Birth- the most incredible day.

Yesterday was one of the most incredible days of my life.

I helped deliver a baby. It was an indescribable feeling to be a part of helping bring life into the world. Nothing I have known before matches this.

family

Its 7am, a friend calls. His wife is in labor. She has been laboring all night in their boma with the assistance of two neighbor women at her side. Something is wrong now, she is loosing too much blood and she needs to get to a hospital.

I am ready for this. Part of me knew that I would see this at some point. Before coming to Tanzania I spent a couple months working closely with Dr. Teresa Knight, an OBGYN in St. Louis. I watched her in deliveries and C-sections, I listened to her talk about procedures and problems and medical terminology that I cannot begin to understand. I created materials for her to use while teaching Midwives in Tanzania. I sat in on seminars with midwives in Moshi as they dialogued about complications that arise and the lack of medical knowledge that exists in villages where women are delivering all the time. Teresa is a wise woman and phenomenal doctor and I am forever grateful for her.  I learned an incredible amount just by observation, but I surely had no idea that this experience would lead beyond observing. Until the phone rang yesterday morning at 7am, then I knew.

We arrive at the boma and Mzee opens my door, “go in”. I walk through the door of the small mudroom, with no idea what to expect. I have to stoop to enter with the low hanging ceiling. It is dark and smokey and I can’t see a thing. It takes a few moments for my eyes to adjust. There is Esther lying on the dirt floor with a thin blanket under her. These women are working by the light of a smoldering fire and one small flame of an oil lamp. We have no common language. Mzee stands outside, translating through the door. I know that we need to try to understand the problem, to know how dire the situation is.  I check her cervix, from my slim knowledge I can tell she is really dilated and beginning to crown, there is a lot of blood. These are the only words I know to describe they way it looks. I look in her eyes and feign a smile trying to offer comfort in the moment of panic that rises in me.  Her eyes are fixed on mine, as if she is searching for an answer. All of a sudden her body tightens, and she moans as contractions come. Something innate in me moves to action, and we load her in the car.

20 minutes on a bumpy dirt road, I hold Esther in the back seat, her head bouncing around in the nape of my neck, her eyes closed, her chest beating in my hands. Contractions come every three minutes and I try to remind her to breathe. I am scared now, that this baby will come in the car, and I am trying to remind myself to breath as well. "Shit, shit, shit, okay clear your mind, think straight." We breathe together long and slow. Peter is driving as fast as the Suzuki can go, we hit bumps where the road has been washed away, the five of us jostling around, exchanging looks that need no words. I offer my first prayer, “okay god please let us have the wisdom that this will take. Please please please.” I think that counts as begging.

We pull into the clinic. The delivery building is mostly deserted. Esther stands from the car and blood drips down her legs onto my hands. There is one nurse who escorts us into a room with two tables. There is a teenage girl on one, battling contractions, lying there naked and alone. The other table is dirty, stained by the remnants of the past. Esther climbs on. The nurse asks me about my medical experience. “None” I say. I have watched this a few times, but that is all. She checks Esther and concludes that yes, she is fully dilated and ready to deliver. The blood is from prolonger delivery. She leaves the room to try to contact a doctor. I stand there with these two women writhing in pain in front of me, and I search myself for some comfort to offer. I go to Esther and hold her hand, gently touching her cheeks with my palms. For the first time I look around the room and realize my surroundings. There is no sink here, no running water. The table Esther is on is flat with nowhere for feet or hands to hold. There is a bucket with dirty rags and a pile of something bloody on the floor. There is one IV cart and no medicine or equipment or machines that I can see. The vast difference from the sterilized white rooms in huge hospitals packed full of educated doctors in St. Louis, sinks in.

The nurse returns with no success in reaching a doctor. An assistant comes in and out, attending to the woman next to us. She hands me an apron and says “you will deliver this baby with me.” And that is that. There is no time for hand washing or second thoughts, or running outside to find reassurance from a friend. I pull on gloves and am at her bedside. She pushes once, her dark slender body moves under my hands, and then there is a head. I cannot wrap my mind around what is happening, my eyes shifting from Esther's face to the face of this small child. The nurse cradles this tiny thing in her hands. She commands something to Esther that I cannot understand. She bends backwards crying out, griping the apron wrapped around me. I get behind her on the table lifting her body forward as she pushes again and then there are shoulders and the beginning of a body. The nurse pulls me lower and hands me the baby as the legs slip out. I am frozen staring at this small humanity in my hands. I wipe its face and lips with my fingers begging it to breath. After an eternity of silence this small being opens its mouth and a faint sob comes out. Life. There are arms and legs and a penis and for now that I what I see. I lay him on his mother’s stomach as the nurse clamps the cord. I reach for a small blade and cut through, releasing this child from his mother’s womb. “Take him there”, the nurse is pointing now. I pick up this tiny life, wet and bloodied in my hands, rubbing off on my arms as I carry him across the room. I am using my finger to try and clear his mouth, the assistant comes using tubing to clear his airways. There is nothing to tie the cord. I tear a piece off the latex gloves, tying it tightly around before we trim the cord. It works, there is no blood. I don’t know what else to look for. There is no stethoscope, no water to wash him, no way to asses his needs. We lay him by a small light to keep him warm. I return to Esther and the nurse looks at me and says “placenta”. Good god, this isn’t over. Esther is still now, lying on the bed, her breath heavy, her body wet. I try to remember what Teresa has said. I massage her stomach and tell Esther to push, the cord is there and then a moment later, the placenta, just like I remember. The nurse comes back and tends to Esther some more, but as we comfort her and clean her, the bleeding slowly stops. The baby is wrapped in cloths of many colors. Only his eyes appear. Big and wonder filled, he searches my face. I have forgotten all about the other girl in the room, who is calling for help now. Her eyes are wide as our gaze meets and I try to offer her a reassuring glance. The nurse removes her gloves and her presence from us, and focuses her attention elsewhere. Esther stands from the bed, I carry the baby and we walk to the next room. There are 5 beds, each with a woman and new child. Esther finds her place and lays with her child. Silent and still watching the child next to her quietly wiggling his fingers exploring a whole new world.

The father is ecstatic as he receives the news outside. Moments later the grandmother shows up. She is frantic and panicked. She got word of problems and when she arrived at the boma, everyone was gone. She enters the small clinic room with her hands in the air, thanking God over and over. I recognize God’s goodness and together all the women are offering praise. She holds my face and kisses my cheeks, my forehead my nose. And when she takes her grandchild into her arms, tears roll. For the first time it hits me what just happened and I too begin to cry. I sit in a room with women where our words and worlds are not understood. In a country where there’s one doctor for an estimated 60,000 people and 70% of women give birth without medical care or skilled assistance, life continues. Humanity perseveres despite the odds. They are battling for life and embracing humanity in the most natural way. Today I stand with them and acknowledge the fight, embracing the journey and opening my self with all the love I have. It is these women who deserve the honor, as they walk this life in the deep everyday. I will forever admire Esther’s strength and carry her and her child in my heart as a picture of peace, endurance, and grace.

They name the baby Raphael. When I think about him I cannot help but smile. When I hold him I kiss his face. There is a connection that I feel deep within. Later, I stand with the father arm in arm. There is an unspoken bond that now forever exists. He looks at me with sincerity, “I will never forget you in all of my life, no matter how long I live, I will always remember you. It is not possible for me to forget.”

And silently with tears on my cheeks I know it will not be possible for me to ever forget. 

Esther and Raphael at the clinic

Grandma and grandchild

a new big sister

bringing baby Raphael home