Mangoes on the Dashboard

It took a while to adjust.
I couldn’t get over the cleanliness of our house where we stayed, it was luxury!
The abundance of fans,
internet,
and a lovely open kitchen with good knives and refrigeration.
We even had a toaster.
Toast! What a novelty!


We got receipts for things,
we ate fresh fruit and vegetables in abundance
(fresh produce is nonexistent in Indian cooking),
and we could wear shirts that showed our shoulders.
What is this place!

Despite feeling quite jarred and shocked at the overt Americanization of this place,

we still managed to find the real Philippines.

Large open markets,
mangoes on the dashboard,
cats in the fruit boxes,
the smell of fresh fish
side by side the smell of freshly baked goods,
slums that flood with tides of sewage water each morning,
children whose teeth fall out at 4 years old from rot,
mothers who are too poor to pay for their birth at a clinic
and thus give birth at home, alone,
families where the father chooses to spend the food money on alcohol,
houses that are caving in and have tarps for doors.

We found these people.
They were just a walk away from the paved highways,
just down the road from the retail stores and fast-food joints.
And they became our friends.

Friends from the slum, attending church. They are so lovely.

Free prenatal check-up in a slum. Measuring the belly....
This is Odette. This is her fourth pregnancy, and the father has run off and refuses contact with her. Her other children have a different father, and he's not around either.

We also saw the effects of generations and generations of broken families.
Years and years of fatherless families have left a gaping hole in the understanding of commitment, nationwide.
Many of the women we saw who where pregnant had never been married and had children from various “husbands”.
The word “husband” and “boyfriend” is interchangable there,
so often I’d be doing a prenatal interview with a woman, and ask who would help her with the baby.
“My husband.”
“Oh! Are you married?”
“No.”

In the Philippines, being a Catholic country,
once you get married, you can’t get divorced (it’s illegal),
and only on special circumstances can you get separated.
Thus,
this generation has decided that they don’t want to get married.
If there’s no way out, why commit in the first place?
Besides, weddings are glitzy and expensive...
so they just move in together. It’s easy.

Unfortunately,
as easy as moving in,
it’s just as easy to move out.
So after a kid or so,
fathers move on to other girls,
and children are left with no dad.
These children grow up with the knowledge that relationships don’t last for long,
and that although their 19-year old boyfriend/husband is with them now,
he will most likely not stick it out for the long haul.
He may even call it quits during the pregnancy.

I did a prenatal check up on a girl who was 18, and thought she was pregnant...
if it was positive,
this would be her 3rd child.
She skipped her period the last month,
and so we did a pregnancy test,
turned out to be negative, and she did a little leap of joy.
18 years old. She already has two kids!

This was such a drastic change from India, where there are virtually no babies born out of wedlock. Marriage is such a big deal,
it means security and strengthening family lines...to disregard it would to bring shame to the whole family.
Here, it would be a surprise to find someone who’s having kids and is actually married.


One time, we were doing a teaching at a free women’s class at a clinic,
and women at all stages of pregnancy and motherhood came pouring through the gate.
As the chairs were filling up,
there were two girls in particular who caught my eye in the second row.

Still having the frame of a young girl and not yet a woman,
a bulge that could have been adolescent fat was showing under her t-shirt.
But no,
she was 16... and 6 months pregnant.
Her friend was also 16,
but a little less far along, maybe 4 months.
The two girls had such young faces,
joking about things here and there,
being teenagers...now having a new life grow inside them.
Being a mom at 16.

During our teaching,
we asked the women any complaints they had of minor things during their pregnancy.
The young girl put up her hand and said she was getting acne.

Pregnancy, or puberty?

And this was not the exception,
it was what was saw everyday.
Most of the women we met had their first child (or two) before they turned 20.
One girl that we got to follow week after week, Michelle,
she was 24 years old and having her 6th pregnancy.

The government's solution?
The hospitals advertised free bilateral tubal ligation (female sterlization) for women with 5 or more children and are under 30 years old.
... is that really the way to fix things?


What about issues deeper than surgery...
commitment,
repairing the fatherless generations,
faithfulness...


We also got to know local women (and their stories) through the government-run clinics.
Our team who had been there for the month previous,
had paved the way with open doors
into various maternal health centres all over the city.

We got to see organized clinics,
midwives and doctors who were relaxed and loved their job.
We saw prenatal care like we hadn’t seen before.
The health centres were civilized.
Needles were disposed of properly.
Every pregnant woman was getting immunized for swine flu,
because the goverment provided it,
and the workers were diligent in following through.

Mothers were on track with their tetanus injections,
and babies were immunized at all the right times.
If they were showing signs of anemia,
iron pills were freely given,
and the women were educated on danger signs in pregnancy at every visit.
They were treated with dignity and love. It was wonderful to see.

So in the Philippines,
with our concentrated focus on prenatal care, I saw how a working,
sustainable, basic clinic could look.
All you need is a room,
with a few dividers,
a few skilled dedicated staff,
a baby scale,
a fridge for keeping immunizations cool....

My perspective was wider for the look of the world’s health...
and it was a nice country to finish off in.

Next stop?
Australia.

Philippine First Days

When I first arrived in the Philippines from India,
I was in culture shock.

I had gone from wearing flowy,
modest punjabis with scarves in sweltering heat,
buying vegetables down the road from a family with a hand scale at a roadstand,
eating with my hands and drinking tea for 3 rupees (7 cents) on the street, to....

Western clothes,
tight fitting t-shirts,
the land of make-up,
hair straighteners,
big box stores,
aisles with everything wrapped in plastic,
plastered with a bar code,
and you could get Hamburger Helper in a box imported from America.

There was air conditioning in every store,
people had keys to their house,
and there was toilet paper in the bathroom.

The second or third day after we arrived
(there were 5 of us who came later, because we stayed in India for an extra month),

the team took us on their “regular Saturday routine”
which consisted of doing a children’s program at a slum in the morning, then walking through an airconditioned mall, to wait at the bust stop next to the fast food joint, to take the free airconditioned bus down the smooth civilized highway,
to an industrial part of town with massive Wal-Mart like stores, shopping carts and long lines.

My eyes bulged open wide as I slowly walked down the aisles in a shocked daze...
beholding rows and rows of canned foods,
mass produced clothing on hangers,
and bar code after bar code of packaged goods.

I didn’t want to be there.
I didn’t know what to do.

Any “list” that I had of things that I potentially wanted to buy,
had flown out the window of my mind. I was overwhelmed.

The others, more adjusted than I, casually filled their arms and baskets with sprigs of this and a can of that,
“Oh let’s try this,” and “Wow, I haven’t had this for months!”

I bought a pocketcomb.



We then proceded to a nearby, massive Starbucks.

The air conditioning chilled you as soon as you entered, and there was a “door opener” who greeted you through the wall-to-wall glass windows.
There was “cafe art” hung.
Shades of cream and mocha and espresso bean coated the walls,
and all the Starbucks “popular favorites” were professionally displayed on the board behind the baristas.
The latest jazz mix-CD played lightly enough in the background to find yourself leisurely tapping your foot while waiting in line.

I got a frama-lappa-chocolate something for 3 dollars ( enough for 4 lunches in India),
and sat on a plush velvet coffee-coloured armchair by the window.

What is this.

This looks exactly like North America.
This scene could be coming straight out of a downtown street in Winnipeg, and yet I am on an island in the Philippines.

My thrift store clothes are baggy and not matching.... but this is outreach, right?
Just this morning we were holding kids in a slum,
and now I’m drinking a frilly chocolate drink,
sitting in a luxuriously comfortable chair,
and I’m actually getting cold from the intense, unrelenting air conditioning!
I tuck my barefeet up into the plush seat and take it all in.

The half-litre of sugary-sweet coffee and whip cream were
settling in my stomach and shocking my system.
We didn't eat very many sweet things in India.

Culture shock.
I don’t like it.
Everything’s so.... organized.
so... excessive?

Oh man,
is this what it’s like?
How am I going to survive!



.....

What Have I Left Behind?

This is a poem:
that I wrote in the Philippines,
to reflect on India.
Remembering moments, situations,
pictures that remain on my mind...







what have I left behind?
dust
rocks in the road
the people whose smiles capture your heart
whose hands are stained with henna
and lean up against crumbling
moist
cement walls.

I have left behind
billowing fabric doors
and one room houses

chubby babies
and thin mothers

and smoke that is so potent with spice
that it makes a burn in
your eyes
your throat
and you cough.

I have left behind smooth
frictionless stairs
and
musty cobbled
ancient backways

that open up to a lively street
of sorting rice
wandering dogs
the whir of sewing machines
and the swing of incandescent bulbs.

Turn the corner and
the goats on the rubble
of the garbage mountain
stop their scurry for a moment
as we take swift steps
down a fork in the winding road.


I have left behind
a place
where rings on your hands
mean nothing
and rings on your toes
mean everything

a place where ears and noses
are adorned with a gold
that shines
bright against skin tones of olive and caramel

a place where
babies look better with eyebrows and
men look better in moustaches

a place that conceals the collar bone
but reveals the ribs

where
children with kohl-smudged eyes
sleep soundly on dark marble floors
of a goverment hospital

nurses scuttle in starched whites
gaggles of Muslim women
huddle in gowns of black
and a young girl faints in her chair
from her first miscarriage

this place
of joy mixed with sorrow
oppression and progression
hard labours and hot climates
silver shackles and pocket combs

in the midst
of it all--

yet
no necklace is too sparkly
no pattern is too outrageous
no crowd is too large
no smell is too strong
no braid is too long


and
there is
always
a reason
to smell of fresh
jasmine flowers.

A Homevisit: Revisited

end of April.


A friend and I went on a homevisit to Riya's house.
Chilled with the family for 5 hours.

Homevisits are so awesome...
This is what I love about Midwifery,
it gets you into people’s homes.
You are able to help them and care for them in a very crucial time in their life,
and then you can come to their house and further develop relationship with them.

You get depth to your view of the women of India.

Mostly we only see women in hospital beds,
in a very vulnerable state, scared, having not slept for long hours,
or seeing them as one of the many:
waiting to be cleaned up,
waiting to be sutured,
waiting on a cold, steel table,
alone,
with a big, clunky lightstand blazing starkly on their wound....
waiting... sometimes for hours.


Even visiting them in the Postnatal ward upstairs adds dimension to their real life.
Bustling with movement during visiting hours:

These are women with
families and
husbands and
mothers and
in laws and
people who come alongside them,
help them,
rejoice with them,
who bring them baby clothes,
and help rip old saris into little squares for fabric diapers.

But homevisits add such another element.
First of all, we get to see them again.
And we get to do a check up. See how the baby and the mother are doing now.

Visiting in them in their home is such an honour.
It shows me that after the birth of the baby,
it is not the end, it is just the beginning.
It's the end of the 9 months, the end of "our part" at the hospital,
but it just the beginning of "life with the new baby".


At home,
you get to see real LIFE.
You get to see the family relations.

We get to sit on their couch, their floor,
play with their kids, talk with their relatives,
with no real agenda,
for 5 hours!

In the downtimes,
you get to see how fathers really act towards their children,
their wives,
their daughters.
We get shown wedding photos and
are given a delicious homemade Indian meal,
and a small cup of hot milk tea to finish.

We get to bond with the children
and have an open door into the
dusty, dry back roads of where people really live in Hyderabad.


We get to hang out with the 19-year old sister,
and see the prospective choice of her arranged marriage:
She showed us the piece of paper with a photo of a man in his early 20s,
and some “stats”:
name,
height,
age,
job,
family’s jobs,
income....

she seemed pretty neutral about it,
she trusted her parents’ choosing.
She had not met him yet,
but she would meet him once before she would choose to marry him or not.
Then she put the piece of paper back on the shelf and carried about her day.


We get to see the comings and goings of a home that is 400 square feet, houses 7 people, and has a curtain for a door.

We get to see the neighbour pop by for a chat and eat a hot rice pudding,
we get to see the teenage daughter brush her freshly washed hair and meet her friend at the gate to go off to a cooking class.


One thing I love about India is the closeness of family.
The family stays together.
The bride comes to live with the husband’s family, with the parents and the siblings, and grandparents.
It’s more about the wholistic family community,
than the isolation of individuals and couples.
Everyone is taken care of.
So the babies grow up with family around,
and the elderly are looked after by the young.

All you need
as a newly married couple
with a new baby,
is one room to yourself,
right?

Well that’s how it is here.
Share the kitchen, share the couch, share the sink, share the bathroom.

Talk about a new take on simplicity, eh!


But I like it,
it’s cozy!

Anyhow, homevisits are a pretty special privilege.
I like spending time with Indian families.
I have a lot to learn from them.

*

Here are some photos from a day with Riya's family.
Riya delivered at the hospital,
and now the baby is 2 months old,
and very cute.
The baby's name is Kasheesh.


This is Riya.
and baby Kasheesh in motion.

















This is Riya's husband's grandmother.
She's chilling on the couch with Kasheesh,
her great-grandchild.













This is Gori,
Riya's niece.

She's 4 years old,
and such a little joy.
I befriended her when we were outside watching dogs together,
and from that moment on,
she was my little buddy all day long.




Gori having fun with her scarf.











Baby Kasheesh.
Cutie!










Riya's mother-in-law, Anita,
is a henna artist.
She does it for big events and weddings and such. Luckily, I happened to have a tube of henna in my bag (gotta love those moments!) and she offered to cover my hands with her skills.
All free-hand.

Alana, my friend who was with me, got her hands done too.

They were lovely. A really sweet family.


Then we took the ride home,
down curvy streets and bumpy roads,
thankful
for the little house
with the yellow walls and
hospitable hearts
located somewhere
down a dusty lane
and twirling ways
that I would
never
be able
to find again.

Dream Home

April 21.


Today I was greatly encouraged.

We didn’t know exactly what the day would entail,
but we knew that we were going to a far part of the city to visit an orphanage.

After more than an hour long rickshaw ride in the morning heat, through the traffic and eventually out of the city, down some windy roads and dusty turns, we arrived at:
Dream Home.

We met Aaron and Gloria.
This lovely couple has a two-floored simple house and serves the Lord with it.
“From the hour we got married,
we decided that anywhere we go,
wherever we are,
we will do ministry.”

They are now mother and father to 15 children, all orphans.
And the children all have one thing in common, they have lost both their parents to AIDS.
Aaron and Gloria are from the coast, but moved inland 4 years ago to volunteer at a Christian HIV and AIDS clinic.
After 7 months of working as a counsellor for HIV positive people,
Aaron shared his vision with the doctor who runs the clinic.

“We want to provide a home for the children whose parents have died from AIDS.
When the grandmothers and uncles and aunts will not take them in, we will take them in.”

The children themselves have not contracted the virus, they are HIV negative, but they have lost both their parents from it.

Three years ago, they started Dream Home.
A big simple house they rent and live in,
and provide a refuge, opportunity, and the love of Christ.
The first year they had dream home, they received 2 children,
a pair of brothers, whos parents had died.
The next year they received a few more, and now,
in their third year, they have 15.

“Do you have any children of your own?” I asked them,
“They feel like they are all our own!!” Aaron responds.
They really do love them.
And the children are so grateful, it really is a dream home for them.
They have been taken out of dire situations, and placed into a family of love and peace,
with two parents at home whose main priority is the children.


It was amazing to see.
Two faithful, loving people, with hearts committed for the glory of God, using their skills and talents to give hope and life to the full.
Gloria is excelling as a housewife.
She cooks, she cleans, she tidies, she loves.
I’ve never seen such a tidy house.
This is a strong and important statement!
In the three months we’ve been in India, I have not seen a tidy house!

Everything is clean, there are gorgeous potted plants on the walls outside, and hallways are swept and beds are made. Each child has their own bed!

Aaron, is a gentle, dedicated man with a gruff beard, with a heart that is humble and close to God. He is a good leader, and is trained as a teacher, and did some theological degree as well.

Things are organized, the children speak English very well, and they play so well with each other. It’s kind of like having a classroom... 15 children is a full-time job!

Aaron and Gloria’s vision is to continue to take in children and grow them up in the ways of the Lord. Their house has enough room for 20 children, so they can take 5 more.
But the house runs on donations and people supporting them, so they say,
when the money is there, we will take more children, if it is not there, then we wait.

They also want to have another house, but this one for HIV positive children, who have contracted the virus from their parents. These children will need more special care, such as a special diet to keep immune system levels high, and also being more careful with scrapes and cuts.

If they mixed the HIV negative and postive children together in one house,
the other children would become jealous because they wouldn’t understand why some where getting different food, and more special care.
Not to mention precautions with cuts, scrapes, and wounds.

So they are looking for a house so they can start taking care of the positive orphans as well.

Words cannot describe how hopeful and thankful I was when I met these two individuals, and their children they have taken in as their own,
using what they have to pour out a better life to these children.

I was so encouraged to see that there are people like this, who are dedicated and stay for the long haul, to be the mother and father to the parentless.

They don’t advertise their needs, or go on support-raising excursions,
they are just people of prayer, and see God provide the finance through a few families knowing about them and giving.
I was so excited to tell my friends and family back home about them, because I think it is a very worthy and trustworthy cause.

I don’t know anything about how much it costs Dream Home to live every month, or how much it costs to take in another child, as he wasn’t concerned about seeing us as white people to support their work. He didn’t even elude to it. We just got to spend time with the children, play with them, and be with them as a family.

But if you are interested in supporting them though, or
If you have been looking into wanting to give to something or something like this,
or want to learn more about them living life as everyday ministry,
I have his email, it’s
aaron.jakkula@gmail.com

I’m sure the whole family would be very encouraged by people they have never met,
from other nations and across the seas,
taking interest in them.
They are so cute!

Just had to spread the word about Dream Home,
a simple little house on the outskirts of Hyderabad,
with a whole lotta love.

Baby 22

....to be read in continuance with the previous story, “Explanation”.




I woke up to the hot morning with a sick ache,
a tightness in my stomach,
almost a shaking in my ribs.


Yet amidst the violent storm of the state of my soul,
glimpses and pieces of scripture flashed on the scene like something solid, an anchor.
.
Isaiah 65 ..... infants of but a few days.... Psalm 84 ... passing through the valley of tears... Psalm 23.... valley of the shadow of death.... 2 Corinthians 1....God of all comfort......

We had an hour in the morning before we started the day together,
and there in the hot stillness of my bed
I was searching these verses,
investigating their truths,
typing the thoughts and reflections...

It wasn’t so much me clinging to them,
as it was them wrapping around me and holding me like a lifejacket.
I still was in the water and feeling the waves,
pretty helplessly,
but the words of God were buoyantly keeping me afloat.

Here is what I wrote from that morning:


The Promise.

"For behold I create a new heavens and a new earth;
And the former things will not be remembered or come to mind.

But be glad and rejoice forever in what I create;
For behold, I create Jerusalem for rejoicing
And her people for gladness.

I will also rejoice in Jerusalem and be glad in My people;
And there will no longer be heard in her
The voice of weeping and the sound of crying.

No longer will there be in it an infant who lives but a few days,
Or an old man who does not live out his days;
For the youth will die at the age of one hundred
And the one who does not reach the age of one hundred
Will be thought accursed.

They will build houses and inhabit them;
They will also plant vineyards and eat their fruit.

They will not build and another inhabit,
They will not plant and another eat;
For as the lifetime of a tree, so will be the days of My people,
And My chosen ones will wear out the work of their hands.

They will not labour in vain,
Or bear children for calamity;
For they are the offspring of those
Blessed by the LORD,
And their descendants with them."

Isaiah 65:17-23



Today I woke up clinging to this promise.
There is a time that is coming.
There is a time that will come where there will be no more sound of weeping,
there will be no such thing as a child that only lives for a few days or a few hours,
and there will be rejoicing.

Families will be able to build and plant, and eat the fruit of their hands.
They will not be subject to another people,
they will not have their vitality taken from them,
they will be able to live so long and so full that
they will wear out the work of their hands.
The sturdy chairs they have made, their quality garments, the stable houses.
All these things will become love-worn, used to the maximum, used to be a blessing for generations to come.

And women will not labour for nothing.

They will carry life to the point of delivery.
They will bear children who will grow up strong,
valued, loved,
and knowing the deep love of God
that transforms.

They will be influence-makers,
exhorters,
watchmen,
watchwomen,
fierce for love,
passionate,
movers of the Kingdom,
bringers of heaven to earth,

and their descendants with them.



Raw journalling in the morning....
Psalm 84, verses 5-7

How blessed in the man whose strength is in You,
In whose heart are the highways to Zion!
Passing through the valley of Baca,
they make it a spring;
The early rain also covers it with blessings.

They go from strength to strength,
Every one of them appears before God in Zion.



notes from my Study Bible, page 805:
valley of Baca: “Baca” can be translated as “weeping” or “balsam tree”. The valley was an arid place on the way to Jerusalem.
they make it a spring: The pilgrims traveling to a festival of worship at Jerusalem turn an arid valley into a place of joy.
from strength to strength: Anticipation of joyous worship of God in Jerusalem overcame the pilgrims’ natural weariness in their difficult journey.



Psalm 23

Even though I walk through the valley of the shadow of death,
I fear no evil,
for You are with me;
Your rod and Your staff, they comfort me.


Study Bible notes:
rod and staff: The shepherd’s club and crook are viewed as comforting instruments of protection and direction, respectively.


2 Corinthians 1:3,4

Blessed be the God and Father of our Lord Jesus Christ,
the Father of mercies
and God of all comfort,
who comforts us in all our affliction
with the comfort with which we ourselves are comforted by God.
For just as the sufferings of Christ are ours in abundance,
so also our comfort is abundant through Christ.


***



It was time to go to the Hospital.
I didn’t know if I was ready for this,
but at the same time, it was the only place I wanted to be.

When we gathered outside with our bags, regrouping to sort out money for the rickshaws and lift up a quick prayer for the day, I was sitting on the concrete with my bag, and
I knew I had to speak up...

“I just wanna ask for prayer...
I’m still feeling a bit shaken up from yesterday.”

My team came around me and prayed out strong prayers, undergirding me with support,
and resisting lies that it was my fault,
or that I’d never want to be a midwife again,
and tears started to rim inside my closed eyes.
I was so on edge and fragile,
that when they were done I could hardly whisper,
“Thanks.”


“Fifi, why don’t you pray out.”

I knew that was what I had to do,
but it was the hardest thing.
There was some silence for a moment
as I didn’t even know where to start,
and as soon as I began to pray,
each word was laced with brokenness and tears.

I prayed for Balamani and her state today,
waking up in Postnatal,
with milk but no baby,
I prayed for her family,
I prayed for myself
and the very weakness I was feeling,

I prayed out not understanding,
I prayed to focus on God’s Truth,
and to trust Him for a
good
last day...
“...whatever ‘good’ means in Your eyes.”

Amen.


My mascara was fully off of my eyelashes and on to my cheeks,
and Rachel did the “mom thing”, and rubbed it off with her fingers.

On that note,
we left.


The labour room was full.
and even though I was on familiar ground,
I treaded softly from place to place,
well aware of the thinness of the state of my soul.

But as I think about it now,
in my weakness,
God truly was being such a perfect strength.

It was 10:25 am.
I was just washing my hands with the hospital bar of red soap by the window, and Rachel walks up to me.

“Do you want to do a delivery?”

“--Yeah!”
Nothing like getting right back in there!


A gentle, fair faced Muslim girl is laying on the bed.
She has big gorgeous eyes
with long thick eyelashes that were so cute!

When she would look
innocently over at me,
blinking and fluttering her dark,
naturally fluffy eyelashes,
she reminded me of a sweet little
storybook jersey cow named Buttercup.

I introduced myself to her, and gave her a big smile.
Rachel was with me,
we looked at each other and knew what the other was thinking.
First thing we did:
check the fetal heart.

I tried with my stethoscope,
couldn’t hear anything.
She tried with hers,
nope.

Classic.
It’s so common to not be able to hear it close to delivery,
because the baby is making its way down and in different spots, manoeuvering through bones, etc.
I wasn’t worried, this usually happens,
especially if you only have a stethoscope to listen with... it’s harder to pick up.
So we just believed the baby was alive and well and descending,
and spoke out in faith that everything would be okay.

The mother was calm and strong.
Her name was Hameeda,
19 years old,
first baby.

She pushed well, she stretched well,
I had to do a little episiotomy to help with the end,
but the baby came fast,
and as soon as the head delivered,
the baby opened its eyes!!!
The cord was loose around the neck,
we did a little manouevre and slipped the baby through,
the shoulders turned and restituted nicely,
and out she came,
a beautiful baby girl at 10:45.


As soon as she came,
the Lord started to speak Promise to me.
It was just like yesterday,

A baby girl.
2.75 kg.

But this one was
alive, active, moving.
This one had life in its limbs,
a cry in its chest, colour in its face.
What a difference Life makes in a body!


Yesterday,
it was a baby girl,
2.8 kg.

Same gender, same weight.
Parralleled beside each other in my mind.
Wow, God.

What an interesting way to redeem the last day.


There was a rest, and a joy, and a sense of peace after the delivery.
The mother was shining and relaxed,
and she had no complications.
Very little blood loss, uterus contracting well.

The baby was quite possibly the cutest baby I had ever seen!
She was moving and kicking and looking around and being a darling little girl.

As I doted over her and prayed for her,
I just kept firmly hearing the word
“Promise”.
and “Hope”,
and newness.
I was praying for a name, though,
and nothing was fitting,
then finally, it came.

Daisy.

It was the only name that fit.
And it spoke of new life and promise, and the hope of spring flowers!

And then I realized that I had made one more baby hat,
it was blue with a little frill for a little girl.

I put it on her head and she looked like a little bluebell flower!


She was my little flower child,
my last delivery,
and promise of newness and life.





The Lord brought me full circle through that delivery.

He brought things to
a fullness and completion,
and healing
in my experience of birth.

It was such a good last day.


The mother had an episiotomy, (which I gave),
and she also tore some as well.
So I sat there with a headlamp and the suturing kit
and did my most complicated suture.
7 stitches,
with 3 different suture lines.

It felt good to be able to finish off the time at the hospital doing a skill
to the highest complexity you’ve done it.

I also put in an IV line without a single drop of blood (which is very satisfying way to end off!)

Everyone had a good last day,
a day of rising to our skills and knowledge of the past 7 months, and
doing them well.

We had a lengthy goodbye, and some final photos,
packed our bags for the last time.
Walked the hallways for the last time,
and wore our “labour room punjabis” for the last time.

We came home, exhausted from the heat and the traffic,
washed my clothes
and gave my labour room shoes
a good final scrub.


It was a long day, a satisfying day,
a thankful day,
and things
felt --
complete.


thank you Lord.

Explanation

*DISCLAIMER: this story is intense.


Baby 21
April 14, 2010

“I wish I had an explanation, but there is none to be found.
When we first discovered something was wrong,
it was already too late.”




I walk in, there are no nursing students.
Today is a holiday.
The power just went out and the hallway is dark.
There are squirming babies filling the newborn room, exhausted mothers in various states
(on stretchers, on the floor, leaning against the wall, in wheelchairs) waiting to receive their babies.
I walk through all of this
and am aquainted with the coziness of a busy day in the Labour Room.

I walk in, and I am drawn to a certain girl with a burgundy sari top.
She has dried blood caked down her hand and forearm,
from what looks like an unsuccessful cannula attempt.
She is hooting and hollering,
and her contractions are tight and strong.


Her face is dark, and moist,
and a scar of a double nose ring indents her left nostril.
One gold stud remains on her right side.
Her eyes are small, but her eyelashes are long, and signs of age have set in around her eyes... even though she is only 23.
She wears a tight burgundy sari top,
the clasps are bursting at the seams trying to accomodate her ever-growing pregnant chest.
She labours in a sari skirt the colour of a Hyderabad sky,
faded blue-grey,
stained with varying states of fresh blood.
Her arms are bare
except for the dull jingle
of a few orange plastic bangles on each wrist.



She locks eyes with me and asks for pani (water).
She is hot to the touch,
and I look for a communal water bottle,
but none can be found.
Finally I see one among some steel bars in the corner,
but when I go to the sink,
nothing.
The power is still out.
The hospital generator has kicked in,
and provided lights and electricity to turn the ceiling fans,
but the water is still not flowing.

I put on a
too-small
resterilized,
re-powdered glove
from the glove tin,
grab some cotton wool and go to a reserve tap in a different room to wet it slightly.

This is our first encounter.
I cleaned her hand, and she held mine.
I told her my name, and I stayed by her side the rest of the day.

The labour room is full of colourful sounds, and bustle.
I then think to myself, I could do this for the rest of my life.


A group of white-coats came in.... students in their early twenties,
that look very official,
much more official than us,
but are 3rd year medical students who have lots of textbook knowledge, but hardly any practical experience.
They hover in clumps,
watching, timid,
and occasionally flip through thin medical books they hold under their arm.

I have the labouring girl turn on her side, and I rub the small of her back.
5 of them attach themselves to me.
Excuse me,
what are you doing?

I explain to them that applying pressure to her lower back, coccyx, hips, etc. eases the mother’s discomfort as the baby descends through her bones.
We talk a lot,
they are eager and shy,
yet willing to learn.
They ask many questions,
and they get to feel a contraction for the first time.
We time some together,
and they get to learn with their fingers what a tight contracted belly feels like.
There we stand,
5 white-coats and myself,
six sets of fingertips on this large belly as Balamani sings a note of pain.

They smile timidly,
and their faces are soft with learning.
“We wish our teachers were like you.”
They freely ask questions, unintimidated,
encouraged and empowered.
Sometimes they ask silly questions,
innocently, such as:
“What does this mean that she has strong contractions?”
“How do you know when she will deliver?”
Things I would have assumed they would know, but hey, it’s great to be the one to explain it for the first time.

Her temperature is high, and the madam (doctor) permits me to give a paracetamol injection.
She’s burning hot on her skin,
but has now switched to shaking and shivering.
How terrible: to be in active labour, AND feverish.

Telagu sentences sputter out in long fluid bouts...
the students translate:
“She wants an operation,
she cannot bear the pain. She cannot bear it.”


Another birth is taking place,
and most gravitate to that one,
so there are about 12 white-coats peeking their heads over each other’s shoulders as this woman screams and pushes.
One of the guy students’ face drops,
and he steps out and goes for a little walk outside.
I forget how intense it is,
especially for first-timers, (I fainted the first time I saw labour in Africa!!)
and probably especially for guys.... this foreign thing called birth.

I look over and one of the other guy students is right at the bedside,
and holding the pushing woman’s hand as she sqeezes it tight..
He’s encouraging her,
and being very nice, and smiling. wow!
Don’t see that often.
Actually, I don’t think I’ve seen that --- ever.
The other white-coats keep their distance,
and have a deer-in-the-headlights look.

My girl, Balamani, wants to get off her bed.
She’s a character, that one.
She wants to stand and move around, and I don’t blame her.
She’s not close yet,
maybe 5 cm dilatied,
so she’s got some time to go.

I help her reach her toes to the ground from the high steel bed (she’s probably only 4’11’’),
and with her massive belly, she is quite the sight to see.
She has polyhydramnios,
which means she has an excess of amniotic waters.
That’s why she’s so big.

She wants to go out of the labour room.
I can see a woman in the crack in the doorway, watching her.
I’m guessing it is either her mother or mother-in-law.
She is a tall woman, she waves and me and smiles,
and puts her hands together in the “Namaste” way. She seems nice.

Balamani makes a few steps towards the door,
but gets the sharp hand-scoot gesture from her mother at the doorway to say,
“Don’t come out here,
go back to your bed and deliver!”

While directing Balamani away from the door,
her knees slowly give out and she finds her way to the ground,
and prefers the cold, dirty tile to her steel bed.
She lays right down against the wall in the corner,
and I’m not going to be the one to stop her...
she’s in labour: she can do what she wants.
She’s moving from sitting to laying to standing,
using gravity to get things going; I think it’s great!
I think I’ll be a mover-arounder too!

The white-coats are watching, in amazement,
and I’m kneeling down,
consoling a fiesty,
tiny,
big-bellied woman on the tile floor.
Not your typical “textbook” labour, eh?

But after some time,
we do need to hoist her up again, and she reluctantly complies.

She’s in a lot more discomfort up on her bed,
and she’s howling, moving around.
But soon she pulls it together, and comes into a strong focus.
I feel her belly, and there are contractions
but all she is doing is closing her eyes.

She has calmed down now.

Getting it together, while still slightly writhing on the bed.

After some time, the white coats get the cue from their instructor to leave,
and the darling one with the paisley scarf wrapped around her head thanks me again with a brightness in her eyes
and off they go.


Balamani starts to get off the bed once again, but we try to stop her.

She eventually gets on the ground again
leans up against a piece of wall right in the middle of the room
and she closes her eyes, nods off for a few seconds only to open them again with a burst of dazed awareness.

She must be so tired
she wants to sleep but her baby wants to get out...

she shifts to a different patch of dirty floor,
I hold her up and help her try to rest,
she’s quiet now,
even through the tightness of contractions
her head falls back into me, and she has glimpses of sleep.

it has been quite some time that she has been sitting on the dirty floor,
and we’re all kind of anticipating the madam to yell at her.

But the madam that sees her is a nice madam,
and nicely asks her to get up.

so with a burst of cooperation, Balamani energetically gets up on the bed, and the madam checks:

fetal heart: present.
dilation: 70% effaced, and 7-8 cm dilated,
0 station.


They give her some epidocin to quicken the effacement, and hook up an oxytocin drip.

Baby’s coming soon, now.

Everyone’s going to lunch, it’s almost 1 oclock.
I don’t want to miss this one
I don’t want to leave her

I get told to have lunch as quick as possible to be able to come back.

i put away my things and go back quickly to tell Balamani I’m leaving to eat but I’m coming back.

An intern doctor then scoops me up and asks me to be the tourniquet
for a cannula for another patient. So my hand is clenched around another woman’s wrist and I see Balamani across from me.

Balamani gets off the bed again
but now she has an IV drip so she can’t go anywhere
she’s standing, with her huge belly and her tiny stature, having contractions --

at this moment
I am standing across from her, holding onto a different woman’s arm as the doctor inserts a cannula.

It is then that I see Balamani’s mother, or mother in law
seeing the absence of visible doctors,
burst in to the labour room,
with a terrible
angry face
muttering things under her breath
gives her a forceful whap on the back
lifts her up by her back
squeezing her belly
barely reaching the edge of the bed
Balamani’s hips pivot on the high labouring table
and with the force of the mother’s push
and her own momentum falling
backward
she falls smash backwards into the steel railing.

I gasp in absolute shock and what just happened.

Oh
My goodness.


The mother gets forcefully ushered out

and Balamani lays quiet
as though nothing happened.


With that moment seared in my mind,
I take my lunch, stunned, and
absolutely horrified.

It’s like her mother wanted her to deliver
and stop fooling around
but this was total
abuse.
Balamani fell so hard backward,
and hit the back of her skull on a steel railing.
This is not okay.


I take some quick food
and within the first few minutes of eating,

Betty comes up to me,
“Rachel wants you ---run!”
I take my water bottle,
leave everything else,
and walk/run as swiftly as I can down the dark dusty marble floors...

Rachel is standing with her,
“She’s going to deliver, the head’s coming ---
get some gloves on Fifi,”

The head is starting to show
my tutor Rachel feels the heartbeat with the stethoscope
it’s fast, (a sign of distress) but it’s there.


Her skin is really tight,
but she is a G2 (gravida 2.... meaning this is her second pregnancy) so she should be able to stretch enough... her body has delivered and done this once before.


I reach in and feel the bony edge of the baby’s head not yet there yet, what we’re seeing is a little bit of caput.
But the skull has yet to pass through
she’s really tight.... is she going to stretch?

She’s pushing and I calmly smile back, good job mama...

More of the head starts to show... this is really painful for her! ouch...
You can do it, mama!

My tutor tries to hear the heart again with the stethoscope,
this time she can’t hear it,
but it could have just been the end of a contraction,
or the wrong positioning...

a little more of the head is showing, and I see a small piece of white-jelly-something at the top, right against the skull of the head.

Is that cord?

I’ve never seen that before, but it could be a part of her anatomy being blanched white from pressure... it’s unclear.
We try to push it back in, but it still is pinched between the skull and the birth canal.
She is taking a long time to stretch... it’s been a few minutes now.

“Should we do an episiotomy?” I ask.

My tutor thinks for a second.
“Well, she’s a G2, she should stretch... I think she can do it,
let’s not cut.
She may tear a little, but that’s okay.”

Balamani’s giving some good pushes, but there’s still not “fast progress”, the head has been at the perineum for 3 -5 minutes...
time is a little unclear in moments like this,
and finally we see some really good descent.
This is it. Here it comes..
Things seem to be fine,
we’re both calm and expectant.
I don’t think twice about not having heard the heartbeat the second time, this usually is the case when the baby is coming down,
you just can’t get a clear sound in between all the muscles and bones of the descent.

I’m trying my best to keep things intact,
she is starting to stretch,
but as the head is finally coming all the way through (she’s screaming...)
I can see her skin get very thin and start to slowly rip under my fingers.

Head is out.
Baby is bluish,
and there is a little bit of blood from its nostrils.
Uhh...
we feel for cord around the neck. No cord.
We need to get the baby out though,
the bluish colour is not very good.

We ask the exhausted Balamani to push once again;
the shoulders are not turning properly,
and we can’t figure out which way the baby is turning.
The baby is just staying straight...
finally there is some release on the right side,
and then the shoulders and trunk just kind of come out straight,
instead of properly turning to the side.

As the trunk comes out,
I can see the body is quite blue,
and there are some white patches on the shoulderblades and back where there’s been pressure on those spots and lack of circulation while coming through the birth canal.
The body slips out with a little bit of a pull.

Out comes a flood of hindwaters.
Polyhydramnios, that’s for sure.
The baby lies limp on the table.
But lots of babies don’t have good colour at first.

Suction!!

We suction the mouth,
the nostrils,
not much seems to be coming out.
Now for the tactile stimulation.
We rub the baby’s head, back, trying to get things going...
come on baby!! Wake up!


I feel the chest, there is no pulse.
I’m trying to feel for any kind of beat,
but I can’t feel anything.
I feel the cord, there is no pulse.
What??

“Feel at the stump of the cord, at the belly button!”
My tutor says with alarm.
She’s rubbing the baby’s back vigorously.
No expression,
no grimace,
no muscle tone.

I feel the base of the cord,
nothing.
“Stimulate the feet!”
I’m flicking the baby’s limp blue feet,
trying to get some kind of response,
nothing.
This baby needs help.

The cord is cut,
the sex is shown to mom,
“Babu or Papa??” (boy or girl)

The mom lies, shocked, and quiet,
and answers,
“Papa.”
This is the first time she sees her child,
held in a tight grasp by my tutor,
non-responsive, and blue.

“Papa.
Right,
okay,
this baby needs to go.”
And with that she whisks her away with fast steps to the newborn room down the hall for rescusitation.
“Fia stay with her!”

So here I am, standing shocked.

No heartbeat?
But we just heard it 5 minutes ago.
She’ll perk up. She has to!

I smile to the mom,
and tell her she did a good job,
but there is not rejoicing or relief,
rather, a tension in the air....
a waiting,
waiting to hear the report.


I want to just run from my spot at Balamani’s bedside,
and run down the hall to be with the baby.
I want to do rescusitation!
I want to be praying over the baby and seeing her perk up,
seeing her respond to the puffs of air filling her lungs,
the chest compressions to restart her very recently beating heart.

But my feet don’t leave their place by Balamani.
I need to stay with the mother in to monitor her and check for bleeding.
I give her the oxytocin injection to help the uterus contract
and wait for the placenta to come.

I am praying in my place,
still in quite confident hopes that the baby will revive.
Any second now,
my tutor will come back into the labour room with a sigh and a smile,
and we’ll look at each other and be at ease.
We’ve seen it so many times before;
babies with rough deliveries,
start to cough and respond and squirm and grimace...
this delivery wasn’t very rough,
it was normal, and this baby’s heart was beating all day!

During those long hours of labour,
placing my hand on tight belly,
feeling the strength of contractions,
I would feel the baby kick under my fingertips.
She’s gotta be alive.

I am still standing there,
waiting.
It feels like no one is around.
The ward doctor is out,
and there is one intern doctor attending to some things.

Waiting for the placenta to come,
waiting for the good news.

Balamani lays on the table, watching me,
and I carefully deliver the placenta.
Good, no extra bleeding.
Thank you Lord. Mother is okay.
I check the tear of her broken skin. Not too bad. Will only need a few stitches.

My tutor walks back in,
but her face is expressionless.
She shakes her head, and looks blankly at me.
“No Fia.
She’s not alive.
The baby’s dead.”
She puts something away, and then leaves again.


What?....

This can’t be.

My face falls,
and Balamani is looking at me,
but she still doesn’t know what is going on.

She’s asking me something in Telagu,
but I don’t understand.

I feel so helpless.

I wanted to be part of the rescusitation,
I want to know the details!
I want to know WHY!?
HOW?


My tutor comes back in,
doesn’t say much,
but confirms again to me that the baby is dead,
it was not alive when it came out,
and asks if I have taken the mother’s vitals.

“No, I just finished delivering the placenta.”

“Okay. So take your mother’s vitals.”

Everything becomes surreal,
as I remove my bloody gloves and take a few steps to find a blood pressure cuff.
I take the mother’s blood pressure,
pulse rate,
breathing rate,
temperature.

Balamani is watching my eyes,
my face,
and I’m trying to be neutral as I stare at the blood pressure gage,
listen for the pulses,
go through the motions of taking vitals after a delivery.

I am in such shock.
I don’t understand.
I do not understand.
And here I am waiting for a thermometre to beep on a mother who doesn’t know that her baby is dead.

This delivery was filled with such joy and expectation.
All day, I was with her.
All day I was the one who was with her in labour,
made sure she didn’t get yelled at when she wanted to lie on the floor,
I was the one who held up her head when she was falling in and out of sleep between contractions.
I was the one who cleaned her hand and stroked her hair,
who gave her water and massaged her lower back when her bones hurt.
And I would be the one to rejoice with her at her vigorious,
kicking baby as she entered the world...Right?

We could hear the baby’s heart before.
We couldn’t hear it a few minutes after,
but it was in the intensity of pushing, and descending... so naturally one wouldn’t be alarmed.

The mother was tight,
the baby was held back because her skin was not stretching as fast as it could have,
and it took a few minutes,
but not that long, before the baby was delivered.
This is normal.
There seemed nothing to be alarmed at during the birth.

NO heartbeat?
Not even a trace?
Not even a slow heartbeat that we could work with and stimulate and bring it back to a good pace?

How can a heartbeat go in 5 minutes??

So the heart stopped in the birth canal?
What?
How?

Did we do something wrong?
Everything seemed normal,
I don’t understand.

The vitals are done,
I walk swifty to the newborn room, and find my tutor there.
The baby is laying in a tray, already on the stillborn shelf.

“What happened?!”

“The baby is dead.”

“We can still revive her ----”
I lunge toward the tray...
“---Did you do compressions??”

“Yes, we did.
Nothing happened.
She didn’t respond to anything.
She never had a heartbeat. She didn’t respond to bag-and-mask,
her lungs never filled with air, even with air being puffed into them.
She’s dead.”


I open my mouth,
and pause--- and ask the unimaginable question:



“Did we kill the baby?”



“I don’t know.”

“I don’t understand---

Should we have cut an episiotomy?”


“I don’t know.”


And then a true, heavy sinking feeling set in.
Feeling shocked,
confused,
responsible,
but not knowing what we did wrong,
or if we did something wrong.
But now the baby is dead,
the mother is on the table
after hours of pain,
feeling the kicks of her unborn daughter,
suffering abuse from her mom,
feeling exhausted,
sleep deprived,
pushing hard,
skin tearing,
much labour,
and her baby somehow died in the final moments.

I don’t understand.
What is the explanation?
So much is unknown.

I remember that piece of white something looking wedged between the baby’s head and the outlet.

“---Do you think that was cord at the baby’s head?
Was it getting pinched off and stopping blood supply?
Do you remember it?”

“Yeah,
I don’t know Fia.”

So much is unclear.
Can anyone give an explanation?
Can anyone tell us what happened?
Did we do something wrong?
What could we have done?
Should we have cut?
If we had cut an episiotomy, the birth would have gone maybe 2 1/2 minutes faster. Is that enough time to make a difference?
Would that have even had made a difference?
Was that small piece of white peeking out, a glimpse of the cord slipping down and getting dangerously squished?
If so, how long was it getting squished for?
If so, by then it’s too late because the pressure is so forceful to be able to push it back behind the head.

Can anyone give an explanation?

Why is the baby dead!!??

Why did she die in the last 5 minutes??
Babies take about that time (or longer, especially first-time births) to stretch the skin and come out naturally.

Why could she have not been revived?
Why didn’t her lungs even fill with air when there was air pushed into them?
Was something wrong with her lungs?


This is too much.
I’m a student midwife.
There is so much I don’t know,
I’m still learning!

I did everything in my knowledge that I could.
And when I asked about doing an episiotomy, I was told, no, just let her stretch, she’s a G2.
Well,
what, then?


I looked back on her notes,
and on her case sheet it said on the front:
“polyhydramnios”
Meaning, excess amniotic fluid.
Which was quite visible;
she had a very distended abdomen,
when she was labouring,
her belly was so full that it looked like
she could even have twins in there.
But it was just a lot of fluid.

What I learned later that day was that with polyhydramnios,
there is risk of cord prolapse,
meaning the cord dropping down infront of the baby and then getting squished by the body on the tight way out.

The cord is the life line for the baby.
As it pulses,
it provides fresh blood, fresh oxygen.... if the cord gets pinched,
the baby will go into distress
as it cannot last long without oxygen.

So it could have been cord that I saw,
partial cord prolapse,
dropping down to the level of the head and then getting lodged there as the head was crowning.
That would pinch off the blood supply in an instant,
and suffocate the baby pretty quickly.

I checked the mother’s anatomy in the same place where I saw this glimpse of cord-like substance,
to see if it was part of her own make-up or not.
Nothing seemed to be there now,
so it could have been partial cord prolapse.

But we’ll never know.
There’s no way to know because we can’t see what’s going on inside as the baby’s coming down.

But what could we have done?
If the cord was being pinched right from the get go (remembering the fast heartbeat at the beginning) The time to do an episiotomy is only right at the end, not while the skin is still stretching naturally. By then, the baby could have been already severly asphyxiated....
there is just so much unknown.

And I don’t like it.

I don’t know what to feel.
I feel like I am responsible... but it is unclear for what.
I don’t know what I could have done differently.
I followed orders, I was supervised,
and yet the baby came out, unable to be revived.

So many thoughts are racing through my head as I stand beside Balamani’s bed.

An intern doctor comes over, all capped and gowned in blue.
You can only see her eyes,
and her voice is a little muffled under the thick cotton mask.
She puts her hand on the steel railing of Balamani’s bed,
leans over
and speaks down to her in
a matter of fact way.
She says a few sentences in the tone of voice
that one would deliver a casual message.

Balamani’s eyes change, her mouth stays open, she lays there, unmoving.

“What did you tell her?” I ask.

“I told her that her baby is dead.”


Then she goes, off to tend to other business.


I can’t believe this is happening.
This all feels so surreal. So not real.

Well,
what do I do next.


She needs to be sutured.

So I make sure all the supplies are there,
the lamp is already set up,
I put on my glasses,
mask,
new sterile gloves,
move the steel stool in close,
and it screeches against the tile.

As I am suturing her, I feel like I am just
going through the motions.
Doing what needs to be done
focusing on the task at hand
infiltrating with local anaesthesia
stitching one stitch at a time
knotting wrapping
cutting the loose ends after the knots

blinking behind my glasses
breathing hot breath through a surgery mask

Balamani is laying still on the bed.

Thoughts are racing through my head,
but my movements are calculated and slow.

The last stitch is done, the last knot is pulled, the last thread cut.

I put the instruments down on the tray,
and sit motionless.

Blinking slow, breathing silent.
The big incandescent suturing lamp still burns hot by my face
and I stare blankly
at the broken skin that has now been restored
and ready for healing.

One of my classmates is standing there.
watching,
and rubs my back without saying a word.
I say nothing,
I am in disbelief,
I close my eyes, and I want to cry.
Actually, I want Balamani to have her baby
In her arms,
alive.

Waves of grief,
of unimaginable loss
are stirring inside.


I tell her it is finished.


She slowly sits up, slowly easing her way onto the pain of the fresh stitches.
As she gets up from the bed, I see the remnants of delivery;
There is blood all the way up her back.
Drying on her skin and seeping patterns into her burgundy sari top.

The daima brings in the tray holding Balamani’s baby girl.
The daima holds the shallow tray with two hands,
like one would hold a tray of cookies,
and they confirm the identity on the handwritten tag tied to the little girl’s wrist.

The baby lays on her back,
her eyes are closed,
she looks perfect,
but she is cold,
blue and lifeless.

Balamani’s stare does not break
as she beholds her little girl,
and then the lady walks away with it.
She shows the family at the end of the hall,
there is sorrow and shock,
her husband turns away.
He doesn’t want to see his baby girl in a tray.


Another daima brings a folded sari and underskirt from her family.
Balamani’s other sari is wet and dirty and in the garbage bin.
She steps into the underskirt,
ties it around her post-baby belly,
and stands there barefoot,
on the dirty tile by her bed,
still wearing the same bloody sari top,
and slowly wraps her sari like she’s done a thousand times before.
She carefully does the pleats with skill in her fingers,
tucks the folds
and swings the fabric over her shoulder.


Her hair is still a mat of tangles;
the strings by her face mixed with sweat and coconut oil.
I walk slowly with her to the door where there is some family peeking their heads.

She talks with them briefly in the dark hallway,
and then returns to the ward.
I help her up onto the dirty metal stretcher
and she lays in the hall to wait
with the 2 or 3 other women who have just given birth.

I take her vitals once again,
and my eyes start to sting
as I fumble with my thermometer and my notepad
my face starts to break
and I cry with her silently in the hallway.

I wish I had an explanation,
but there is none to be found.

When we first discovered something was wrong, it was already too late.

I pray with her and hold her hand.
I pray for her protection,
from shame,
from confusion,
from feeling like she did something wrong,
from her family and the opinions and judgements,
I pray that she would heal,
and her next baby would come to the point of delivery.

My voice is weak, and soft and raspy, and my lips are trembling from talking through tears.

and she looks at me.



***
The rickshaw ride home was surreal,
the warm wind in my face,
the weaving and dodging of motorbikes, buses, people...
I just sat looking out at the things passing by,
my head still full of unresolve.
It was the worst day.
It was not how I expected my second last day at the hospital to be.

The rest of the night was a blur...
it was Wednesday, the night where we take different hours to pray throughout the evening. (we’re plugged into part of a 24 hour prayer chain)

After the hour that I was alotted for with some of the other girls,
they left,
but I felt such a burden to stay in the prayer room.
I felt like there was an anchor keeping me there
and I knew why God was prompting me to stay.

So I sat on the bench with the hot fans whirring around me,
crumpled into a ball with my knees to my chest
and I cried
and cried
and talked to God honestly
and cried
and prayed
and felt
as if
I was
breaking.

45 minutes later, I came back to my room at 11:15 pm,
and everyone was asleep.
I got ready for bed in the dark, filled my bucket with water,
wrung out my sheet,
and tried to fall asleep.


**
I was lying in bed that night,
and my mind was a fast-slow scatter of tension and release,
of sickness and promise, the thick heat of the night and the thinness of my sleep
forcing me to wake up,
only to be made concious of the constant thoughts racing.

Flashes of reliving the horrific moments of the day;

her falling backwards and smashing her head on the steel rail,
her mother abusing her,
the full term, strong baby girl,
blue and lifeless
the feeling of a non-pulsing cord between my fingers
frantically flicking the soles of her limp blue feet

this is how my sleep was.



**to be continued.... see next post, "Baby 22".