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