense.

As "Hazel" got settled in postpartum, I held little "Onem". All 6 pounds, 6 ounces of him. As I gazed at his sweet face the feeling came that so often comes when one holds a precious newborn. As he opened his eyes, blinked and stared up at me I wondered what the Lord may have in store for this little life. Moments later he fell asleep in my arms. I looked down on his perfect little face and in that moment, he took my breath away....