This really is the longest post in the history of computers. . . . .
Damn. It’s been a busy some-odd days.
I went to VT with john, jesse, and katie and learned to ski – which I like a lot and will hopefully do much more of in the future – when I have money. My ass muscles hurt very intensely for a couple days, but seem to have healed since.
The best thing though is that I saw two babies born – unrelated to skiing. I called this clinic in El Paso, TX – which is one of just a few of its kind (in the sense that it is a free-standing birth clinic in the U.S. that employs almost entirely student midwives and also serves an almost entirely mexican population) – and asked if I could come do a 24 hour shift there – just shadowing the midwives and seeing what it is like to work in that kind of environment. It was pretty much the best thing I have done up to date.
Get ready for the long part.
The Clinic: Maternidad La Luz
It’s called Maternidad La Luz and is in El Paso, about 10 minutes from the border with Mexico. I’m not entirely sure that even one non-Mexican lives in El Paso (with the exception of some of the student midwives at the clinic) – everywhere you go everyone speaks Spanish – I heard just as much Spanish in El Paso as I did every day in Madrid. It was great. You forget to speak English and I did my grocery shopping and stuff all in Spanish. Very wonderous.
Anyway – the clinic. So, 90% of their clients are from Juarez, Mexico (a city of about 2 million laying on top of the U.S.). The clinic has ONE non-Spanish speaking client. . . and they have A LOT of clients. There are staff midwives – ladies who have been delivering babies forever and are certified in everything. The staff midwives oversee most of what goes on but do not really DO a lot of the catching babies – they make sure everyone is safe and teach the students how to do things.
Then there are intern midwives who are students who have completed one year at the clinic and are now CPM’s (Certified Professional Midwife) – they are sort of in-charge and defer to the staff midwife when they have a question. Then, there are students who are doing either 3 month programs (where they won’t be a midwife when they leave, you just get exposure) or one-year programs (where they graduate as a CPM). The students do most of the bulk work, like appointments and actually catching babies. There were about 4 students on when I was there, 2 interns, and one staff midwife (“la titulada”).
The whole place is run totally in Spanish because, with the exception of that one client, everyone only speaks Spanish. There are three birthing rooms, two exam rooms, a main living room, and a huge kitchen on the first floor. Pretty much all the activity goes on in the kitchen – which is a wonderful thing – all the families get together, the midwives, everyone is cooking and talking and excited.
Then, on the second floor, they have three beds for the students who are on their 24 hour rotations, two offices, and a full shower/bath. It’s a very very great building. Oh! And there is a fenced-in backyard with lots of clotheslines full of linens, chairs, tables, picnic amenities and other wonderful things I want my life to be filled with.
My first birth!
I arrived at the Clinic at 7:30 in the morning – I wasn’t due there until 8, but I was early – and a student midwife (who was totally insane and not really someone I think I would want to be around a lot) asked me to drop my stuff and help her with some labor checks. We did two labor checks – both women were only 2 cm. and we sent them home. . . my job was to do the paperwork and stuff while she asked the lady questions.
Then, around 8, the entire staff switched – all the girls that had been there the previos 24 hours (including the crazy one) turned their patients over to the new shift. Both shifts all stood in a circle holding hands and went over the previous day’s patients/births and then we started the day. We did a bunch of citas (appointments – prenatal and postpartum) and then I was sort of assigned to this lady Carmen, to shadow her during a birth. Carmen was not actually a midwife – she had been an administrator at the clinic for 18 years but was not a licensed midwife. They were understaffed though and since she has been there so long and knows everything, she catches babies when they are understaffed. She was amazing at it too.
So, we got in there when the girl starting pushing (she was young). She was very calm through the whole thing and the father of the baby – not her husband though – was very cute through the whole thing. For awhile, he stayed at her side, holding her hand, and rubbing her forehead with a cold towel. I just sat in the background for awhile. Then, after about an hour of pushing, the babies head was very close to the opening and they brough the dad of the baby around to watch the baby come out. My new job was to hold her hand and tell her to push and breath and that she was doing great – thank god i speak spanish – they put a mirror between her legs so that she could watch – but she wasn’t really up to opening up her eyes.
Anyway, the midwife had to do some finger forceps – where she puts her fingers pretty far in the vagina and then uses then to seperate the pelvic bones a bit and helps guide the head out a bit. Watching the baby born was possibly the most bizzarre, wonderful thing I have ever seen. The dad watched in awe and cried (he was young too) and it was very very wonderous.
After the baby was born, the Carmen waited around for the placenta and then helped the mom latch the baby on to nurse. It was just a very very fun thing to be around. One thing I did not know to expect was HOW MUCH blood there is – I knew there was postpartum bleeding, and I asked Carmen if this girl was bleeding normally – she said it was fine – but still, there is a lot. My job was to help the mom to the bathroom and to hold her hand while she peed – which she did a LOT of – I helped write out her chart while Carmen did postpartum checks every 15 minutes for an hour. . . and then every 30 minutes for a while.
The whole thing was so great and I could not have asked to see a better birth for the first time.
Birth #2
At about 6 PM, a woman came in who we had sent home earlier that morning (because she still had a lot of dialating to do). She came back and we got her situated in a room with her mom and the father of the baby – i’m not sure if they were married.
At around 9:30, the student midwife who was in charge of the birth, Sarah, called, “Birth Team” – which is a funny thing they do when a lady is getting ready to push because they shout “Birth Team” out the door and people come jogging in and it seems very military like . . . anyway, I went in with another student when she called Birth Team and, unfortunately, in the next room, another student called, “Birth Team,” – so there were two women pushing at the same time.
Our lady, seemed to be much farther from actually birthing the baby than the other woman, so Sarah kept telling her to breath through her contractions and try not to push becuase the “titulada” was busy with the other lady who was yelling a lot. After about two contractions, we saw the head and so it turns out that she was way further along then they thought and Sarah just had to get down on her knees by the side of the bed without gloves on our anything and start catching the baby.
Mom’s bag of waters burst all over Sarah – and the “titulada” who ran in at the last minute – all this fluid just shot out at them into their faces and everyone laughed a little. Got a little on all of us. But then, the babies head just sort of stuck there – without moving – even though Mom was pushing – so Sarah and the other midwife got nervous and it turns out the babies shoulders were stuck.
So I had to go bring Mom’s knees back to her chest, basically into her face, and the midwives had to grab the baby’s neck and just start yanking up and down and side to side – the scene was like this:
I was at Mom’s head, holding one knee to her face, the grandma was at the other knee but didn’t really know what to do so she grabbed her ankle and tried to yank it past her head – So I had to calmly try and explain – in Spanish – that she should just grab the knee – meanwhile, the father of the baby has never been at a birth before and is on his hands and knees on the floor with his forehead on the ground yelling (in a Spanish accent) “F U U U U U U U U CK – F U U U U U C K!” The midwives are yanking on the baby’s neck really forcefully, Mom is just bright purple and not making any noise except for grunting and looking really terrified – and the Grandma is looking at me yelling, in spanish, “Is everything ok?????? Is she going to die!??” And I just keep saying, “No, todo esta bien – es normal – no pasa nada – Es normal.” What the hell do I know!?
Finally, little baby pops into the world and, following her, is an explosion of blood because the placenta seperated (or something – I didn’t really understand)- everyone has splashes of blood on their clothes – the midwives have blood on their face -scary. Poor Mom is just laying there having just had this baby yanked from her vagina. Man – it was very intense. Probably the most instense part though was trying to clean up everything – we had to change all of Mom’s clothes, the bedsheets, everything – just minutes after birth because everything was DRENCHED. Poor Mom had to shift around and keep rolling from side to side as we made the bed – she just wanted to lay and sleep.
The baby ended up fracturing her clavicle – which it turns out is not uncommon for big babies. The first baby I saw born was not even 6 pounds – this second one was just about 11 pounds. Almost double. It had leg rolls, back rolls, chin rolls. So godamn cute. But huge. And the midwife kept whispering jokingly, “Es tu culpa mi amor” – “It’s your fault you fractured your arm, my love.” She’ll be fine though – just wear a cast for a few weeks.
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