First Day of "Work"

I woke up very early today to go to five prenatal visits with Odilia. So exciting! It amazed me how the whole family was already up and dressed and ready for school by the time I dragged myself out of bed at 6:15 am. Santos (Odilia’s husband) drove us around in their pick-up truck to each visit – Odilia knows how to drive but has problems with her tailbone so she can’t comfortably sit and shift gears at the same time. Too bad I don’t know how to drive a manual car or else I could drive! J

The first woman we visited was a woman named Maria Luisa (no HIPPA in Guatemala so I’m allowed to give names!) I gave my first physical prenatal exam to her all by myself and Odilia told me I passed! She wanted to take a picture of me doing it but I didn’t bring my camera today. This is how a prenatal exam goes:

1. First, look up the client’s name in Odilia’s little notebook

2. Use the calendar wheel to put in the woman’s FUR (fecha de ultima regla/date of last period) and find out how many weeks along she is, as well as the FPP (fecha de parto probable/date of probable delivery) and write these dates down

3. Measure the A/U (altura de útero/uterine height) using the tape measure – from the pubic bone to the top of the uterus

4. Palpate the abdomen to figure out the position of the baby – all of the babies today were already cefalico (cephalic position/head down)

5. Use the Doppler to find and document the baby’s heart rate – on the baby’s back if you can tell where it is by feeling around

6. Take the woman’s P/A (presión arterial/blood pressure) and record it

Then, Odilia takes the woman into her temascal (the sauna/bath thing) for a prenatal massage and I wait patiently and write in my journal. I’m hoping sometime this week I can go into the temascal, too, we will see!

After the first visit, Santos, Odilia, and I had breakfast at a cute restaurant called Café Rancho. The owner was really nice and didn’t charge us for breakfast! Odilia told me he likes it when she brings students there – I guess the free breakfast was a “Welcome to Guatemala” gift (but I’d like to think it was a birthday present, too!)

Next we went to the 2^nd woman’s house, Flori, who is due in mid-July. I did her check-up as well! We chatted there for a long time with Flori and her friend Josefina. A lot of the time Odilia and the patients start speaking in the native Mayan language here which I can’t understand, but I try to pick up bits and pieces that sound a little like Spanish. (PS – my Spanish is way better than I thought it would be! I think I picked up right where I left in Peru. I am improving quickly since there is virtually nobody here that speaks English.)

Estella, the third woman we visited, was only 14 weeks along. She has had two spontaneous abortions so she is considered “high risk” and because of this she went to a doctor in town to have an ultrasound. Odilia read the report from the doctor and it said she had a partial placenta previa – which means the placenta is partially covering the cervix, blocking the head and causing bleeding. I was excited at first because I actually knew what a placenta previa was from class, but very sad because it also means she must have a cesarean section. She was not happy at all to hear that – hospital births are something women don’t like here, and cesarean sections especially. Also, it will be expensive for her and judging by her “bathroom,” she doesn’t have a lot of money. (It was a raised hole in the ground surrounded by totally see-through wood slats and a make-shift piece of tarp blowing in the wind for a door THANK GOD FOR HAND SANITIZER). I really liked Estella – she kept joking with me that she wanted me to give my eyes to her baby so her baby could have blue eyes.

The fourth woman we visited was Petrolia, who is 38 weeks along and due on May 30^th! Her visit was very short – I measured her and took the vitals and we left without Odilia going into the temascal with her. She seemed a little hesitant of me which makes me nervous because she will probably be the first birth I see! Hopefully she will let me observe and help.

The fifth woman, Dilma, is only 6 months older than me! She is pregnant with her first and thinks it will be a girl, yet she doesn’t know for sure. I chatted with her for a while and did the prenatal check-up while Odilia tended the fire in the temascal. She is due on the 24^th of June but Odilia thinks she might go a little early – a whole week I hope so I can see (if the baby is ready, of course)! I finally measured the uterine height correctly with her, which I am very proud of.

Odilia sees her patients every 15 days before 35 weeks gestation and every 8 days after 35 weeks. Each prenatal visit costs 25 quetzales – which is around $3.30 USD. Very hard to believe! Most women we visit are very poor and don’t have a lot of money – but they always offer us something to drink and/or eat. At the first place I had a Sprite, the second apple juice and cookies, the third Pepsi and cookies, nothing at the fourth (it was a quick one), and orange juice at the last one! I didn’t eat one of the cookie packs and the orange juice because I was getting too full of sweets. It is rude to not take it, so I just put them in my bag and saved them for the kids to have when I got home.

The other day Odilia said something that intrigued me – she said (in Spanish, of course) that all over the world there are different foods, different music, different customs, different jobs, different clothing, and different people, but everyone living in the world came into it the same way. Birth is truly the only constant!