Thursday, April 17, 2008

Project HOPE Volunteers Celebrate Birth in Liberia

Yesterday I had the honor of watching Project HOPE midwives, Margaret Canter and Nancy Ward delivery a baby at the JFK Hospital in Monrovia. The setting was unlike any other labor and delivery room I had ever been in. Laboring women, and those who have just given birth, occupy six side-by-side beds with plastic coverings draped only by a sheet. If the ward is crowded, sometimes two women share one bed. The laboring women are separated by delivering mothers only by a thin curtain.

There is no air conditioning in the labor and delivery ward, only open windows , making it almost impossible to keep out dirt and grime. When I walked into the ward, I saw a mouse running across a counter. On one delivery table, a young woman was enduring a painful post-natal procedure. Right beside her, another patient, Rose, was preparing to give birth.

Margaret and Nancy were attending to Rose, checking her progress and offering compassionate support. Rose had been in labor for a number of hours and while she was fully dilated, her contractions had stalled. She told Margaret that she had given birth to her first child at home and did not want to come to the hospital to have the baby. Margaret encouraged her to stand up, walk around and move a bit to get her labor going. Nancy rubbed her back and legs. At one point, Rose looked up exhausted and in pain and reached her arm out and placed her hand on Margaret’s waist for comfort.

I had to step over puddles of blood still being cleaned up from a previous patient as I made my way to the corner of the room to take photos. I looked down and noticed a mouse skittering across my shoes. I gently hopped to the side and kept taking photos. Rose was getting close to giving birth when the electricity, as it always does at the hospital, went out. The midwives in the department just opened the curtains that separated labor and delivery to let in the sunlight.

While the surroundings sound incomprehensible, the miracle of a healthy birth is always humbling. Nearing the end of her labor, Rose moaned, waved one of her hands in the air and sang words I could not understand. I know she was in pain, but her melody was magical.

Nancy told me later, “It is so interesting how these women, who have not read books about birth and no one tells them how to do it still naturally figure it out their own way.”

As Margaret began to deliver the head of the baby the whole room filled with excitement. The JFK midwives gathered around, offering their opinions on how to do the delivery. Nancy praised Rose telling her she was doing a great job, and Margaret slowly received the beautiful baby boy and laid him on his mother’s belly. Somehow, I was able to keep shooting photos.

Later, I was pulled into the C-Section room by Ms. Cooper, the head of the Labor and Delivery ward at the JFK Hospital. As she pulled me down the dark hall, I was trying to explain, “I’m not a medical person like Nancy and Margaret, I’ m not sure I can handle this.” She just smiled, opened a door and the operation began. It was over in five minutes, but the doctor insisted I take a few photos of the operation. When the baby was delivered, he had hard time breathing. Nancy helped resuscitate the baby, and soon he was bought into the nursery wailing strongly.

Nancy and Margaret have been working hands on with the midwives at JFK for two weeks. They have personally delivered a dozen babies. They have also witnessed heartache, watching a premature baby delivered who didn’t make it. While they deal with circumstances like this in their jobs back home, the environment is very different here and there was not a lot of compassion shown to the mother. She was not shown the baby, and after the birth she was put in a bed with other mothers who had given birth to live, healthy babies. “In the delivery room, the woman whose baby died was encouraged to be quiet,” Nancy told me later that day. “And she was. So I just went over and touched her and told her how sorry I was. The tears started to come. People just need a human touch and need to be with someone when something like this happens.”

In addition to delivering babies, and teaching classes in prenatal care, Nancy and Margaret are modeling an example of caring and compassion to the JFK midwives. “I have been in a high tech hospital and this experience has made me appreciate what women can do without and have a baby,” Margaret said. “It's not the technology and medical intervention, the things that these midwives aspire to, that will make the difference. It’s the comfort and patient care that will really make a difference. I hope we are modeling a different way to treat patients,” Margaret added. “When we deliver, we are rubbing backs, talking to the patients in a reassuring way, just being tender.”

Margaret, who served on a Project HOPE mission to Latin America onboard the USNS Comfort last year said that she has really enjoyed this land-based opportunity. “When we were on the Comfort, we set up clinics, using all our equipment, all our supplies, pharmaceuticals and all our people. Here, we went into their environment, working alongside providers in their actual facilities, using what they have to use. You really see what they have to deal with and can make health education suggestions based on that.”

Over the course of two weeks, Nancy and Margaret have modeled better patient interaction and taught a few practical skills.. Through health education training, they have provided the midwives with information on how to better date pregnancies using pregnancy wheels provided by Project HOPE, and have shown the midwives different ways to count a baby’s heartbeat during contractions to determine if the baby is in stress. “Yesterday there was time when I was listening to the baby’s heartbeat and three midwives came around to see how I was counting beats,” Nancy said.

Nancy, a first time volunteer for Project HOPE is eager to go on another mission. “It has really been inspiring to see women who can deal with the situation at hand. The mothers and the midwives have such resilience and Ms. Cooper, the director of the Labor and Delivery Ward at JFK is very forward thinking and open for education.”

And while the environment at the JFK Hospital may not be the perfect setting for birth, women sometimes find what they need on thier own. "The crowded unprivate labor rooms actually sometimes add a support system to the women in labor,” Margaret said. “On our first day in labor and delivery, the laboring women were walking the room, kneeling on the floor and moving and moaning in a rhythm in their brightly colored wraps, almost like a song.”

Nancy added, “One young woman looked at me with tears rolling down her cheeks and asked me, ‘Sister can you can take a contraction for me?’ I would have if I could.”

Help support the Project HOPE humanitarian assistance and health education mission in Africa

--Melanie Mullinax

1 comment:

  1. It was very nice to read your blog, as I will be going on Project Hope's mission to Panama and the Dominican Republic in a few weeks. I know Margaret, we are both midwifes here in Tallahassee. Reading their experiences fuels my joy at my upcoming experience. Thank you for sharing.