Of Cows and Babies

Ayen came in early yesterday morning, calmly slumped in a chair, then didn’t move as she explained she was in labor. She didn’t smile either.

Watching her body movements (which were nil) and facial expressions (stoic and bored), I had a hard time believing she was in labor. But she insisted.

Digging deeper I learned that she was having a contraction an hour but when they came they hurt. Smiling to myself, I brought her in the clinic for admission.

If this mama thought labor had begun, I wasn’t going to tell her otherwise.

As I checked her in, I was surprised when I felt one of those elusive contractions roll over her body; it was intense.         -- No kidding it hurt!

I also did a vaginal exam and was equally surprised to learn she was already 6 cm dilated. All she needed was for her contractions to find a steady groove and this baby would be out! And I told her so.

She nodded in response, still refusing to smile in the least.

Looking more annoyed than anything, she decided to walk a bit and I promised to check on her regularly.

By noon, her contractions were every 15 minutes and getting longer. By one pm she was trying to push.

Even though her contractions were better... they still didn’t give me pause. Externally she was not showing me any indication it was time. Nevertheless, she wanted to push and did so with determination.

Knowing that a short push every now and again (especially for a multigravida) can help things go faster I wasn’t in a hurry to get her to stop. But it didn’t matter since her pushing got us nowhere.

Suspecting an anterior lip to be the cause of the delay, I asked her if she want me to hold it back. She just scowled at me in confusion.

This was her seventh child; she never needed anyone to hold anything up for her in the past. Why would she need it now?

I agreed with her. “I don’t need to do it,” I explained, “I just want you to know that if you let me help, the baby will come out in one or two pushes.”

She silently deepened her scowl and kept pushing in the reclining-kneeling position typically adopted by the women here. I tried to get her in forward-leaning position, but she ignored me completely.

She wasn’t being stubborn. She just couldn’t find it in her to trust me; and I can’t blame her.

I am a good decade younger than she is; I obviously don’t have seven children of my own; to her I’m just an overly opinionated punk kid with a doppler!

She looked at me like I was a mosquito buzzing around the room --annoying but ultimately insignificant and easy to ignore.

Laughing at her (inwardly only of course), I sat next to her and waited. If she was not in a hurry, I was certainly not in a hurry either. I did remind her however that I was always here to help her if she changed her mind.

An hour went by.

Then after the second hour came and went, she finally agreed to let me help. As I reached in to lift up the anterior lip I noticed she was very close indeed. All I needed to do was hold it up for her and she could deliver.

But.... she didn’t like my help, and squirmed for me to stop.

Her friend who was holding her shoulders and digging her knees into Ayen’s back to help her push, asked with unbridled disdain, “Is this how they deliver babies in this clinic?”

Ayen murmured back to her in an equally disgusted voice, “I guess so. Right now she has her hand all the way inside me...  like I’m a cow!”

When my translator told me what they were saying I stopped trying to help her and laughed and laughed.

To think! I deliver babies like cows! Ha!! Who would have thought! Ha ha ha...

Perhaps it was her perfectly knitted brow dripping in more disgust than sweat that made me laugh. Perhaps it was her annoyed tone and frustration that her baby wouldn’t come. Pain will do that to you, and she had more than her fair share.

Another hour went by.

Three hours sitting at (almost) fully is a long time to wait --especially for a G7. But really I was in no hurry.

As the third hour ticked past, I offered again. Did she want my help?

Finally, she nodded briefly and let me do a bit of the heavy lifting.

No joke, two minutes later at the end of her first real push out came a slimy, goop-covered girl with lungs!

When she cried her forehead knitted in the same disgusted expression as her mother! Priceless!

But as I expected, once Ayen’s pain was over she not only found her smile, she found her laugh. And together we celebrated the birth of her little girl!

And now as I think of her I can’t help but laugh.        --Ha ha... a cow! Ha!

Chubbiest of All the Land.

Amouk arrived in the morning with a fountain of gushing amniotic fluid each contraction; it pooled on the floor -- a puddle but not quite a lake.

Splish-Splash

Expecting her 7th child, she looked like she was carrying twins by the way her belly hung. It was a mountain beside her lake.

When I checked her, she was 4 cms dilated with abysmally short contractions. But with a G7, you can never guess how quickly labor might go. So I admitted her and watched.

She spent the morning trying to augment her contractions with nipple stimulation and walking. And I knocked off prenatal after prenatal from the line. There were at least 35 prenatals to see.

Each time I checked her baby’s heart tones, she would comment on the fact there might be two inside. What did I think?

I told her that I honestly didn’t know. I felt and heard only one baby, but she was the size of two babies... maybe even three!

We’d laugh each time and she’d go back to waddling around the clinic. I’d go back to my prenatal ladies.

When the very last prenatal was seen, I brought her back in for another vaginal exam. It had been hours (8 hours to be precise), and she was looking no closer to delivering. What was wrong?

Her second vaginal exam showed her to have made no progress whatsoever. She was still 4 cm and 50% effaced.

Hum...

But by this time, her helper had changed. It was no longer her mother but a young lady named Martha. When Martha saw me she laughed excitedly and asked if I remembered her. When I said I didn’t and that I was sorry, she laughed again.

“But you delivered my baby last year! I’m Martha,” she exclaimed, “I named my son Stephen after you!”

And together we slapped hands in excitement and caught up on how my namesake had been doing. Martha was Amouk‘s niece and had no doubt encouraged her aunt to deliver with me.

So back to my story. When I told Amouk that she was not progressing and that I wanted to augment her labor with an IV drip, her only concern was whether or not she’d get home before dark.

Hum...

It was about 4 pm already and it gets dark around 7:30 pm. Would she deliver before dark? I couldn’t say. But we induced/augmented anyway.

However once the oxytocin was running, her contractions kicked up a notch. In fact, just 30 minutes later she was asking to push.

Not sure if she was exaggerating things or actually ready, I did another vaginal exam. Not only had she dilated to 9 cms, but his head had dropped 2 stations. It was a go!

I let her push a few times but she wasn’t making progress so I asked her to hold off pushing until she was fully dilated.

Another 30 minutes later she started pushing with earnest. Although fully, her baby’s head wasn’t coming.

She pushed and pushed. The head molded and molded. I could see it crinkling up inside; but it would not come.

Hum...

After 40 minutes of this, I tried the vacuum. And even then... he wouldn’t come. No doubt we were dealing with a bigger baby than normal.

However, with time his head started to crown and he eventually emerged.

Roughly the size of a mac truck, he squealed and complained as I wiped him down. Rolls of stocky legs and chubby arms, he flayed his arms in excitement.

He was HUGE!

If I hadn’t watched him come out, I would have sworn he was a 3-month old! And would you believe it, he is officially the biggest baby I have ever delivered!

10.3 lbs (or 4.7 kg) of kissable cuteness!

Twins he was not, but he could have been!

Afterward, Amouk laughed in relief while her mother --eyes greyed with age and cateracts-- took my hands and lifted them to the heavens --this is how the midwife is honored in this culture-- and together we praised God for His goodness in giving us a healthy baby!

Inchelich Nalich! Praise God! Inchelich Yesu! Thank you Jesus!