Saturday, December 18, 2010

G6! G7! G8!

Akur with her new boy.
Three ladies have come to deliver in the last three days. The first one was a G6 (“gravida 6” meaning she’s pregnant for the 6th time). The second was a G7 and the last a G8. They are all prenatal regulars and I’m so glad they came in.

The first one, Akur, came just 30 mins after my plane landed. She delivered an hour or so later on her knees but tried to fundal pressure her placenta out. I kept insisting she not do it and she kept insisting she should.

(Fundal pressure for those who don’t know is the pushing on the top of the uterus to expel the contents. It’s painful and dangerous as it can cause hemorrhage and/or uterine prolapse. Risky.)

She explained she needed to ‘bleed a lot because the blood is causing all this pain. It must come out.’ I told her that the blood was keeping her alive and she should not do anything to her fundus (top of her uterus) and certainly NOT do fundal pressure in the squatting position as there is a risk of uterine prolapse.

We debated the benefits of not dying or hemorrhaging for awhile. Once it got a little testy but eventually we were able to come to an agreement. She wouldn’t do fundal pressure but I would do CCT (controlled cord traction) to help pull the placenta out. It worked like a charm and she was breastfeeding in no time. We were able to laugh about it later--Thankfully.

Once she was finished, Gai came in. She was expecting her 7th child. She has quick deliveries so I asked her to come in early labor. She did. I wasn’t sure how fast she’d go, so I got her settled in for the night. She quietly sat outside in a chair and watched the ‘goings-on’ at the clinic. (We were hustling around getting an anemic girl transfused - or at least trying to. Read her story here.)
Gai and her newborn Son and young son behind her.



I checked on her regularly but I couldn’t even tell she was in labor. She didn’t writhe in pain. She didn’t contort a face. She didn’t even breathe heavily. She just sat there calmly and watched the circus act.

She called me a while later saying the contractions were more painful, so I did a vaginal exam. She was already 9 cm dilated. So, we set up the delivery room and waited. Her contractions were short, so I encouraged nipple stimulation and they picked up like a charm. Within 30 minutes she was ready to push.

I asked her at one point during transition if she needed anything. She responded, “I don’t need anything because I’m going to die!” We all had to chuckle. She was far from dying. In fact, I was still having a hard time believing she was 9 cm along. She was the essence of serenity.

Not long after, she held her precious boy in her arms and we all giggled at how cute he was.

Then yesterday, I was called to another birth. Her name was Adhieu. She is beautiful and startlingly tall. The top of my head barely reaches her shoulders. But she didn’t labor standing up. In fact, she spent almost all of her time on her knees. She would walk off in the distance and kneel alone. She didn’t want to be disturbed.

This was her 8th child and she knew what worked for her. She was so quiet and calm. The only tell-tale sign she was in pain was the sweat beads on her upper lip and the occasional “very painful” murmured to anyone close enough to hear. She would look me straight in the eye and whisper it over and over, “Very painful. Arem Apei. Very painful.” I would nod and she would labor on.

She progressed quickly and an hour or so later, she came to find me saying it was time. My translator, Dongau, was a bit nervous since it was his first birth. But she didn’t notice. She just knelt on the floor and leaned against her friend. Two pushes and a little girl was born! She was almost born in the caul (meaning the membranes were still intact). But I ruptured them at the last moment.

After the placenta was born, the Sister-Wife came in and kept patting me on the back. She was SO excited for this little girl. She told me over and over again how happy she was and praised God with both hands raised in thanks. Her enthusiasm was contagious. She kept saying she would tell their husband how good of a midwife I was and that he would be very happy.
Adhieu and her oldest and youngest daughters.

I had to laugh. Even now, thinking about her, I can’t help but smile. She must have pat me on the back for over 30 minutes non-stop. I told her that when she tells her husband about me, make sure she tells him how strong and brave Adhieu had been during the birth. Make sure he knows how wonderful a wife he has. She just smiled a big toothy smile and nodded enthusiastically. She would!

So, there you have it. Three simple yet remarkable births. Two boys and a girl. They feel a bit like early Christmas presents.

Thank you for continuing to lift up these women in prayer. Thank you for praying for me. Thank you! 


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