Monday, September 24, 2012

Woah. Things just got real.

Well, I've officially surpassed what I ever expected to be doing while in Haiti! I spent an entire night as a birth assistant AND an English-Creole translator for a birth...!! 

Quick background: Sarah is about to come back, but Melinda and Ninotte had to leave for a midwifery conference and Ninotte's midwifery exam (Good luck!!), so another midwife has come for a short while to help hold down the fort. It's her third time doing midwifery work in Jacmel, and she worked with Melinda and Ninotte back when they were at Jacmel's other birthing center. This midwife, Yvette, is a lovely person who seems to have truly found her calling in midwifery, and it's been a delight getting to know her and living with here here! 

Yvette has a bit of basic Haitian Creole from her previous time here, but she didn't really have a chance to learn much in the past and it'll take a bit of time for it to all come back. This means that... in the clinic, as I'm the only other English speaker, I'm suddenly in the position of translator! We thought that maybe I'd translate in French to Gislaine, who could then translate into Creole, but given that I haven't been using my French at all... it turns out that it's somehow less of a headache if I just try to keep it in pure Creole instead! Crazy. 

So back to the story. Yvette and I were just getting ready to lay down to sleep in the clinic with the girls - we had put them to bed, showered, and had just turned out the light - when Gislaine called with the news that a client was in active labor! Yvette and I got back up, grabbed the birthing kit, our client's chart, truck keys, phones... Gislaine lives close by and managed to meet us outside the clinic by the time we had everything ready to go, and we all quickly piled inside. With Gislaine's directions, Yvette's driving, and also, suddenly, my first need to be translator, we made it to the client's house just as they were bringing her outside to meet us. 

Although it wasn't marked on her chart, it turns out that the client also goes by Yvette! ha! She and her brother got in the truck while her husband (boyfriend?) followed on his moto. The truck ride was uneventful, and she still wasn't very loud or distressed yet. 

While Gislaine checked Yvette-client in and took her vitals, Yvette-midwife and I made sure we could find all the things in the clinic that we'd be needing over the next several hours. At first, Yvette-client was pretty restless and uncomfortable, but it was only a matter of time until she found her zone, or rhythm. I think it helped her to have baby's papa there to support her, since Gislaine was the only other person she really knew in the room. And luckily for the girls sleeping in the next room, she mostly had a pretty quiet labor, only speaking in low tones up until right before the pushing started.

During all of this time, Yvette-midwife is in charge, making decisions and suggestions, while Gislaine and I tried to make ourselves as helpful as possible. We both helped with translation - when the sentence was simple enough as Yvette said it in English, Gislaine could relay it in her better Creole, but I still had to do a lot of quick thinking in order to communicate all of Yvette-midwife's other messages to Yvette-client! This is already way more Creole than I've spoken so far here, so as I thought about this all in retrospect (I was way too busy and focused to realize it at the time)... it's really quite shocking and lucky that it all worked as well as it did! 

We had arrived back at the clinic around 11:15 pm or so, and after only about 2 hours or so, Yvette-client was starting to push! She was very uncomplicated, other than an extra water-filled amniotic sac that made it a little tricky to feel the baby's position early-on. After pushing for a bit while lying on her side on the floor, with head and leg propped up, she changed position to be squatting on her feet and leaning forward against the bed (and later against her man). I think this helped the baby get a little extra pull downwards from gravity, because pretty soon after that, we started to see some hair peeking through! 

At this point, I mostly recorded notes as Yvette-midwife caught the baby and Gislaine was an extra pair of hands for her. And boy, was it a good-looking little boy! It was obvious that he was in great health right off the bat, and good-sized, too (about 7 lbs)! Hooray! We got Yvette-client down into a sitting position so she could relax as I held her little baby snuggled up against her stomach/lap. The placenta took its time detaching and coming down, but with a little encouragement and fundal (sp?) massage, suddenly it came right on down! We had been sitting and waiting for about 15 minutes before Yvette-client had any little cramps that she could use to push the placenta out, so it was a bit of a surprise when suddenly she took care of that placenta with one well-timed push!

The rest went off without a hitch, and we got mamma and baby snuggled in bed to rest for a while. Gislaine, Yvette-midwife, and I took turns helping take vitals or record the numbers every so often, and Yvette-midwife had a pile of forms to fill out with all the information and stats from the birth. But we got to bed eventually, and napped from maybe 4:30 am onwards. Yvette-midwife got up to burn the cord before I was up; I think I woke up around 6:30 or so to help out with other clean-up and preparations to take our client home. (Needless to say, we were getting pretty worn out by now.)

We needed to go down a big long checklist that OTP has in each file for a thorough postpartum education about mama care and baby care and what to expect over the next few days and weeks. This meant... more translation! SOMEHOW, we managed to get through it all, and Yvette-client claimed to understand everything. I'm still somewhat in shock that I had that much Creole in me. Language is cool!! Just sneaks right up on you before you know it. (or just sneaks right into your brain?) I'm so grateful to Yvette-midwife (and Yvette-client, for that matter) for her patience with me while I had moments of language confusion. :)

After we took our new mama home and got her settled, we dropped a sleepy Gislaine at home and finally came back to get some long-needed rest! I was still in the scrubs that I had put on as pajamas in the clinic (right as we were about to go to sleep; right before we got the initial call from Gislaine), so when I finally was woken up by Dada around noon... I was STANKY!! Seriously, I think that might be the worst I've ever smelled. Sorry to provide nasty, TMI-type information, but it was such an ordeal that I couldn't not mention it! Haiti's heat/humidity + all-nighter + birth + excitement + too many hours in way-too-hot scrubs... It's really not a good thing.

But all in all, it was a really satisfying, fulfilling, surprising, great birth experience! We got lucky with a client who was really good at being in her zone and just taking care of herself, and then a little baby who was just about perfect! I can't wait for our next birth... I almost hope it happens before Sarah gets back, just so I can practice my Creole again, big-time! :D Hooray for life. 

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