By the way, I am in Davao City, Philippines. I guess I needed to make that more clear at the beginning of my blog, and throughout for those who are jumping in, in the middle.
I arrived 6:00 am, on shift, sleepy and half hoping all would be quiet until I woke up. (wasn’t sure when that was going to be…) 2 scrambled eggs and a piece of apple were not enough to get rid of the groggy feeling in my brain. I think that the go go go go schedule is catching up with me, after all I am 43! I did get 6 hours sleep last night, so I am very thankful for that.
No sleeping allowed. An active labor was endorsed to me. She was a G 5 P 4. That means that she was pregnant with her 5th baby and has had 4 live births. Anyway, I was lazily hazing through her last birth history and saw that she went from 5 cm to crowning in 1 hour, last time. Yikes… I jumped off the couch and went to see how she was doing.
I took one look at her and proceeded to set up my birth cart and oxygen tank. She was progressing fast and I decided to just plant my bottom in a chair and to sit and wait. Her BP was rising, (160 / 90 ) and I was really hoping she would just spit this baby out, as I really, really did not want to transport. Felt like I was watching a race against her rising blood pressure and the birth.
5 minutes later, BOW (bag of water) was visible… and then baby crowned and then she was out. Baby looked terrific. Apgar 9 / 9. She was just barely 6 pounds and really cute. Here is a picture.
Placenta came 10 minutes later. We did give mom a pitocin injection, because she was anemic and I didn’t want to chance her bleeding and running out of juice with all of those little ones to care for at home.
It is interesting getting to know the woman of Davao, Agdow district. In this particular family, (as in many others I am working with) they are not officially married with paperwork. It is very expensive here. Her bana is a laborer. Probably one of the cement workers that are building a new retaining wall for the ditch full of water down the street. It is very hard work in the sun, and it is all done by hand, mixing, carrying and everything. This particular birth cost the family 450 pesos which is about $5.00. They looked in dismay at the bill. I felt so badly. I would love to just pay for the births out of my own pocket that I do here (after all, I am the student and they are the victims….) but it is not allowed. It is so obvious that this lady loves her bana very much, in fact is giving her little daughter his last name, and hers, thorugh they are not officially married. The woman are called on the birth certificates (housekeepers).
After mom has recovered for about 1 hour, we get the moms up right away to the CR (comfort room). That is if they have not lost a lot of blood and are dizzy. The mother then walks to the CR and pees, then squats to clean herself off with COLD water. The toilets do not flush here either, and as in many 3rd world countries that even have toilets, a big bucket is kept near by with a scooper to “flush” when you are done. Toilet paper must not be put in the toilet either, but placed in the trash. All of this effort must be really hard so soon after giving birth, but they want the moms to empty their bladder as soon as possible so that the uterus can contract well.
Mom is brought food in by her bana or banti (mother-in-law), or aute’ (sister). She eats rice and a piece of chicken or vegetables. There is a sari-sari stand that sells food for bana’s to buy, along with fruit, coke, adult diapers and baby diapers. As soon as she eats, we give the baby a bath, complete with soap.
The bath is actually a blessing to these families, as many do not have any way to bathe baby at home. Most cannot afford diapers and just use pants. If they do use diapers, they keep them on them until they weigh a ton. I bought a big bag of baby diapers to share with my moms when they go home. I just give them a slug of them and they are so grateful, it makes my heart ache.
Then I do a complete newborn, I give the baby a vitamin K, and Hep B injection. Then the paperwork begins. I am still pretty confused about it all, but I am doing better. Mostly because of all the details and some of the forms are written in Visayan and I don’t read Visayan yet. So I invariably get something wrong on the birth certificate or something.
I can relax a little now, as I keep an eye on them until they are ready to go home in about 3 hours.