Monday, September 17, 2012

Ismani's Delivery!!

Ismani's big day finally arrived! Late on Friday night, we could tell that she was starting to go towards actual labor, and it seemed like her water might have been leaking slightly already. I almost slept in the clinic with everyone else, for fear of missing out, but Melinda assured me that it wouldn't happen until at least the next morning.

When I arrived in the morning, Ismani was still not ready to go, but definitely on her way. She wasn't making much noise yet, but you could see the pain of the contractions on her face as he squatted against a chair or against Melinda. Meanwhile, around 7 that morning, another laboring woman had arrived! This woman, Yvette, was making those characteristic yells and even crying with some of the contractions as she walked around the clinic. When Ismani started yelling, too, we had quite a chorus going on! Ismani's moaning at one point was the most musical I've heard yet. In Haiti, it often takes on a rhythmic, repetitive, sing-songy quality; we're all trying to figure out why/how almost every single woman here makes the same (or at least very similar) sounds during labor! One of the classics is "Me zanmi woooo" and it somehow always has the exact same rhythm no matter who says it!

Melinda helping Ismani through the early phases of her labor...

Melinda kept Ismani in her room in the clinic for most of her labor, just to help her center herself and turn more inward to let the labor progress naturally. Most of her laboring was done on her side on the floor, but she had her own little position changes, too. We tried to minimize the number of people in there at a time, because there was quite a crowd of people who cared about her and wanted to be there (Melinda, Ninotte, me, Sheila, Danaelle, Dada, Mirland with her baby...!). 

Ismani labored a lot with her back (a phrase my mom taught me on the phone the other night), so she was in a lot of back pain and needed lots of massaging. She mostly wasn't very amenable to doing anything we asked, like drinking a cup of juice or water, or like having an internal exam, which certainly made things difficult! A little while after the birth, Melinda said she's had enough of these teen births (Ismani just turned 15) because they don't have the right attitude or the maturity to agree to do things that are necessary to one's (or one's baby's) health, albeit uncomfortable.

At the same time that Ismani was yelling NO whenever we nicely (or sometimes forcefully) asked her to please do something, she would calm down and alternate with very sweet, appreciative moments. She told each of us that she loves us, multiple times, and she would sweetly say "Thank you so much" whenever we'd do a tiny favor like hand her a cuvette so she could spit. ...Although those sweet moments still didn't make her more agreeable to doing what we asked. 

After a while, her yelling got very loud, and if someone wasn't there with her during a contraction, she'd scream for Melinda or Ninotte or me, even though nothing different was really happening yet. Time went on and on, and finally she was getting a little too tired out. She wasn't able to eat, so we'd been trying to keep her energy up with Emergen-C drinks, but we finally decided that she might as well rest for a short while. We gave her a little wine and milk (the wine puts a little pause on the contractions, allowing for a little rest), and... about 5 or 10 minutes later, she suddenly said she felt the baby coming! 

We got set up for the next step, and it wasn't long until the pushing began! And still... there was plenty of time left before the actual birth. As we were checking the fetal heart tones, they seemed to get a little low, so we brought our spankin-new oxygen tank in and put the mask on Ismani. We had to keep her on her left side as much as possible, too, because that also helps bring oxygen to the baby. At some point, despite the fact that we thought her water had already broken, Melinda, Ninotte, and I were all standing or squatting down below Ismani's legs.... and there was a huge, projectile SPLASH of amniotic fluid!! I didn't get hit by much of it, but Melinda was front and center, poor girl. She ran off to change her pants quickly, saying that she felt like she had been baptized! 

After a quick clean-up, we continued on. With Melinda ready to coach Ismani and catch the baby, and Ninotte at her side to take notes, help out, and hand Melinda tools, I positioned myself at Ismani's head to keep her drinking, keep the oxygen mask on, and hold her head up each time she pushed. In order to keep the contractions coming, after we had given her that wine that slows contractions down, I had to give Ismani nipple stimulation, too! Unexpected. ha. (Nipple stimulation causes the release of oxytocin, a hormone that causes and increases contractions.)

Pushing took a little while, and at some point we brought a mirror in so Ismani could watch as the baby's head/hair started to show a little. Dada and Danaelle both put gloves on so they could hand Melinda towels or do anything else of use (which Dada especially loved!), and Mirland came in to do the video taping. Ismani continued to tell us that she was going to die and that she couldn't do it and that she was going to break in two... but she did it, and suddenly there was a head, and then the rest of the baby (at 4:50pm)!

There she is!!

There were maybe 5 minutes of concerned, quick action on Melinda's part as she did some resuscitation; the baby was trying to cry, and really trying to breathe, but it was obviously in some respiratory distress. When Melinda's attempts to help it didn't seem to change much, Brian and Ninotte quickly whisked this little newborn off to the St Michel hospital to get checked out. Apparently, there wasn't a doctor working in the emergency department, so it took a little time to find someone to check out the newborn, but eventually a doc showed up and ... apparently everything was fine. They brought the baby back and she seemed to have gotten past any struggles, and was quite content and peaceful!

Happy new mamma!

Ismani named this little baby girl... Ismania. ha. That's NEVER going to be confusing. We took a few photos, tucked them together, and that was that!

All of the girls, very happy and excited about new little Ismania!

I'm feeling particularly attached to this birth, since it's
the one in which I got to participate the most (so far)!

Since the birth, we've had some struggles with getting Ismania to successfully breastfeed, although she seems to be gradually catching on. Her tongue doesn't seem to come out very far, which makes her latch a little less great and makes it harder for her to stay attached... but she'll continue to get better at it! Melinda's expert advice is helping Ismani and Ismania make great strides in that department. :)

Dada adores babies, and Ismania is no exception to the rule!

P.S. Just to wrap up the other woman's story - she seemed to be stuck at the same stage of intense but not-really-changing labor until we decided to go to bed, at which point Melinda and Ninotte explained that her baby was oriented towards the woman's right side, rather than the left. This meant that it would have to rotate all the way around before it'd be able to fit down through the pelvis, which can sometimes take AGES. (Ninotte once had a 3-day labor/delivery because of this same problem!!) I left to go to bed around 11pm Saturday night, expecting to come back the next day for the birth (or maybe it would beeven later) --- but she gave birth at hour or so later, just after midnight!! The baby just turned right around, really quickly! And everything was fine. Done and done!!

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