Many have contacted me wanting to know how to give to the Dominican women or how to sign up for a trip. Below are some resources:
Lisa Aman, LM
http://www.midwifetobe.com/
Lisa is going to the DR in August 2011 and possibly November 2011 . She runs the Midwife To Be program and has done many, many trips to the DR in the past. She will take doulas and student midwives. If you want to send supplies or money, this is the person to contact also.
Med Share
http://www.medshare.org/
This is a Christian medical missions programs that collects sterile equipment from local hospitals and for a small fee will let you "shop" in their warehouse to take supplies with you. They have two locations, one in Decatur, GA and one in CA. If you live too far from them they will take orders over the internet. Here I got bulb syringes, hemostats, forceps, IV start kits, chux pads, sterile gloves, mesh postparum panties, idione scrub brushes, speculums, blood pressure cuffs, and stethoscopes. Wonderful resource!
If you are interested in becoming a doula, I highly recommend going to a DONA training.
http://www.dona.org/
Wednesday, May 25, 2011
Tuesday, May 24, 2011
Midwifery Trip to The Dominican Republic: Coming Home
Midwifery Trip to The Dominican Republic: Coming Home: "I didn't expect to feel so changed by my eight days in the Dominican Republic. I went from shock, to anger, to compassion, to understandin..."
Coming Home
I didn't expect to feel so changed by my eight days in the Dominican Republic. I went from shock, to anger, to compassion, to understanding about their birth practices. The Dominican people are such kind hearted people. They were so thankful for anything we gave! I left Sunday morning with tears in my eyes. I sat on the plane ride home listening to all the tan Americans talk about their week on beautiful DR beaches and I just cried and cried. The people here had truly touched my heart.
Coming home is hard. Questions start to scream at you in your head. Why was I blessed enough to be born here and not there? The DR is a short 2 1/2 hour plane ride away from me and yet the women suffer so much. Why did God put me here and not there? As I went grocery shopping for my family on Monday I just sighed at all the food. Why should I be able to buy all this? Why should I have access to all this food and education? In the DR there is no welfare, no WIC, no public housing, no childbirth education classes. Even the poor here in the US are rich to them. A midwife shared with me that the OBs there get about $500 USD every two weeks (and that is IF the government pays them). Homebirth midwives here charge around $2700 USD/birth. We are living in pure wealth even when we think we have very little and struggle to meet our bills. I always knew this in my head, but I had never experienced, even for one week, the realities of life in a third world country. And even then, my experience was not the total Dominican experience. I had an airconditioned hotel to come home to and money in my pocket. I had clean water to drink, healthy food to eat, and the ability to leave the country whenever I needed to.
The suffering in pregnancy, labor, and childbirth there is intense. As I tried to explain to my children about the DR they had many questions. They even told me the hospital didn't look that bad to them. And I suppose, looking at the pictures myself, they can't capture the full experience. I learned that the Dominican doctors are suffering just like the women; they are overworked, underpaid, and lacking BASIC medical supplies. They are frustrated with a medical system that doesn't work and a government that doesn't seem to care. They want good care for women and that is why they keep coming to work even when they get no paycheck for months. They know that women need support in labor (no family members are allowed) and a sanitary hospital. They know women need to eat and drink in labor (only allowed if family members bring the food or water; most women starve during labor and postpartum. There are no hospital meals). They are doing the absoulute best with the hand God has dealt them. What seems outrageous and brutal to us, begins to make sense when you start to see the full picture. Heartbreaking; but you begin to understand.
Coming home is hard. Questions start to scream at you in your head. Why was I blessed enough to be born here and not there? The DR is a short 2 1/2 hour plane ride away from me and yet the women suffer so much. Why did God put me here and not there? As I went grocery shopping for my family on Monday I just sighed at all the food. Why should I be able to buy all this? Why should I have access to all this food and education? In the DR there is no welfare, no WIC, no public housing, no childbirth education classes. Even the poor here in the US are rich to them. A midwife shared with me that the OBs there get about $500 USD every two weeks (and that is IF the government pays them). Homebirth midwives here charge around $2700 USD/birth. We are living in pure wealth even when we think we have very little and struggle to meet our bills. I always knew this in my head, but I had never experienced, even for one week, the realities of life in a third world country. And even then, my experience was not the total Dominican experience. I had an airconditioned hotel to come home to and money in my pocket. I had clean water to drink, healthy food to eat, and the ability to leave the country whenever I needed to.
The suffering in pregnancy, labor, and childbirth there is intense. As I tried to explain to my children about the DR they had many questions. They even told me the hospital didn't look that bad to them. And I suppose, looking at the pictures myself, they can't capture the full experience. I learned that the Dominican doctors are suffering just like the women; they are overworked, underpaid, and lacking BASIC medical supplies. They are frustrated with a medical system that doesn't work and a government that doesn't seem to care. They want good care for women and that is why they keep coming to work even when they get no paycheck for months. They know that women need support in labor (no family members are allowed) and a sanitary hospital. They know women need to eat and drink in labor (only allowed if family members bring the food or water; most women starve during labor and postpartum. There are no hospital meals). They are doing the absoulute best with the hand God has dealt them. What seems outrageous and brutal to us, begins to make sense when you start to see the full picture. Heartbreaking; but you begin to understand.
What I Saw
Some of my friends who are reading this are considering a midwifery trip to the DR in the fall. Here is a list of complications that I was able to see in one week. These are things that we read about in our text books but rarely get to see. Here we had a hands on experience with all of these:
Neural tube defects
Club feet
Premature babies (2lbs)
Anencephaly
Twin c section
Several normal c sections(every shift)
Fetal demise/still birth (every shift)
HIV
Hep B
Chlamydia
STIs
Pre eclampsia
HELLPs
Malnourishment (mother)
D&C; 1st and 2nd trimester
Retained Placenta
Hemorrhage
Broken Cord
Shoulder Dystocia (my first catch)
Neural tube defects
Club feet
Premature babies (2lbs)
Anencephaly
Twin c section
Several normal c sections(every shift)
Fetal demise/still birth (every shift)
HIV
Hep B
Chlamydia
STIs
Pre eclampsia
HELLPs
Malnourishment (mother)
D&C; 1st and 2nd trimester
Retained Placenta
Hemorrhage
Broken Cord
Shoulder Dystocia (my first catch)
Monday, May 23, 2011
Why are you here?
As the days went on, I was asked this more than once. Residents would want to know if I had to do this as part of my midwifery training (no). They wanted to know why I would choose to spend my time here, in the dirty, poor hospital instead of the beautiful Dominican beaches. Many of the interns were there just "doing their time" and they told me, in their very limited English, that they hated this rotation. I understood. But I was able to tell them that I really wanted to help, and that I really wanted to understand how birth was "done" in their country. I also told a few of how I love Jesus and wanted to serve Him.
I have to admit, after my first shift I was wondering why I was here. I was shocked at the conditions. I don't think anyone could have prepared me for what I was going to see. Women were begging me for food and water (none given, even if you labor for three days). Many women were infected with Hepatitis B, HIV, and sexually transmitted diseases. There was death with every shift. And there was the filth; blood, urine, or feces, left on the floor for hours before anyone bothered to clean it up. None of us on our first shift wanted to go back...but we did because that was what we were here for.
It got easier as the week went on because I knew what to expect. I bought cups at the store and water and started giving the mothers food and water (and each day if I left a stack of cups I would find them gone the next day; some staff steal supplies). I also saw how thankful the mothers were for the midwives. They NEVER thanked the OBs after a birth, but were raving after a birth supported by any of the women on our team. One doctor told me "The women like you. You are more gentle. The want midwives!". It was exhausting working 8-12 hour shifts every day but to see the women we had worked with in postpartum and how their faces would light up, it was worth it. If you went over to the postpartum ward and found a woman you had helped, she often had her family with her and they would immediately be embracing you and thanking you.
As we ended the week it became apparent of why this system is like this. The head doctors told us how they had not been paid their meager salary for two months. The doctors had to work 24 hour shifts with little sleep. There were very few nurses; most of the staff was either OB doctors, residents, or medical interns (medical students). When you don't have basic supplies, like sheets, pads, or even water to drink it can become fustrating. And the constant busyness of birth (literally several births an hour), it can wear you down. You barely have time on some shifts to wash your hands. And then there are no paper towels to dry your hands! I could see why it would make them tired and not so gentle. Not having the supplies they desperatley needed would be hard for any medical professional.
We also, as the week went on, got to know the doctors well. Some of the things they did amused us. Salsa danicing in the labor ward anyone? Cafe at midnight? They would often put Latin music on their laptops and blare it in the labor ward as the night wore on. On the last night I finally convinced the friendly head OB doctor to put something relaxing on---that I loved his music, but it wasn't good for active labor! He laughed and put on something more relaxing and then told me I was going to make all his doctors go to sleep with this music! The same doctor told us on the last night that he was sorry we were leaving, that we hadn't had time to come to a party with them. He was genuinely kind to us, like many other doctors, and I had invitations to come back and bring my family to stay with them. As I said goodbye to one doctor she kissed me on both cheeks and said she would miss me, that she hated that we had to go. And while I missed my family, I was wishing I could stay also. I was genuinely falling in love with the Dominican people.
I have to admit, after my first shift I was wondering why I was here. I was shocked at the conditions. I don't think anyone could have prepared me for what I was going to see. Women were begging me for food and water (none given, even if you labor for three days). Many women were infected with Hepatitis B, HIV, and sexually transmitted diseases. There was death with every shift. And there was the filth; blood, urine, or feces, left on the floor for hours before anyone bothered to clean it up. None of us on our first shift wanted to go back...but we did because that was what we were here for.
It got easier as the week went on because I knew what to expect. I bought cups at the store and water and started giving the mothers food and water (and each day if I left a stack of cups I would find them gone the next day; some staff steal supplies). I also saw how thankful the mothers were for the midwives. They NEVER thanked the OBs after a birth, but were raving after a birth supported by any of the women on our team. One doctor told me "The women like you. You are more gentle. The want midwives!". It was exhausting working 8-12 hour shifts every day but to see the women we had worked with in postpartum and how their faces would light up, it was worth it. If you went over to the postpartum ward and found a woman you had helped, she often had her family with her and they would immediately be embracing you and thanking you.
As we ended the week it became apparent of why this system is like this. The head doctors told us how they had not been paid their meager salary for two months. The doctors had to work 24 hour shifts with little sleep. There were very few nurses; most of the staff was either OB doctors, residents, or medical interns (medical students). When you don't have basic supplies, like sheets, pads, or even water to drink it can become fustrating. And the constant busyness of birth (literally several births an hour), it can wear you down. You barely have time on some shifts to wash your hands. And then there are no paper towels to dry your hands! I could see why it would make them tired and not so gentle. Not having the supplies they desperatley needed would be hard for any medical professional.
We also, as the week went on, got to know the doctors well. Some of the things they did amused us. Salsa danicing in the labor ward anyone? Cafe at midnight? They would often put Latin music on their laptops and blare it in the labor ward as the night wore on. On the last night I finally convinced the friendly head OB doctor to put something relaxing on---that I loved his music, but it wasn't good for active labor! He laughed and put on something more relaxing and then told me I was going to make all his doctors go to sleep with this music! The same doctor told us on the last night that he was sorry we were leaving, that we hadn't had time to come to a party with them. He was genuinely kind to us, like many other doctors, and I had invitations to come back and bring my family to stay with them. As I said goodbye to one doctor she kissed me on both cheeks and said she would miss me, that she hated that we had to go. And while I missed my family, I was wishing I could stay also. I was genuinely falling in love with the Dominican people.
Mariel
Mariel was laboring loudly. She is Haitian and speaks French with a few Spanish words. The Haitian women are not seen as a priority at this hospital and I could tell as I started to rub her back and provide counterpressure that the Dominican women were looking at me like something was wrong. I always thought it would be hard to doula a woman in labor who didn't speak my language. While it was hard, it wasn't impossible. Mariel immediately responded to the counterpressure, the cold wash cloths, and just the constant companionship of having another woman there with her.
When you enter the labor ward you can pick the Haitian women out immdiately; they are loud, REALLY loud. They have the vocalization part of labor down PERFECTLY. They often are lifting their arms up praising God during contractions or singing during an intense labor pain. I am sure it gets annoying to the staff and I found even one doctor imitating them in a very mocking way (I later told him that making noise HELPS a woman laboring naturally; he was annoying). Of course, it is very distracting to have a woman moaning loudly, "Ohweeeeeeohhhhhhhhhh!". But I also found it beautiful. The Haitian women aren't crying or thrashing about. They have just found their rhythym in labor and are not letting all the on lookers stop them. One doctor told me "The Haitian women give birth easily. One push and the baby is out!". Maybe this has something to do with it. They weren't afraid to move, make noise, shoo the doctors away, and tell the doctors to stop touching them.
During Mariel's labor I took heart tones, did cervical checks, and provided any support she needed. At one point she even shooed the OB away and insisted that I check her instead. It's no wonder when some of these doctors are incredibly rough. When Mariel's baby was born I was there assisting the doctor. I pulled the baby right up to her chest, all fresh and perfectly wet. She pushed the baby away; not a totally unheard of response for any woman exhausted by just giving birth. But what she did next surprised me. She shot straight up in bed, grabbed me, and kissed me on both cheeks. And she said the few Spanish words she knew to me "Muchas gracias! Muchas gracias mi amiga! Estas bendiga!" (Thank you! Thank you my friend! You are a blessing!)
This is what makes the ugliness of birth here truly beautiful; to see a woman supported during labor and taken care of gently.
When you enter the labor ward you can pick the Haitian women out immdiately; they are loud, REALLY loud. They have the vocalization part of labor down PERFECTLY. They often are lifting their arms up praising God during contractions or singing during an intense labor pain. I am sure it gets annoying to the staff and I found even one doctor imitating them in a very mocking way (I later told him that making noise HELPS a woman laboring naturally; he was annoying). Of course, it is very distracting to have a woman moaning loudly, "Ohweeeeeeohhhhhhhhhh!". But I also found it beautiful. The Haitian women aren't crying or thrashing about. They have just found their rhythym in labor and are not letting all the on lookers stop them. One doctor told me "The Haitian women give birth easily. One push and the baby is out!". Maybe this has something to do with it. They weren't afraid to move, make noise, shoo the doctors away, and tell the doctors to stop touching them.
During Mariel's labor I took heart tones, did cervical checks, and provided any support she needed. At one point she even shooed the OB away and insisted that I check her instead. It's no wonder when some of these doctors are incredibly rough. When Mariel's baby was born I was there assisting the doctor. I pulled the baby right up to her chest, all fresh and perfectly wet. She pushed the baby away; not a totally unheard of response for any woman exhausted by just giving birth. But what she did next surprised me. She shot straight up in bed, grabbed me, and kissed me on both cheeks. And she said the few Spanish words she knew to me "Muchas gracias! Muchas gracias mi amiga! Estas bendiga!" (Thank you! Thank you my friend! You are a blessing!)
This is what makes the ugliness of birth here truly beautiful; to see a woman supported during labor and taken care of gently.
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