Everyone loved Mallory the Midwife’s first guest post, so I asked her if she’d write again. Not only did she comply, she also signed up to be on Team NiceGirlNotes during the Color Me Rad 5k, and is bringing her fiance along! You can run along with us. (Well, you can run along with them, or huff and puff along with me. The choice is yours, babycakes.)
I really like this post. Made me sniff sniff a little bit.
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A few years ago, I took a trip to the Dominican Republic as part of a volunteer program. With four other healthcare professionals, I spent 10 days working in a hospital in the small city of San Francisco de Marquois. The hospital had two sections: one side for the rich and one for the poor. We never stepped foot in the rich side. All we were told was that the circumstances were better. We worked in the maternity ward, which consisted of a few rooms, each with metal cots, without sheets. You were given one sheet upon arrival and that was all you got, unless you brought your own. If you broke your water, you lay in a wet sheet. There was a room for postpartum women, though they didn’t stay long- not more than a night. A room for teenagers. A room for laboring women. And if you made enough noise (your stage of labor didn’t matter, just how loud you were), they moved you into the “active” labor room, another room with cots and a delivery table. The birth certificate office was down the hall from the maternity ward. You could also get your daughter’s ears pierced at that office.
delivery table... no sheets, just a cloth that hangs into a trashcan
This part of the hospital had no running water, but it did have electricity. And in the active labor room, there was air conditioning! This is where you could find most of the residents, who - in general – ignored patients. There seemed to be no one supervising them. The nurses did all the work (including delivering the babies). On my first day I was with a woman who was having her ninth child. She had been told to push and was trying hard, though it seemed to be taking some time. For a 9th time around, the baby should practically slide out. I quickly did an exam and found she was only 7cm (despite having been told to push). A little midwife magic and I massaged her cervix to almost fully. She pushed out the baby moments later just as the electricity went out.
delivered her ninth baby in the dark
She delivered on the cot, because the delivery table was in use. Women are usually put on that table because it’s cleaner- one cloth under her bottom that draped into a trashcan, so all the mess is easily taken care of. In a way, it’s very smart for a hospital with no running water. On another day, I was with a teenager who had her baby on that table at 34 weeks. The infant was placed in her arms, and I brought the baby to the “NICU” – a room with three incubators. 34 weeks is about as early as could survive there (for comparison, in the US some babies can live as early as 23-24 weeks).
I spent another day with a woman named Maria. She had been laboring all day with little progress. I spent all day, rocking her hips, giving counter-pressure, making soft comforting noises in a language I barely spoke. I used all the midwifery ticks I had to help her labor progress. In our world, I would have given her a little pitocin and she could have progressed normally. But pitocin is scarce here, and few get it, so at the end of the day, the physician who was overseeing that day opted for a c-section. Because even if he decided to give her some of the scarce pitocin, he would have to be there longer, and with a c-section, he could be home in an hour.
I went with Maria for her surgery. They asked me to put on their scrubs for the operating room, which would seem reasonable. I was dressed in scrubs from my own hospital and when I entered their scrub room and picked out a pair, I found ants everywhere! In some ways it didn’t surprise me. In all the patients’ rooms you could usually find a line of ants snaking up the wall somewhere, but I guess I thought the OR environment would be different. The c-sections there were very fast. The quicker they were, the less potential for bleeding. They were done in half the time as the ones I had seen in my hospital. At one point they even lost electricity briefly, but they continued on by the light coming through a window.
The program I went with had done a lot fundraising, in an effort to bring a bathroom with running water to the maternity floor. They negotiated with the hospital, that if they built one, the hospital would provide running water. The project was completed when I was there and the bathroom was stunning! Nicer than mine. But still no running water, so it was essentially useless. Funds had run out.
The hospital provided food, but nothing to drink. Patients sometimes got IVs, but if they were thirsty, they had to rely on their family. Families could visit two times a day and that’s when patients got their drinks for the day.
As a treat I had brought a Polaroid camera to the hospital. I had come prepared, though it had been hard to find the supplies. My sister had the camera, but very few places had film (and it was expensive). But I brought what I could and took photos of mothers with their babies to give to them – possibly the only photo they’ll have of their child. My two packs of film ran out pretty quickly.
Ultimately our goal was to help educate nursing staff and develop a doula (labor support person) program. Mostly, I felt I made a small difference in the experiences of a few local women. Regardless of resources, the basic needs of women everywhere are the same. A little labor support goes a long way and women value this immensely. After hours and hours of labor followed by a c-section, Maria delivered a beautiful baby girl. She and her husband had a boy’s name pick out, but were at a loss for a girl’s name, so they gave my one of the coolest gift I’ve ever received – they named their baby “Mallory.”
Maria + her husband, Mallory and Baby Mallory
