Nursing - and another birth!

Feeding the baby girl I delivered

Badger babies - in the clothes Odilia bought for them

the one on the left is giving me quite the look...

having ice-cream with Odilia in the back of a pick-up on the way home from Tecpan

Hello, Wisconsin

cooking blue mushrooms

On Friday afternoon Santos was feeling really sick and having a hard time seeing, most likely due to hyperglycemia but we won’t know his blood sugar until Tuesday when the other student comes and brings the glucose test strips Odilia asked for. The other student is another nursing student from UW and I’m excited to spend a few days with her before leaving! I recognize her from class and we’ve been e-mailing about things here. Odilia bought two liters of saline solution from a pharmacy in Tecpan and started an IV in Santos’ hand. It amazes me how she can just buy whatever she wants from a pharmacy without showing her midwifery license – even vials of vitamins and analgesics to be injected. Anyone can buy antibiotics over the counter here. Anyways, I thought Odilia was an expert IV-inserter until she said “well, I think this is what to do, I’ve only ever observed.” She had IV starter and tubing supplies that Jenna (head of Midwives for Midwives) had brought from New York. We talked it out verbally, me coaching along using the knowledge from the few IVs I’ve seen started. She got it on the first try! I helped by getting the bubbles out of the tubing and removing the IV when it was done. He must have been really dehydrated – after two whole liters of saline he still didn’t have to pee!

After that we went to Rebecca’s house, a woman who is 39 weeks along and who lives up the hill from us. She went into the temascal with Odilia and was having intermittent pain – when I asked if she was having “contracciones” (contractions) she didn’t know what that meant! So I got to give some good old labor education. Yay nursing! I showed her the usual butt circles and dog/cat stretch on the bed to deal with the pain and loosen up her pelvis. Then I started reading “The Girl Who Kicked the Hornet’s Nest” that was in my room. I’ve been wanting to start it but didn’t know if I would get it since I haven’t read the first two books in the series. I’m glad I started it – it’s something to do while Odilia is chatting in Kaqchikel or in the temascal with out patients. Now I just have to finish the other 700 pages before I leave!

Odilia knew Rebecca’s birth would be that night, but we went home for dinner and to rest in the meantime. Alex, the son in his 5^th of 7 year in school to become a priest, came home to visit on break and brought a bunch of blue mushrooms – similar to the orange ones but I like the orange ones more!

I slept for about 30 minutes before one of the daughters woke me up at 10 pm to go back to Rebecca’s. Her husband and father-in-law were waiting in the living room to walk us there. When we got to her house for the second time that evening, Odilia checked her and she was still only one centimeter dilated – she was in false labor and not progressing, so after some talking we left again, this time to sleep a bit more. I slept midnight until 4 am when Odilia woke me up saying it was time. This time, the father and father-in-law were waiting to escort us, both named Roberto. Oh, and Rebecca’s husband is also named Roberto! We arrived for the third timem around 4:15 am after walking up this big hill again and her water had already broke a few minutes before we got there. Odilia checked her and she was a full ten centimeters – we had missed the whole progression! She was laying on the floor on blankets on top of a woven grass matt, which Odilia suggested be right next to the bed for easier moving of Rebecca post-birth.

She began pushing with her mother-in-law, grandma-in-law, and mother supporting her. I know her mom, Silvia, from prenatal controls with Leticia, Rebecca’s sister-in-law who is also pregnant. Silvia also has another pregnant daughter, Blanca, who we visited last week. How lucky, she’s going to have three new grandbabies within a few months of each other! Roberto (husband) was just sitting in a chair on the other side of the room not saying anything, which bothered me. Eventually he came over and supported her while sitting in a chair behind her head so she could squat. I could tell Rebecca was very nervous and had a hard time remembering the typical labor breathing – it’s her first baby and she’s 27, pretty late for a first baby in this culture.

I had asked Odilia between the first and second visits if I could catch the baby or if she was going to – she said if it’s fast I could catch it, but if it’s slow she would because it might be asphyxiated and the “minute of horror” would be especially important. When she had been pushing for over an hour, I knew I wasn’t going to be the one delivering the baby, but I was ok with that. I also didn’t provide as much labor support as I did with Maria Luisa because there were so many other people there for support, Rebecca was nervous, and Odilia was taking charge. I still got a front row sweat next to Odilia with gowns and gloves! When the baby’s head really started descending, I supported the perineum with some material dipped in warm water, as instructed by Odilia. The big 7 pound baby boy was born at 5:45 am with such a bad cone head after being in the canal for so long. He cried right away, but it took a while for Odilia to suction enough to make that distinct wet cry sound go away. After clamping and cutting the cord, she wrapped up the baby and put him on Rebecca’s chest – she was so happy! The placenta delivered easily – dang, no surprise twins this time. All three Robertos lifted Rebecca into the bed after Odilia changed her clothes and Odilia proceeded with the weighing, heart and lungs listening, umbilical cord cauterizing, and dressing of the new baby. Then a prayer was said and the baby was passed around to his dad, all four of his grandparents, and his great-grandma, who all said an additional prayer/thanks to God while holding him.

Maybe I’m biased from what I’ve seen in movies and have read in books, but none of the births have been how I expected. I alwys thought the mom would yell and scream and demand things like water and a cold washcloth for her forehead, but none of the moms have. And I thought the dads would be more active in the encouragement and support of their wives during the delivery of their babies, but all of them have been almost silent. The biggest thing I thought was that right after the birth there would be tears of joy and kissing of each other and the new baby between mom and dad – but there hasn’t been. The mother-in-law of the mom in labor has always helped way more than the husband and has always held the baby before him. Are these surprises just because I’ve only seen three births? Is it a cultural thing? Or did watching A Baby Story and other various things just skew my expectations of roles and emotions of people involved in birth? I’m not too sure.

The baby was placed on Rebecca’s breast to start nursing while Odilia and I washed our hands before having the coffee and bread the family set out for breakfast. The sun was up and I was happy I had witnessed another birth – I came to Guatemala wanting to see at least three, and this was my third! As I sipped my fake coffee (that actually wasn’t unbearable) and nibbled the pan dulce, I thought about how much I love the “calm after the storm” – just an hour earlier Rebecca was in extreme pain, sweating, and choking down cans of tomato juice her mother-in-law was giving her, trying ot push with all of the little energy she had left. Now, her new baby was sleeping by her side, she was all cleaned up, and her mom and mother-in-law were building a fire to burn the placenta (it’s custom here).

New baby!

Walking home from Rebecca's on a beautiful morning, satisfied after seeing another birth :)

After a more official breakfast Odilia and I left the house with Santos. We made a quick stop at Petronila’s house to give her a shot of an anti-inflammatory for her still large uterus. The baby is now 2 weeks old and is getting big! I held him for a few minutes and they told me they finally picked a name – Wilson Fabian.

Then we went to Maria Luisa’s house to do the final temascal and ceremony for the twins. I was so tired from only sleeping a few hours before the birth but stayed positive. I stripped the bed they’ve been living in after moving the babies and Maria Luisa to the bed she had given birth in, then swept the floor. I put the pine needles all over the bed and floor, then helped Odilia pull flower petals off a bouquet to line the bed. The twins didn’t go into the temascal because they have colds, but I got to go in with Odilia and Maria Luisa! Odilia taught me how to do the massage she does with all off her patients and I tried my best to do part of it, then laid with my head by the doorway to watch Odilia finish the massage and tuck two corn cobs into a thick cloth belt over Maria Luisa’s uterus to support it and help it shrink back to normal size. How lucky that Maria Luisa let me come in to observe! I did my first ever prenatal control with her, delivered my first baby with her, and now had my first patient temascal with her. Afterwards we had lunch with the family in the room – a beef stew with rice and tamales and they even had Coca Cola Light, awesome.

Ceremony

Odilia's oldest daughter, Estella, came over to see the twins and give them a gift

Me and Maria Luisa with her babies

After resting a bit at home we went to Rebecca’s house for the fourth time in 24 hours – the babe and mom went into the temascal to get all cleaned up and I took some pictures. Everyone was so exhausted from the birth earlier that morning, including us.

Today we went to Tecpan and I went to an internet café to upload some pictures while Odilia went to mass. Today is corpus Christi so there were colored saw dust “alfombras” and flowered arches all over, along with a procession throughout the streets of Tecpan. It reminded me of Semana Santa in Ayacucho, Peru. Not much going on today at the house but I’m happy because we have a busy week ahead of us! I can’t believe I only have a week left… I’m hoping for just one more birth before I head home J

Rebecca's baby boy, the fourth baby and third birth I've seen

Me and the baby's grandmas :)