Update from Sarah August 3

Good evening. I must give the disclaimer up front, that this post contains "birth talk". I.E. Discussions of various fluids and functions that you may not want to know about. While I think it's fascinating, if you are squeamish or otherwise disinclined towards birth stories, I advise you to skip this post altogther. Now that you have been duly warned.....

Last night we threw a party for our Ghanaian friends. Things were just getting started when Richard (one of the night watchmen) came to me and said a man from the clinic was here for me. The runner sent up by the clinic came to say that there was a woman in labour and they would like me to come. I gathered up a few things (change of clothes, water bottle, hand sanitizer, gloves, snacks, face shield) and headed out.

There were two women in labour - Joyce was by herself, did not speak any English, 4cm dilated, and this would be her third birth. Faustina was with her husband and sister, speaks and understands some basic English, only 1.5 cm and this would be her first birth.

After introducing myself to both women, explaining why I was there, and asking their permission to be present, I settled into supporting Joyce through her contractions (all this was translated through the midwives and then through the clinic night watchman, as the midwives did not speak much of the Joyce's language - Ga). Joyce found that deep pressure on her sacrum made a big difference. We also walked around, while very loud Ghanaian soap operas played on the t.v. in the main area, and goats roamed the front steps.

Joyce's contractions were coming about every 2-3 minutes, and lasting 60-90 seconds. She was very calm and relaxed. I could tell that her contractions were getting more and more difficult by the depth of her breaths and rolling of her head back and forth. The two midwives and nightwatchman came out to where we were and said "We must go to the village for supplies. We will be back." And off they went, leaving me entirely in charge of the clinic and two labouring women! Wow. As I sat with Joyce, I realized she was in transition, and that given how quickly her labour was progressing, birth could be imminent. The supplies were not set up in the birth room, and because of the "sparseness" of the clinic, I had no idea how they actually did things, or where anything was. As I was contemplating moving Joyce to the birth room, the midwives returned. Phew.

Within a couple contractions Rebecca (soon to be head midwife at the clinic) said she would set up the supplies. Once the room was ready Joyce walked back and got on the table for an internal exam. She was fully dilated and her bag of waters was bulging, so Rebecca ruptured it. The closest description I can give is a balloon full of water exploding - fortunately I got out of the way in time! The water was lightly stained with meconium, but the midwives were not concerned. Rebecca said to me "Please. Put your gloves on. We would like you to deliver the baby." I had only been up at Joyce's head, but had my gloves ready in my pocket. I proceeded to put on my gloves, but said "You may catch the baby - I will just watch." At this point the baby's head emerged, and Esther, the secondary midwife said to me "Come quickly and deliver", then stepped away from Joyce. I reached over just in time to catch the slippery little guy as he slithered out healthy and happy. I placed him on Joyce's abdomen, and Esther proceeded with clamping the cord. Joyce gave birth to a 3.4kg boy at 11:56pm on Tuesday August 1. Esther then said "Please take the baby to the table." So I managed to navigate getting him (long cord, clamp and all) over to the table where they would weigh him etc. Because of the high risk of disease, and the scarcity of gloves, it is necessary for the midwives to wash the infants fairly quickly after the birth in order to protect themselves. Esther then administered a dose of oxytocin into Joyce's thigh, to help with the delivery of the placenta and help prevent post-partum bleeding. Because of the high incidence of anemia (which can lead to excessive post-partum blood loss) oxytocin is standard practice at the clinic. Once the baby was clean and wrapped up snugly (it was a cool rainy night), I helped Joyce get her baby well-latched on to the breast, where we suckled happily until it was time for his oral polio vaccine to be administered. All in all - a pretty wonderful evening.

I slept the night at the clinic in case Faustina's labour progressed, which it did not. At 5:30am Rebecca had me listen to the fetal heart rate through the fetoscope and tell her what I thought. I said that I did not have experience to do that, but she said to listen anyway. I listened carefully and watched the clock - the FHR was a little more than 2 beats per second, but less than 3 beats per second, and steady. I told Rebecca this, and she said "Good. Good.". Faustina decided to stay at the clinic for the day, because she is from a nearby village and did not want to travel. Daniel (YFC staff who has been staying with us) and Abraham (helping in the kitchen) drove down and picked me up at 7am, so I could rest for a few hours (and by "rest", I mean: eat breakfast, do laundry, check on the cuts and scrapes of team members, tidy the first aid supplies, re-pack my bag for the day, shower, and catch a 20 minute nap).

I was called at 11:30am to go back to the clinic to teach the TBA's (traditional birth attendants). It was supposed to happen Tuesday, then it got changed to Thursday, and ended up being today - Wednesday. Yesterday morning I sat in on the midwives visits with women and answered any questions they had (both the midwives and the women - nothing too complex) Both yesterdays clinic time, and todays teaching, went well. The teaching is another post of it's own still to come. Two fetish priestesses were among the attendees, and two of the TBA's received their knowledge of birth through dreams/visions the night before a woman showed up at their door wanting help. Around 2:30pm I walked the 30 minutes home (accompanied by two members of Joseph & Theodora's church who lived nearby and happened to come out just as I was settng out). Had a quiet afternoon.

Now I am waiting for the call to go back again for Faustina's birth. I have a mobile phone in my pocket and am listening carefully for it to ring, or for there to be a knock at the gate if they send a runner for me.


When the team members saw me today they said I was 'glowing'. While it might have just been sweat from the walk, it might have been the joy I feel too. What an awesome privilege I have received. Thanks for sharing the journey with me.