reentry

I am home. I arrived almost two weeks ago, and finally feel totally in this time zone. 

 

It takes me a while to find my feet again after travel,  to readjust to time zones. 

I have been hanging out with my family, seeing friends, and catching up with my clients. I have had two conversations with midwives planning trips to Bali to volunteer at the clinic. 

I have attended two births of fabulous women, strong, beautiful, fierce women. 

Next week I have a root canal scheduled, and I hope to get to work in my garden. It is an overgrown mess. 

So am I a changed woman?

Have my views on life or birth changed?

Will my practices change?

I don't know.

I am still a bit numb from the experience, still processing all I saw and did. I do know that I would like to  delay clamping and cutting the cord more often than I did before I left.

I do know that I have more faith that even slow slope second stages resolve well, if mom and baby are fine. 

I know that I am privileged, and that our flawed frustrating medical system is pretty damn good. 

I will know more later after I sit in a few more births, and hang out with my family some more. 

treesa 

Home again

Hi 

I am home again, but before I write about re-entering my life I want to tell you all about the last couple of days in Bali. I am going to break my own rule and describe two births. I am not going to give any names or anything though. 

So 

Only in Bali

A few days before I left Bali, I was oncall as the western midwife.  I was called by a woman in early labor. She was Australian and wanted to check in with the midwife who would be at her birth. She had been having contractions for a while but they were not regular or very hard yet. She just wanted to know who the english speaking midwife would be. As it turned out I had done a prenatal for her a couple of weeks before so we knew each other. 

I asked her to call back after a couple of hours. 

Later they called to say that the water had broken, but contractions were still sporadic. I let them know that they would increase in frequency and strength and that they could stay home a while or come in to the clinic. 

They arrived at the clinic with contractions that were 7 minutes apart but quickly became 4 minutes apart once she had a room.  She had the support of her husband, mother, and a Doula from the clinic and of course the Indonesian Midwives and me. 

Now here comes the only in Bali part. 

While I am checking her in, and getting everything ready for her birth, a local midwife is calling the local woman who provides massage to the midwives and arranges a Lur Lur for me. 

So after I check them in I go back to the Ashram (with my cell phone and the Massage lady) and receive a full body massage and lur scrub. The scrub was made of spices, the main one being tumeric, first she massaged my skin vigorously and then smeared the spices on. Then she proceeded to rub the spices into my skin until they pilled up taking all the dead skin with them. Then she whisked it all away. 

I felt and smelled wonderful. My skin was silky smooth. I felt refreshed. A quick shower and back to the birth center. 

My client was doing great, her husband rubbing her back,  a Doula was with them, and their family was waiting on the couches outside the birth room. After checking in with the birthing mom, she was progressing great, and sending the family off to eat, I was able to thank the midwives for setting up my massage. 

I also noticed that the men of the clinic where having their hair cut by the barber, on a chair in the parking lot. I inquired as was able to get a trim of the back of my hair while I waited on the baby. Now all of the men had a good laugh at this crazy American midwife getting her hair cut by the barber. 

Soon the mother wanted to push. 

I had the most amazing experience as a midwife.  The mom was pushing, her husband holding her  in his lap, the grandmother, a midwife was loudly encouraging her, her doula was quietly encouraging her. Her MIL was asking questions in german, and I was surrounded by the Indonesian Midwives, one sat behind me and rubbed my back and reminded me to sit up straight, one sat on my right, her arms brushing mine and occasionally embracing me. Another was on the left, holding the mothers leg. Soon another Indonesian midwife came and added her bright smile. 

Together we encouraged her to push, in English, and Indonesian  we encouraged her, keep pushing, truess,  truess, truess, and slowly slowly, palon, palon, and all singing the Om Bur a mantra that is sung at most of the births at the clinic. 

The midwives sang so beautifully, I never learned all the words, I was only able to hum along, but I heard and felt the support and love of all of them, for the mother and family and for me the midwife at that birth. 

I will never forget the peace of that birth, the mom crowned her baby slowly and then was able to reach down and bring her baby to her chest. She was amazing and strong and incredible. Her husband cried, as did her mom and MIL. 

Soon the grandpas wanted to see the baby and after everyone had a look, I kicked out everyone but the dad and told them that we needed some privacy to have the placenta, so they all went out and mom and dad had time with the baby. 

Then the placenta came over an intact perineum. 

NSVD of a baby girl.

Normal Spontaneus  Vaginal Delivery

the Birth happened at 7 or so in the evening. 

Clean up and then go eat. 

Read a bit and to bed.

My Last Birth

at 1 am a call

Over to the clinic, two women in labor, oops make that three one more just came in. 

I check in with the Midwives and find out where I can help. 

A doula with one of them 

I work with the moms, check babies heart rates, moms cervixes, everyone is doing fine. Progress is being made on all fronts. 

Then the mom I am working with is complete and wants to push. The baby is high, really high. So we set up a make shift birth stool with two office chairs, (don't tell the office staff) and woosh the water breaks, heart rate is fine and then the baby has descended. It came down and then it stayed their, pushing and pushing, sit up, squat, lay down, push baby doesn't come down any more. 

All of the midwives try things, the Indonesian midwives encourage her to push hard, keep going. Finally we do not know what else to do. So we consider transport to hospital. 

The baby is big and the mom is small, they measure her height and estimate the babies weight. 

The Indonesian Midwives call the doctor, and I get the mom up for one last try squatting. Something shifts the baby comes down. 

In come the Indonesian Midwives, we are all excited. She goes up on her husbands lap, and then she pushes with all her energy and the baby is born. The mother was so strong, and she is so happy to hold her son. 

It needs a bit of help, an so we stimulate, suction and help the baby to breath. 

One of the Indonesian midwives sutures the mom. 

NSVD of baby boy.

In both of these births I feel the strong sense of trust that the Indonesian midwives and I have found with one another. It is what I will take from Bali the sense of working together with all of our strengths to help mothers. 

Another busy day

Well so far today I have caught three babies, another was born while I was at those births and someone came in a Bemo (local cab) and had had the baby in the car. 

I am sitting with the fourth woman I have helped today. I am the midwife managing her labor and I have a Doula helping me as well. 

It has been a bit of a crazy day. I was able to nap in the afternoon and I have tomorrow off altogether so I am going in to town for a massage I think. 

I also managed to go to the local organic farmers market and get corn on the cob, and I also picked up some small gifts. 

I hope this mother has her baby soon. 

In just over a week I will be home.

treesa

Busy morning

Yesterday we had a busy day at the clinic. I arrived and two women were in labor, one was pushing and the other was 3-4 cm. I checked in with both moms and a third woman came in she was also 4 cm. I was asked to start a prenatal for a western woman, then to attend the birth of the woman who was pushing. 

All of a sudden we here the last woman to arrive let out a deep loud push. So I grabbed gloves and ran to her. She was complete and pushing. One of the Doulas came to assist me, and helped with hearttones, and gathering the supplies for the birth. When the baby was crowning another midwife joined us, and the Doula and I caught the baby. From her first push to baby was 12 minutes. the baby needed a bit of help getting started but then was crying loudly for about 29 minutes until it fell asleep on mom.

I felt great about managing the birth, and postpartum with this woman. I felt as though I really was able to contribute.

Soon I will be going home, just a week and a couple of days more. It seems like I just arrived and like I have been gone forever.

I want to be home to see family and friends and to see my clients again. I have several clients due in late spring and summer, and I cannot wait to be working with them in familiar environments. 

I am also looking forward to seeing Rosanna, my preceptor for midwifery and my peer review, and apprentice midwifery groups. I want to thank them all for the great training I have had. 

see you soon tree

W

some babies do not make it

Sometimes babies die.

Yesterday I got the news that one of the babies we had to take to the hospital for breathing problems has died. 

I find that at the moment I am a bit numb to the fact. I cannot quite touch the emotions that are under the surface. 

I do not know how to react. This is the first time that a baby I assisted with has died. I wish that I had had a deeper relationship with the family, but I do not know why I wish that. It would not help them with their grief at all. 

I am so sorry that this baby did not make it. 

treesa

Meghan

Yesterday was a big day around here. Meghan my daughter is here and she and I and Abong, a friend I have made here went touring around the area.

We went to temples, to a market and sat out a rainstorm drinking tea at a Warung, saw misty, foggy lakes, and walked down to a twin waterfall. 

We walked and talked and stopped by the side of the road for fruit, Meghan tried Durian and did not like it at all. 

I have pictures of our adventures that I will publish when I upload them to the computer. 

It is great to have her here sharing my adventure, and when I return home I will have someone to say, "remember" to.

It was also a great day for another reason. When we arrived back in our village, I went to check in with the clinic and to say hello to a mother whose labor I had attended the day before. She had a challenging labor and early postpartum. She was having a VBAC and really had to work hard to push her baby out. 

When I saw her she thanked me and gave me a big hug. I asked the babies name and she told me Made, which is a common name, and that she wanted to also name the baby callista and would I help to name the baby as well. Would I give the baby a name

So now there is a baby, Made Meghan Callista in Bali.

it was a great day

Meghan

a

So it has been a few days since I was able to write for this blog. I did actually have a nice piece about  listening to music here but it was lost in an internet snafu.

I have settled into life at the clinic. I am being called when babies are being born and have caught a number of them. I enjoy working with the midwives here. It is a challenge to merge all of the styles of midwifery, the cultures we come from and our personal styles. 

As my journey on midwifery seems to be, I have had to find a way to observe and surrender some of my ideas about midwifery, midwifery education and birth, while keeping my core values intact and remaining grounded. I have been unsuccessful and successful here at different times. I find it challenging to watch different practices that I do not understand and may not agree with happening. However I am a guest worker here, so I try to ask respectful questions and then come to the births knowing that even though we are different we all want the best, healthiest experiences for the moms and babies here. 

I have seen amazing births here. Most of the women are quiet during labor. Often they arrive at  the clinic in early, early labor and spend the day walking and resting until active labor arrives. Most women have husbands and other members of the family with them when they arrive. We try to provide emotional as well as physical support to the women and their families. 

Sometimes I find myself looking into the eyes of a new father or a distressed grandmother who is scared or concerned for their daughter. I try to reassure with the few words of Indonesian that I have, Bagus, good, Sehat, healthy, Ibu Sehat, mother healthy, Baiyiah sehat baby healthy.

After a recent birth I watched a father gently stroke his new baby girls arm and gently open her hand. He was quietly crying, and so happy. It was one of the most wonderful things I have witnessed here. He was young, both parents were 19 I think and he had been concerned during the labor, but very attentive to his wife, they obviously loved each other very much and their baby was coming into life with joy as well as pain. 

Now on to Bali

The photo here is a temple in the neighborhood. There are temples everywhere, in homes, in the clinic, in towns and at the gates of everyones compounds, inside the gates of compounds. Each is decorated every day. So much industry goes into the ceremonies of everyday life here. 

The photo I posted earlier is of bakso, i had spelled it incorrectly before, is a local soup. It is sold by a guy who wheels around a cart, and it is 5000 rupiah or about 50 cents. It is the food that reportedly President Obama misses the most. It is a great filling lunch, with chicken meat balls, broth, noodles, tofu, and fried wonton like pieces.

I have also had some great padang food. At warungs, small stores that also sell cooked food, you point at what you want and then get a paper cone with rice, veggies and whatever proteins you have chosen. I have had great greens, tuna, chicken, and tempe. I love the potato fritters and the corn fritters. Because so much food here is fried, I do try to order the stewed foods or stemed greens when I can. I have also had padang breakfast, black rice porridge, or burbur, and it comes with coconut milk and you can also get banana fritters as well. This is sold at the local padang, that also has fresh mixed fruit juices. They just put whole fruit in a blender with water and there you are. 

Yesterday I went and got Burbur inji, balck rice porridge and fritteres for the whole Ashram. there are 4 of us. It came to 14,000 rupiah or $1.40 for breakfast. 

enough for now. 

treesa

Flowers at the guesthouse

everyday events in bali

Cleaning and organizing

Today I cleaned one of the birth rooms, washing down all the tables and chairs and equipment. I have also sorted through boxes and organized closets while I have been here. 

I also made packets of clothes for the mothers to take home. Each mom gets a pack of clothes and a baby blanket to take home. For some of the babies that is all they have. So the baby blankets that were made are all being put to good use. Thank you all. 

I am setting up a crash cart for emergencies. Basically organizing everything that already exists into a cohesive  cart that is labeled in english and indonesian.

There are two women here in labor, one a third time mom and one  a first time mom. It will probably be a long night.  

I am enjoying my time with the Indonesian midwives, they have been very generous with me. Helping me to catch babies, and teaching me the language as we go. However I am hopeless at the language. I keep trying, they laugh and correct me and I keep trying. 

wonderful women

I am fortunate to room with two amazing young women, we all stay at the ashram, as volunteers. Our house is rustic, but together we make it home. We watch out for each other. We are constantly asking each other if we have had enough to drink, or brining home treats to one another. We plan our meals together and cook together and just hang out together. These women are brilliant, smart, well traveled and very aware of the cultures around them. They have enriched my experience. 

It came in handy the other day when we had 9 patients in labor, and 8 babies born in less than 24 hours. One of the moms had to be transfered to the hospital. Together these young women and I assisted the midwives, listening to heart tones on babies, rubbing the moms backs, helping them to relax or to Jolong-jolong (walk) in turns. 

I was able to catch three babies and help out with all of the mothers in some way. It was an intense and exhausting day. We all managed to eat and get short breaks. We worked together to make sure each mom had support when she needed it and to clean up, as we went.

These women are my friends and family in Bali.

usefullness

These are the Daily Offerings left every morning on our doorstep. 

They are beautiful small creations. 

Last night we saw 92 clients in prenatal and acupuncture clinic. It is amazing to see, all of the women and their families sitting patiently. It was exhausting. And in the midst a baby was born. I was working doing prenatals when the baby made its appearance. 

A day in Bali, though the day before, no clinics, no babies, just quiet, also a day in Bali. 

Being useful here is challenging. Sometimes I feel as though I am just an extra set of hands trying to do a job that is already being done, and no help is really needed. Sometimes I feel useful. Of course I prefer to feel useful. So maybe I will learn b

birth stories

I have been thinking about the stories of the births I have witnessed. 

I will not be writing specific birth stories or posting pictures of the families I help here. I cannot communicate well enough to ask permission of the families, and I do not feel comfortable sending their stories and images of them out into cyberspace. 

I have been to 7 births here and assisted with  of the births as a midwife. I have seen some complications, shoulder dystocia, labor dystocia (dystocia means stuck) and babies presenting with their heads just cocked slightly off center. One baby delivered LOT which basically means he was looking at his mothers leg instead of her back when he was born.  At every birth I am learning about midwifery, my role as a midwife, the practices I want to embrace and those that I want to avoid. 

Here I am also witnessing faith and spirituality completely intergrated into life. At births blessing are given and received, and prayers are sung to the new babies.  At one birht I sang Amazing Grace, and was brought to tears by the power of those words to hearten the mother, and strengthen the father. 

I have been embraced by new mothers and fathers, their families and the other midwives. The gratitude that the families express is overwhelming at times, because I am so grateful to them for allowing me to be present with them.

Tiramakasi/sama sama

Thank you or I give you love/ I also give you love

Because it is such an amazing an experience I will send snippets of stories, and images of the community in which I practice. I will always be grateful to the families here. 

love tree

three women at the clinic, one in active labor, two in very early labor. Acupuncture fertility clinic with about 30 people waiting. One volunteer out with the flu and another at the beach. It is warm and the mosquitos have not yet started to bite. 

Prenatal clinic will start soon and we will see somewhere between 20 and 30 women. 

It is always busy here. I worked with two westerners today one with a colicky baby and another who had fallen and was nervous about her baby. 

I keep trying to work on a project - online research for the clinic but never seem to have the time. I don't feel super busy I think it is just that the pace of things here is so different. I am always with other people. Almost no time alone. 

It is a cultural whirlwind, balinese traditions, hindu, muslim, christian, and then all of the westerners bring their cultures and beliefs, including of course me. I am trying to have an open heart and head, to learn from the teachers that appear before me. Two of the bidans, Indonesian midwives have taken time with me to learn, here they are my gurus. 

Terimakasih

thank you

Hi everyone

I am sitting in the office at the clinic. Had a very busy day today. At least three babies born today, and I assisted with one. It was amazing and a bit overwhelming. It was a waterbirth. We had slow shoulders, and that is always a high energy event. Baby came out and is fine. 

We also had a cleansing ceremony today at the clinic, and the whole community is getting ready for another big ceremony so all of the neighborhood women are dressed in temple clothes. 

We had several visitors who decided to drop in to see what we are all about.

There are so many people here all of the time I become overwhelmed with the number of people I interact with everyday. I live with 4 women so there is that as well. 

I have had fun though, getting a massage in Ubud our nearest city and also doing some shopping, It is an artists  culture here and I am enjoying all of the sites. I will post pictures tomorrow. 

bye for now

tree

Birth in Bali

I attended my first birth here a few days ago, and it was a gentle waterbirth. I am most struck by the families. They come and go and bring food for the mothers, They hold the babies a little, but mostly the moms rest with the babies for a day or two until the breastfeeding is established. 

I seldom here the babies cry.

I am beginning to feel like I might understand my role here. There are several other volunteers here, birth and office and accupuncturists. There are so many people. I feel as though I will never learn anyones names. But being here a few days, and I am starting to recognize people. 

Since my first birth I have attended two more, and was able to catch the baby and assist with the labor. It was wonderful to participate in a birth with so many different points of view. I am still in the role of a student so I ask lots of questions, and say "is it ok to do this or that" alot. 

Nights are very long here, for me. There are dogs everywhere and they fight at night so I wake up and sometimes can't get back to sleep. 

I did have Boxo which is the local soup sold by a vender in front  of the clinic. It was great, noodles and broth and meatballs, and crunchy fried things, mmm. And the clinic always has food too so today it was greenbeans and coconut. 

Tomorrow I think I will be going to a big temple ceremony with people from the clinic. We will take a two hour bus ride to the main temple in Bali. I have to wear special clothes. Really a serong and long sleeved shirt, I don't own real temple clothes. 

I miss everyone and my house, and cats. 

tree

sitting in bali

I am settling in. I am in Bali and I am finding my way.

I arrived day before yesterday, it was evening and a driver came to pick me up at the airport. My indonesian lessons began then. Pagi is morning. Sore is evening. Now I am going to take lessons with the other students here. there are three other students here now, and more arriving soon. 

We have our own space to live in, very rustic. When I got into bed, I heard, frogs, and crickets and so many unfamiliar sounds, and when I woke up it was to the voices of our next

door neighbors getting ready for the day and the roosters crowing. 

I began with a tour of the facility and then we went to a local guesthouse for lunch and a swim. 

As we walked through our neighborhood we saw statues and small altars everywhere. It is amazingly beautiful and green here. 

All of the students are very friendly and welcoming. 

I am going to  go to the store and ATM today and also purchase a phone, and figure out groceries. 

more later

treesa

Hong Kong

I flew from San Francisco to Hong Kong and arrived early in the morning. I stowed my bags at left luggage at the airport and hopped on the A21 to Kowloon to my guesthouse.

Above is a picture of my room. I checked in and then when out to explore. I walked all over the neighborhood and really enjoyed my day. I started out by walking to Nathan road and discovering Kowloon park. A beautiful place with lots of singing birds. 

I made it to The Avenue of the Stars for the light show over the harbor that happens every night, but I was not impressed. The harbor is beautiful but it was so foggy none of my pictures came out. 

I went to Ladies Market and to Temple Night market and ate food from stalls, octopus balls, doughy balls of octopus, corn and cabbage with a great sauce, sausages, and dumplings, all served on small sticks. I also loved the coconut sago, a slightly sweet coconut-tapioca drink. mmm and only $6Hong Kong Dollars, or about $1 us. 

Saying Goodbye and hello

Saying goodbye

So my friends and family are all calling or emailing to say goodbye, have fun and work hard. 

I have a large community. My family, Charlie, my husband, my son Brian, daughter Meg, and my Mom and sister, Donna and Mary, and my mother inlaw Judy, have had almost daily updates. It will be hardest to say goodbye to them. They have supported me through my midwifery journey for many years. In the case of my son and daughter, their whole lives have been lived to the mantra, "we can unless I have a birth"

I love them all and will miss seeing them and talking to them everyday. 

I also have my Charquin family, those friends made when my children were in elementary school, and it consists of both an immediate and extended family. At Charquin, we valued alternative education, and different learning styles. Well you can't get much more alternative than midwifery education. So I will think of all of you and the days and days we sorted rocks together as I am learning a new language, new skills, and a new culture. 

I also have my birthing community, it is big, the families I have supported, the Doulas I have worked with and the midwifery community that has welcomed me. I will have some amazing birth stories when I come home. 

saying hello

Today I added a new member to my community, a new student midwife, she is considering going to my school, Midwives College of Utah, and I was able to tell her what I love about it. I also was able to steer her toward finding connections in the birth community. 

In Bali, I already have tow dates to meet up with friends one a friend from an international doula group and the other a grandma of one of the baby's whose birth I attended. I have an email out to another midwife who lives in Bali that I met on line and I hope to get to see her too. 

Community is really important to me. I am glad that the relationships I have grown at home will be with me throughout my journey. 

treesa

PACKING

Today I packed. 

I am leaving for bali on Thursday night, traveling first to Hong Kong for two days, and then on to the birth center in asia . I know I will be on call for births, work in the prenatal, pediatric and accupuncture clinic. 

I am traveling with Singapore Air and I can take two suitcases, but I have had so many donations that I am unsure I can fit everything I will need into two suitcases. 

I have dozens of baby blankets, hand made by Holly and Dorothy and my mom. I have herbal tinctures from Pam at Herblore, B/P cuffs from spike and Dr. M. Friends have donated baby clothes, and medical supplies, money so I could buy more medical supplies, ( stethascopes, and oxygen tubing). Gloves, and speculums, and ictometer and dee lee mucus traps. 

and more and more and more

Thank you all, patty, rosanna, leslie, maria, the whites, laura, ron, rose, gail and rigs, deanna, and jennifer,louis, and martin (whose gamelan played for us), elizabeth, joanne, margaret, patricia, patricia, donna, carl, elizabeth, stacy (and girls), constance, valerie, ken, derek and marianna, irene, kathi and kevin, eliana and josh, suzanne, major, susannah,  donye and catherine and dennis, kiley, robin and ian, roxanne and all of the babies.

I am so lucky to be surrounded by such a generous and loving community. 

HI,

I am Treesa Mclean, I have been a birth and postpartum Doula for over 20 years and am currently a student midwife enrolled in the Midwives College of Utah, and working with my preceptor, Rosanna Davis, LM, CPM in Menlo Park, California.

I am off to Bali in 2009 to participate in a Midwifery Internship. 

I was drawn to participating in Midwifery abroad, both because it offers me the opportunity to work in a free clinic, and to learn about birth in an entirely different culture. 

I am so excited to be to accepted  in baliand to travel there. I will be taking medical and midwifery supplies with me to Bali when I go. Before I leave I will be collecting supplies and fundraising for the clinic. 

 On the links page there are links to a wide variety of midwifery organizations,  my college and the practice with which  I currently work. 

Whether you are a pregnant woman, family of a birthing mother, new parent or  birth professional consider supporting these organizations as way of supporting your local midwife and the larger American and International Midwifery community.

Treesa