Breech Taxi Birth

This last week while on shift we had a memorable birth. The four of us working, Lois, Medea, Jane, and I arrived on shift at 6:00am. We had our first birth just after 7am. Unfortunately the baby wasn't responding well to life on the outside and we had to transport him to the hospital for further care. While that was happening I heard some commotion outside the clinic but didn't really clue into what was going on until 3 women ran into the clinic screaming in pure panic. I realized that that probably meant that a women was delivering in a taxi outside of the clinic. I grabbed gloves and tools for a birth and headed out the door. When I got outside of the clinic I saw Laura in the back of the taxi assisting the mother. She had just gotten off of night shift and heard the taxi from our house and came over to help. I stuck my head in the taxi and was horrified to see that the baby was breech and the body was already delivered and the head was stuck inside. Laura was trying to deliver the head but wasn't able too. Susan (one of our filipina midwives) came down from the 3rd floor of the clinic to help. Laura and her were able to deliver the head. We resuscitated the baby in the taxi on the mother and he came around pretty quick. His first cry was loud and powerful as if he was saying, "I am ALIVE!!" By that point there was quite a crowd around the taxi. It seemed as if everyone at the same time sighed in relief when he started crying. We brought the mother and baby into the clinic to continue caring for them. Later the mother told us her birth story. She said she woke up that morning in pain but wasn't expecting the baby to come for another couple of weeks so she wasn't really convinced that she was in labor. Then in her bathroom her water broke and she could feel the baby coming down. At that point they hopped in a taxi and headed to our clinic. The baby started coming out on the way to the clinic. For those of you who know Davao she said that the body was already out by the time they passed fairlanes. Her friend who came with her also had a 2 month old baby which she brought with her. She said she was holding her baby in one arm and the half delivered baby in the other. Everyone involved was happy and relieved with the ending. This story could of been a devastating one, yet God protected this little boy. He even brought the extra hands we needed to help.
This picture is of Laura and the baby. He was born frank breech meaning that while still in utero his legs were straight up leaving his feet next to his face. After frank breech babies are born they are kind of awkward. They find it unnatural to bend there knees. Breech babies also have a swollen bruised bottom from the birth process. This little boy was most comfortable laying on his side with his legs straight out in a 90 degree angle. He was so cute. The next day Lois and I were mimicking him for fun laying in that position and saying, "Who am I?"

Oh the rain!

Over the past week we have had some substantial weather. The rains have come to Davao. A few days ago I was riding a motor bike to the store to buy groceries. It takes about 5 minutes on bike to get to the store from where we live. About halfway there the rain started pouring down and it came fast. My driver and I were stuck, the only thing we could do was to continue straight ahead. When we got to the store we were both soaked. I was very thankful I was wearing a black shirt cause I still needed to shop. When rain like this comes the city floods in a matter of minutes. Davao does not have good drainage. Our neighborhood in particular is one of the worst. It is very common to have standing water midway up to your knee after an evening down pour. It makes life a little more of an adventure here, especially if you are out stuck somewhere. Life most of the time gets put on hold until the rain stops cause transportation is very hard to find.

As far as clinic news goes, seasons are changing around here. We are having a midwifery class graduate at the end of this month. It is exciting seeing another class reach completion. Are other students who are now half way through their training are going on their 1 month break in the next couple of months. So many girls are leaving, some are coming back and a new school will be starting this August. During the summer months when we have so many girls leaving, we invite midwifery students from the states to come and intern at Mercy. We have 6 women coming to help out during the summer months. The first two will arrive at the end of this month.

I am also excited to update you about baby Kian. He came into the clinic for a check up this last week and he is already finished his corrective cast therapy. He only needed 2 casts to correct his foot. His doctor said the club foot was postural. This is great news. He should be fine from now on.

I'm Back!

Hello everyone!
I am back to blogging after taking a long break, too long actually. I apologize for not keeping you updated on what has been going on in the Philippines. Below are various entrees that I have failed to post. Hope you enjoy!

Anita

In the past few months I have had the opportunity to catch a few babies. Anita though is a different story. I first met Anita in 2006 when I was her midwife with her first baby. We bonded through the birth and postpartum of her first baby Rexan. When I found out she was pregnant again and was having her prenatals at Mercy I jumped at the chance to be her midwife again. It was great to see her again and continue the relationship. One of my favorite things about being a midwife is getting to care for a woman through multiple pregnancies. Knowing a woman’s history helps in giving her excellent care. The challenging thing about committing to being with a woman when she delivers in being on-call. Especially in cases when she waits until the last minute to come into the clinic. This was the case with Anita. She came in and delivered within 5 minutes of arriving. And it just happened to be on a morning that I was out. My friend Laura and I were at a 5k fun run. Within 5 minutes of finishing the race I received a text saying Anita was in labor and to come fast. Then 2 minutes later I received another text saying that she already delivered. It was a bummer, but I was happy to have finished to race before getting the text. It would have been worse to have to quit the race and still not be there for the birth. Laura and I headed back to the clinic and I helped finish up the care after birth. Anita had a little girl this time around. She is so adorable!

Miracle Baby

Like Anita some women time their births perfectly, meaning come in with little time to spare before their babe emerges. Inday was the same way. She came in around 4 in the morning on one of the busier night shifts. We already had 3 deliveries that night making me next up to take care of the next women coming into the clinic in labor. She came in calm but hasty to make to a bed. I could tell that she was ready to deliver. In these cases you try to get as much information in the little time you have before the baby is born. I like to be a part of these births. It is exciting! Almost like a race. Well after a couple pushes she delivered a healthy baby boy. Startled by the cry of a new baby, one of the other midwives hallered from the other side of the birth room, “Jonna did you just have a birth?” I said yep! The other girls didn’t hear her come in. When the placenta came out I was shocked at what I saw. In rare cases the umbilical cord can connect into the membranes instead of the meaty part of the placenta.

This is very dangerous to the baby. When the bag of waters breaks it can tear into one of the blood vessels. If this happens the baby can bleed out in a matter of minutes and die. Luckily for this baby the membranes broke on the other side of the placenta. We thanked God for keeping this baby safe. He is a miracle baby!

Fabie Students

Over the past couple months we have had we have had Filipino midwifery students from a local college (Fabie Midwifery college) intern at Mercy. Monday through Saturday they would rotate working day and night shifts. We have had Fabie girls intern at our clinic in the past but it has been a couple of years. I wasn’t too excited about the idea of having them come. When I was a student we had some intern and I didn’t have the best experience with them. But to my surprise I really enjoyed having them with us the last couple of months. It is a great opportunity to give back to the Filipino midwifery community by teaching local students. Our clinic is different from the birth experience they get in the hospital.

Also by being a part of our team they are exposed too so much more then just midwifery. We regularly pray together as staff between shifts and have devotionals together before clinic. Also they have the opportunity to pray for patients or at least be present when patients are being prayed for. All the girls that came to intern seemed to really enjoy themselves.

Dead Shifts

When coming on shift in the birth room you really don’t know what to expect to what the 8 hours will hold. At times it starts out crazy then dies down mid-shift. Other times it’s the opposite. There are also times where you are endorsed an empty birth room and nothing happens for the 8 hours you work. What do you do? Well I guess there are a lot of things you can do to keep yourselves entertained for hours. On this swing shift we decided to have a book reading where we all took turns reading out loud to each other.

We read The House on Mango Street. It is a book of memoirs of a tweenage latino girl living in a latino community in Chicago. It is a quick read and was a great way to pass the evening hours on our swing shift

Baby Kian

When working a night shift you have to be mentally prepared for anything. It could mean that you will be running around all night or you might have the luxury of sleeping all night. You never know. A few weeks ago I was about ready to go on night shift. I felt pretty good, was in a pleasant mood, relaxed. Then one of the girls mentioned to me that there were 5 labors at the clinic. My eyes got real wide and my adrenals started pumping adrenaline into my veins. I though wow, it is going to be one of those kinds of nights. One thing that I fall back on to keep my sanity is chanting to myself, “It is only 8 hours. I can do anything for 8 hours.” So I headed over to the clinic ready to accept the challenge of the night. The first women delivered even before endorsements were over. Two more were transported for high blood pressure by midnight. Since there are only for midwives working and 5 women in labor I decided to watch 2 of them. Jean was one of the 2 ladies. She seemed close to having her baby, or at least I hoped she was close cause she was not able to handle the pain. She was in labor with her first baby and seemed terrified. Her husband was really great at encouraging her. Thankfully I was right with my assumption and she delivered not to long after that. She had a handsome little boy. Not to long after the birth we noticed that his left foot was clubbed. Jean was devastated. Babies who are born here with disabilities do not always get the care they need. Especially the women we serve are poor, and even though they want the best for their babies, it is not an option most of the time. I referred the baby to a pediatrician we work with for an evaluation. He referred the baby to an orthopedic surgeon. When Jean came in for her 1-week checkup I was shocked to see the baby with a full-leg cast. Baby’s bones are soft, by putting his foot in a cast they are able to manipulate the bones into a correct place. So for now Kian will be put in a new cast every week until his foot has been corrected.

We praise God for making a way to correct his foot. It is common to see adults here walking around on uncorrected club feet. I am thankful that Kian will not have to deal with this disability later in life. Another praise is that the casts are being put on for free at the government hospital here in Davao.