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....



Monday, July 14, 2014

Eye of the tiger

I had written a whole long post about life and its busyness. Then my browser crashed and I lost it all! Suffice it to say I have been wicked busy! My life is full with time in the clinic and studying for my NARM exam in August.

It is hard to believe that my time here is quickly coming to an end. In 22 short days I will be heading home. So many mixed emotions. I leave that discussion for another post another day.

In the midst of final preparations and studying I still find time to spend time with friends! I have also been able to spend some more time with art work. Here is my most recent piece...


Tigers- such amazing animals! This was done for a friend of mine. The eye of the tiger is a well known metaphor. You get knocked down, but you get back up. You focus, you stay committed. Your eye is set upon the prize... wait- kind of reminds me of a passage in Scripture. 

Philippians 3:13-14  " Brethren, I count not myself to have apprehended: but this one thing I do, forgetting those things which are behind, and reaching forth unto those things which are before, I press toward the mark for the prize of the high calling of God in Christ Jesus."

and this one...

Proverbs 24:16 "For a just man falleth seven times, and riseth up again:..."

Just thought I would share this thought with you. No, life is not easy. It is not easy to be a missionary away from friends and family. It is not easy to look toward the next step of transition. There is much to do... it can be overwhelming... There are many things in life that can pull one down and throw off ones focus. But it is important to get back up and press onward for the glory of God! Focus on the Lord! Stay Strong in Him! Set your eye on the prize- like the eyes of the tiger!
 

Well, I should get back to studying! I did just want to let you all know that I am still here and doing well! Just been super busy as of late! I will try to not wait so long between this and my next post! God bless!

Wednesday, June 25, 2014

When Life gives you Ants...

Ants.... those tiny creatures that are hard workers.... the ones mentioned in Proverbs?...yes, those little guys.... lets put them in the spot light for a bit...

Just so you know, they are EVERYWHERE here in the Philippines!
Now, before you jump to conclusions PLEASE do not get me wrong... I am NOT complaining. I have learned a LOT from them!

Here are a few of those lessons...

#1. I have learned that they are a part of everyday life here.
#2. I have learned to wipe the counters, tables, and stove multiple times a day, even when they appear clean.
#3. I have learned to check my towel before I use it as one of their favorite trails runs near the towel rack in our bathroom.
#4. I have learned what an ant bite feels like and to be alert to anything that feels like an ant crawling on my skin.
#5. I have learned that even when you clean the entire kitchen and spray existing ant trails with baygon (bug killer spray) they ants will still return within a few hours.
#6. I have learned that ants generally float.
#7. I have learned that ants can get into any place and always show up uninvited.
#8. I have learned that ants love any kind of food they can get to.
#9. I have learned that ants can chew through anything.
#10. I have learned that ants taste good. (or at least don't taste like much and flavor is easily masked)

Yes, you read that correctly. I have eaten ants on more than one occasion since living here. Maybe it is partially due to the fact that it is easier to eat them at times than to spend forever picking them out of rice (or any other food). Maybe it is because I have just decided a little extra protein won't hurt me. Or maybe it just makes for a great blog post. Either way, they are hardly noticeable most times...

The other night we decided it was time for a treat. Our dorm had been saving a bag of hint of lime tortilla chips for just the right time. I found a can of re-fried beans & jalapenos on the shelf and there was some salsa in the fridge. Time for a delicious treat!

We opened the bag and soon discovered our lovely friends had made it there first.The clever creatures had chewed tiny holes all throughout the bag!


Not sure if you can see, but there are numerous little ants all over that chip...that isn't just lime seasoning ;)  But did it stop us? Absolutely not! Who would let a few ants ruin our special meal? Definitely not us!


When life gives you ants just add beans, salsa and lime!


One girl mentioned they were still crawling around. I quickly determined that by placing the beans and salsa on top of them you could pretend as if they were not even there! It is hard for an ant to crawl with beans and salsa on top of him!


Lami Kaayo! (very delicious!) Would I do it again- absolutely! What wonderful memories!

Monday, June 23, 2014

17, Young and Excited

She was 17, young, and excited as she entered the clinic. “Cring-cring” was expecting her first baby. She had named her little girl Trixie (suspected per ultrasound). I asked her about her labor and discovered that her bag of waters broke at 2am and contractions started around 3. A quick glance at the clock showed that it was just after 6 now. 

“Cring-cring's” contractions were not very intense but evaluation of her progress showed that she was in fact in labor. The supervising midwife told me that if her contractions progressed, she would be able to stay at the clinic. I advised “Cring-cring” various exercises to stimulate her labor and brought her some water. 

Moments later the supervisor came to tell “Cring-cring” that her mother was on the phone. I looked up in confusion. Normally the parents would be waiting outside or on their way. Ate told me that her bantay (companion) was actually her nanny and that her parents would come later in the afternoon. "Cring-cring" was a single mother and living with her parents. There was no boyfriend or father of the baby in the picture. “Cring-cring” finished on the phone and told me that all was well. With a smile on her face she set off to walk around and exercise with high hopes for bringing on more contractions. For a young and first time mother in her situation, her confidence and smile was surprising and refreshing!

“Cring-cring” labored beautifully! Her focus, determination and strength was amazing! Around 9am she ran in with intensity and informed me that she wanted to push right now. Seeing that her contractions had just started to become painful, I encouraged deep breathing and massage to help her cope. The various techniques appeared to work and “Cring-cring” gained her composure after each contraction. 

Around 10:15am, I could tell that “Cring-cring” appeared close to giving birth. I spoke with the Ate and after a few minutes it was determined that she was indeed ready to push. She tried a variety of positions. It was neat to see how connected this young girl was with her baby. I grabbed a mirror and she immediately locked her focus on her baby and progressed. However, despite various positions, baby's head would not descend past the pubic bone. Finally after many positional changes and 46 minutes, at 11:19am baby entered the world!

Baby was placed skin-to skin with mother and I suggested she look at her baby. A midwife gently lifted baby and “Cring-cring's” eyes widened. We all laughed as I stated “Nope, definitely not a little Trixie!” (I had seen he was NOT a girl as soon as he was born and enjoyed the look of welcome surprise).

Matteo James was a small little guy weighing in at only 2300g or 5 pounds 1 ounce. I enjoyed spending time talking with “Cring-cring” and her newborn son. They recovered well and no problems arose. Her parents were on the phone shortly after rejoicing in the news. 

I was blessed again today to visit with "Cring-cring" and Matteo. They are continuing to do very well. According to her dates, baby may have been slightly early (36 weeks). Regardless, he continues to do well and "Cring-cring" is showering him with love. I am excited to see how this young girl is blooming into a mother. Yes, life's circumstances may be sad, but when life hands you lemons- make lemonade!



Tuesday, June 17, 2014

Breathe... 2.... 3....

Breathe...2...3... Breathe...2....3....

The words repeated in my head as I heard the heart tones drop to 90, 80, 70. Part of NRP training the algorithm for PPV flooded into my mind and I prayed it would not be needed. I had long before taught myself to review the routine before each birth and again if heart tones dropped. I said the words again in my mind.

Breathe...2...3... Breathe...2....3....

I stood by the bedside as the baby's head emerged in the caul. The midwife quickly removed the membranes and wiped thick mud-like meconium from the blue baby's face. Her body was limp and I helped her lift the baby to the mother's chest.

Time seemed to slow. I helped clean the baby and avoided stimulating her as the supervising midwife suctioned her airway. Thick meconium secretions were removed as baby slightly opened her eyes. Then they closed. Her midwife called out a heart rate of 90 and dropping. The cord was clamped and  cut.
I lifted the limp, blue baby onto the resuscitation board and turned for the mother to see her baby briefly as I reached with my other hand for the bag and mask being handed to me. I started PPV.

Breathe...2...3... Breathe...2....3....

I said it aloud as I ran to the ambulance with two experienced midwives.

Breathe...2...3... Breathe...2....3....

I continued to provide PPV as one midwife found the heart rate to be 60 and started chest compressions. My rhythm changed to match the "1 and 2 and 3 and breathe and" pattern. "Lord help us!" we prayed aloud! Thankfully baby's heart rate quickly rose again and I reverted to the pattern I had before...

Breathe...2...3... Breathe...2....3....

we were almost at the hospital now... I continued...

Breathe...2...3... Breathe...2....3....

she gasped once then stopped.... "Come on Baby... just breathe!" I cried as I continued...

Breathe...2...3... Breathe...2....3....

I continued as I jumped from the ambulance and rushed inside with the midwives. We ran through the ER to where the doctor immediately accepted us. The nurses and staff took over and SALAMAT SA GINOO! (Thank the Lord!) the baby finally gave another gasp and a weak cry. After ensuring the doctor had been fully informed, we left and returned to the clinic.

The words continue even now to ring through my head. Breathe...2...3... Breathe...2....3.... I am thankful for the training the Lord has provided. I am thankful for His faithfulness and goodness to us. I am thankful that even when the most horrible things happen, I can look to Him for strength as I know He is in control. I have since only heard that baby is breathing on her own. Please pray for precious little Abby (named for her midwife) and her sweet parents (They have been reunited at the hospital). Pray that the doctors will have wisdom and be able to provide appropriate care for her.

 I will update when I hear more!

*Update 6-18-14: I just found out that baby Abby passed away this evening around 5:30pm. Please keep her family and midwife in your prayers. Thank you!


Monday, June 16, 2014

Opening Eyes

The familiar sound of my alarm went off. I slowly opened my eyes, looked at my phone, knowing it was much to early for my alarm, and realized it was a call from the clinic. As I answered with a sleepy hello, the midwife on the other end gently explained that "Divina" was at the clinic and actively in labor. She offered to send the guard in 5 minutes in order for me to get ready. I thanked her and quickly climbed down from my bunk bed.

I had just enough time to put on scrubs, grab my backpack, and fill my water bottle by the time the guard arrived. On the short ride to the clinic, the guard explained that "Divina's" bana had left to go home and get some things without asking. Thus, she was without a bantay (watcher/companion) at this time. I tried to force my mind to wake up as we pulled up to the clinic and I jumped out.

As I entered the clinic, I saw "Divina" on her hands and knees near the post partum area. She was having a contraction and looked up at me pitifully. She whimpered "Help me". I quickly rushed to her side and helped her breathe through the contraction and then supported her to the birth room.

"Divina" was a sweet girl. This was going to be her third baby. However, she had lost her first baby 2 days after his birth due to prematurity. Her 2nd baby, a girl, was healthy and strong. During prenatal care, "Divina" had appeared to be scared about this baby and birth. I quickly tried to reassure her that all was normal to this point and we would do all we could to help.

As she reached the bed, I could see another contraction come over her. I encouraged her to breathe as  fetal heart tones and vital signs were monitored. She had only been 2-3 cm an hour before. As the next contraction came, so did a gush of fluid and tufts of baby's black hair were visible.

8 minutes later at 3:58am little "James Aldritch" entered the world. I was so thankful to be able to see this mother grasp her new son and welcome him with tear filled eyes. It was less than 30 minutes from the time I first opened my eyes until I watched this little baby open his eyes for the very first time. An hour later as the sun peeped through the clinic windows, I knew I had a long day ahead, yet I also knew there was no better way to start the day then to welcome a new life into this world.



Friday, June 13, 2014

A WILD Ride!

Sirens approached. We heard them outside the clinic, and then we heard shouting. I pulled on gloves and ran outside with a birth tray in my hands- ready for anything (I thought) "A midwife" "Help" "Baby at home" "Veloso St" were the broken phrases I heard. The next thing I knew I was ushered into a 911 Police truck by two officers and we were off. My mind quickly pieced together what had happened. I had no clue what adventure lay waiting ahead!

The sirens wailed as we drove along. It was a quick ride, but seemed to take forever. The Philippine sun was hot as it beat down. The wind whipped my hair in my face as we flew down the street. I tucked it back, not wanting it in the way. As we screeched to a halt three gloved midwives jumped from the back of the 911 Police Truck- one carrying a tray with birth supplies, another with prepared injections of an oxytocic drug (for hemorrhage prevention/treatment) and another with other supplies. The midwives hurried to follow the police into the little home.

I entered the dimly lit house and saw a woman laying still on a bamboo bed. Between her legs lay a blue baby boy. His cord wrapped once around his head, once around his arm and a third time around one leg. I avoided a puddle of fluid on the floor, which I presumed to be amniotic fluid, and quickly moved in closer. The first midwife set down the tray, grabbed the baby, unwrapped his cord, and started stimulation. The head midwife assessed blood loss and the third injected the mother with pitocin.

"Baby's first Apgar score is 7" spoke the first midwife as she clamped and cut the cord. "Current estimation of 50cc blood loss" assessed the head midwife. The third helped hand necessary supplies and find a plastic bag for the blood. There was lots of commotion as little children milled about crying and scared. Some had eyes wide open in wonder. The police waited at the door and the father moved back and forth as if unsure what to do.

The first midwife continued to stimulate the baby who had a weak cry while the other midwives tried to talk with the police and father about bringing mom and baby to the clinic. Suddenly the first midwife noted that the mother had started to bleed again! She called out to the head midwife that the mother was bleeding and jumped in to rapidly deliver the placenta. She sat at the end of the bed and used a method called continuous cord traction (CCT) while supporting the uterus. The placenta followed with a gush of blood and the head midwife gave a second injection. "300cc estimated blood loss" said the first midwife to the head midwife who was firmly massaging the mother's soft uterus. It rapidly firmed and the third helped wrap the baby in a clean blanket as the other midwives examined the placenta to ensure it was complete.

No stretcher was available. The mother would need to be carried to the truck. The head midwife covered the mother with a towel as the first midwife grabbed the mother's head and shoulders while a policeman grabbed her legs. Together they hoisted her out and into the truck where she lay across their laps- the floor was much to hot from the sun. The head midwife grabbed the supplies and the third midwife held the baby. Sirens were again on and we sped off.

Once at the clinic, everyone again jumped into action. The guards rushed out with a stretcher, the first midwife followed her in and helped to stabilize her. The head midwife reported to the supervising midwife and the third rushed the baby to get some oxygen as he was still blueish from his shocking birth. He recovered quickly and was returned to be placed in his mother's waiting arms.

The midwife who helped to stabilize the mother continued to care for the mother and her little son. She learned this was the 41 year old woman's 8th baby and her 3rd boy. The mother had no prenatal care anywhere. She knew of the clinic and once she realized a taxi would not arrive in time for her to go to the hospital, she told her bana to call for help. The 60 year old man hurried out the door and yelled to the police who happened to be at a small eatery a few houses down. They rushed in as the baby's head was birthing and the mother told them to get a midwife. The poor policemen rushed to summon us- and the rest has been told.

One never knows what each day will bring! I am thankful that I was able to help welcome this little guy into the world- even if I did only witness the birth of his placenta rather than him as well! Happy birthday Baby Jerome! Born at approximately 12:25pm June 12, 2014 weighing 3600g (7lbs 15oz)!



Monday, June 9, 2014

A Taste of Home

Some days you really need a taste of home. Something familiar. Something comforting. Let me share with you the story of a recent blessing! This is the story of a bowl of a blessing!

The other week I strolled down the aisles of the grocery with my dear friend Melissa. Those who know me very well know my LOVE for shopping. (Though I must admit, it can be fun if you are with the right people) Anyway, as we wandered the aisles filling our cart, my eyes landed on a lone can on a discount shelf. One little can, but the label jumped at me and stood out among the many other bigger and brightly colored objects.
I gasped with recognition and said aloud “I know where that is!”

Yes folks- Real Maine New England Clam Chowd-ah some how made it all the way here to Davao City- THE PHILIPPINES! Just for me! I was so very excited! I could imagine how delicious it would taste! Then I stopped. This was (obviously) imported and may be expensive. However, a quick check showed the Lord had me on His mind. After seeing that it was in my price range, I readily added it to the cart. I smiled knowing that a delicious treat would be in my near (ish) future. We finished up shopping and returned to the dorm. I placed it on my shelf and there it sat...

Today was a good but long day. After spending my day at the clinic and studying, I returned to the dorm hungry and worn out. Tonight was “fend for yourself” dinner night. I placed my back pack on my desk and looked up to the lone can on my shelf. I smiled- CHOWD-AH! I had a delicious dinner ahead! A few minutes later the sweet aroma of clam chowder wafted to my nose as I stirred the pot on the stove and ladled some into my bowl. YUM!

It was wonderful! Definitely not like homemade or fresh chowd-ah, but it was a taste of home! I felt so blessed as I enjoyed the flavor! God is so good to me! He sent that little can all the way to the Philippines just so I could have a taste of home! I am wicked blessed! Ayuh!

Sunday, June 8, 2014

Fashion Show

I had the opportunity the other night to attend the fashion show of the year! What a fun opportunity! Hope you enjoy the photos (below)! I also was thankful to spend some time hanging out with these great kiddos! We had a lot of fun!











I am wicked thankful for the friends the Lord has given me in my “home-away-from-home”. I am so blessed!

WhenTime Stands Still

I met “Sha-sha” at the beginning of my shift. She was happily expecting her 3rd child- which they believed to be a little girl. “Sha-sha” was very responsive to help and readily tried a number of suggested positions which greatly helped her cope through the strong and regular contractions. Though she was only 5 cm at 6am, labor was strong. However, she was stronger. “Sha-sha” focused well. She breathed through each contraction and pressed into her bana for support.

I should note here that her bana was also amazing. He brought her food, milo (a chocolate type drink), and water. He breathed with her, whispered to her softly, and gently massaged her back. When her hands and feet started to cramp, he massaged them and talked quietly with her. He was so kind and gently yet a strong support for her! I wish I saw this more often!

Around 8am, intensity increased. “Sha-sha” had a more difficult time breathing, but still could. When I asked how she was doing, at this point she told me “Not so good now Ma'am”. Further evaluation showed she was doing wonderfully! She just needed a little encouragement and she and her bana labored on.

9 am came and I could see that “Sha-sha” wanted to bear down with each contraction. I tried to help her breathe or blow through each contraction, but it was not effective. I suggested a hands and knees position. It helped for about 15 minutes, but with each contraction it became more and more difficult for “Sha-sha” to not push with force. A short time later I discovered that she had almost reached full dilation. With the next contraction or two she was fully dilated and the baby's head descended into view.

I alerted the supervising midwife and she quickly appeared. Ate picked up the chart as Emi assisted me. As the baby's head began to emerge, I saw that Violet had entered the cubicle for backup. I was glad. My instincts told me something was not quite right. The head slowly became more visible with a contraction then disappeared without one. This repeated itself with the next contraction. My alert sense heightened. I turned to Emi and told her this was called the Turtle sign and could indicate a nuchal cord or impending dystocia. As she checked the baby's heart tones, they came loud and clear. I prepared myself for what I expected to come and as I looked up I saw Violet thought the same thing. She had called for Brittany to be on “stand by”. 

Violet moved closer as the baby's head emerge from the perineum. Ever so slowly it came out and retreated. Finally the head was born. A nuchal cord was immediately ruled out. The anterior shoulder was not coming as it should. Immediate action was needed. Time stood still as the team sprang into action. The next moments happened quickly, yet felt as if time had stopped.

The anterior shoulder was not coming so Violet and Brittany performed McRobert's maneuver (straightening and then hyperflexing the legs. This movement rocks the pelvis and often is enough to dislodge a “stuck” shoulder). It did not help. We called for the “edge of the bed” as I saw the baby's face turn a deep purple. I knew we had to act quickly. If this baby did not come quickly, brain damage or death were real possibilities.

While still inside searching for the shoulder, we grabbed “Sha-sha” and turned her to the edge of the bed. With the sacrum off the bed in this position, it can help to open the pelvis and give baby more room. Still no shoulder. McRoberts was swiftly repeated. Nothing. We tried it a second time. As Brittany and Violet moved her legs into hyperflex, there was movement. My heart lept for joy! The shoulder was coming!!!

Seconds later, baby Jasmine's body followed and we all praised the Lord! Time seemed to resume at a normal pace. As I looked up, I saw the bana standing in the corner sobbing. My heart went out to him! He was terrified. “Sha-sha” was thankful to hold her precious daughter and slowly, her bana moved in for a closer look. We gave Jasmine a little oxygen to help her “pink up”. She was born at 9:57am and her APGAR scores were 7 and 9. 

A little while later (after things were cleaned up some and both mother and baby were stable), I sat down with “Sha-sha” and her bana while I explained what had happened. I told them how the baby's shoulder had become stuck behind the pubic bone and how each of the positions helped baby to be born. They both understood. My mind wonders what the alternative outcome would have been if no trained attendant was present.

I am always surprised how time seems to slow when you are in the midst of an intense birth like this one. The should dystocia “only” lasted 1 minute and 20 seconds, yet it seemed like time stood still. I am thankful that the Lord allows this to happen at times. The Lord helped everyone remain calm, controlled and focused. Some say that with a shoulder dystocia one has 3-5 minutes before brain damage occurs. I am thankful the Lord helped the baby come quickly!

Despite the “difficulty”, it was an amazingly beautiful birth. I loved the experience of teamwork in the midst of a complicated birth. I loved watching the parents interaction before and after. I saw once again the true beauty of midwifery! I also have an even greater appreciation for the training I have received. God is so very good!



Proud Parents who are thankful for their 7lb. 3oz Miracle

The Amazing Team! From Left to Right: Ate Ermie, Sarah, Violet, Emi, Brittany, and Rio


I am wicked blessed! **All photos and names used with permission!

Friday, May 23, 2014

A month and a day

A month and a day may quickly pass by, yet at other times it drags slowly onward.

I arrived to shift with many hopes and prayers that I would be privileged to welcome a sweet baby into the world. It had been over a month now! However, I knew that God's timing would be perfect and I had better be patient.

Endorsements revealed that there was a 3rd time mother in labor. "Bing" had a history of precipitous labors, yet this one appeared to be going a little slower. Her labor had started at 5am when her bag of waters ruptured. At 8:30am she was 1cm. The midwives encouraged various methods to help get her labor going. Around 1pm she was 3cm dilated. Some progress... we would monitor her closely for any signs of infection and see what would happen.

I labored with her for a little while awaiting time for the next exam to evaluate progress. At 4pm she was 6cm. However, all signs pointed to progress. Her contractions were now strong, steadily 2-3 minutes apart and lasting about 60 seconds. I again prayed with her and the supervising midwife decided to delay transporting a little longer in hopes she would deliver. (It was almost 12 hours after ROM which can increase risk of infection and would generally indicate transport per protocol here).

A recently arrived intern was shadowing me. I explained that we should prepare the birth cart and cubicle as she was a multipara and had a history of fast labors. I told her that we did not know when baby would come, but we should prepare anyway. As I pulled the cart into the cubicle, "Bing" told me she wanted to push. At first logic questioned, but past experience led me to believe her as I looked at her and observed various "clues". I had her prepare as I alerted the supervising midwife and moments later, black hair slowly emerged. A few short, beautiful minutes later a sweet baby boy was born. 4:29pm.

I was filled with thankfulness! Not only had I been blessed to be a part of a breathtaking birth, but the Lord had answered my many prayers! He is ever faithful!

After moving "Bing" and baby "Andrie" to postpartum, I finished up paperwork and decided to later take pictures. When I went over again, "Bing's" 2 year old daughter was there. We had a fun time playing together. I loved to hear her little laugh and see her smile. Such an adorable girl! God had greatly blessed my evening!

A month and a day... it may seem like forever at times, but as I am constantly learning, the Lord's timing is perfect. It is always worth the wait!