From Daukura with Baby

It was about four years ago that I arrived in Daukura for the first time. The panga ride up the coast was more than harrowing as the drunken captain pumped his fist in the sky, weaving his way in wide circles through waves, his thick plated gold chains slapping against his chest. The driver’s precarious maneuvering left us without diesel sooner than what is the norm. He rocked clumsily along with the waves as he tried to switch the plastic tubing from one bright blue tank of fuel to the next. I can imagine him, one eye closed, trying to focus on where he was going to insert the tube when the large rouge wave came letting the panga slip onto its side, throwing me halfway into the Caribbean Sea. As the boat righted itself he was able to get the tubing in and the boat started again, at the same time that it was filling with water. There was not a pail, bucket, or water jug on board to bail out the sea water whose level was slowly rising. Many hands and a little innovation later threw the water overboard.

Soon after, as we pulled into a community different from my final destination, I gladly jumped ship, setting my feet in Daukura.

It was in Daukura that I met Anhet. A Miskito woman who speaks excellent Spanish due to working abroad in Guatemala and later in Panama. We created an instant friendship. As I have passed the years visiting Puerto Cabezas I always take the opportunity to visit my friend when she is in town.

When I first arrived in September there was a rumor about Anhet. I knew that she had been in Panama working, but everyone said she was back. They said she was pregnant. I eagerly sought her out in the house of her cousin. A stilted wooden home painted a rich lilac color. A house so large with a fence so famous that when giving the direction to a taxi driver you simply say “Kelvin’s house”. I saw my friend lounging on the terrace, seated at a wooden bench, an obvious belly protruding up from under her billowy red shirt. Her due date was set for March, and I would be here.

We discussed what she wanted for her birth. She told me of how her mother and her two aunts are both midwives. But her mother was afraid. She didn’t want Anhet to have a homebirth with her. We talked about having a home birth where I attended her, but in the end she felt that what she wanted was to birth in the hospital. I made Anhet a promise that day that I hoped I could keep: to give her tender loving care during her labor and attend her delivery in the hospital.

So the months wore on. Anhet’s belly grew and stretched with the new life growing within her. We talked of labor, love, and newborns. She went for an ultrasound. We smiled together, our eyes softened, as we read the report. She was expecting a baby girl. She pulled miniature dresses in pastel colors and tiny red socks ringed with tulle out from plastic bags to show me her preparations. The days ran together as Anhet’s time came closer and closer. I had a moment of panic as I realized I would be out of town for five days the second week of March. I crossed my fingers that I would be able to keep my promise to her. Dios primero, as people say here.

On Sunday I headed to the beach. I left my phone at home, as usual, where I knew it would be safe and out of the reach of thieves. I basked in the warm February sun, enjoying the light glinting off the white caps. My friend’s son ran circles around me, standing on his hands, attempting back flips. When I made it home later in the evening there were eight missed calls on my phone. Anhet.

“Estoy mal amiga. Desde la manana he tenido dolores.” (Friend, I’m bad. I’ve been having pains since the morning)

So I filled my bag with some sterile gloves and my stethoscope and headed off to
Loma Verde, a growing community on the outskirts of Port where Anhet lives. The taxi dropped me off in front of the lime green cement home wringed by a wood and chain fence. I opened the slated gate and walked inside. When I passed the threshold there was that quiet hush that accompanies the beginning of labor. It’s like a dense cloud of expectation of those around, the cousins and aunties holding back their breath through tight lipped smiles each time a contraction grabs someone they love; and also there is that shift in energy as the world prepares itself to greet another being. But Anhet was still smiling. I knew it was early, and she had a long road ahead of her.

After chatting at the large wooden table in the kitchen we moved into the bedroom. Anhet lay across the king size mattress shrouded by a light blue lace mosquito net. Her baby lay as a mound over her abdomen, her tiny limbs pushing and probing through her skin. I kicked off my shoes and curled my legs underneath me, adjusting myself at her side. I pulled my stethoscope from my purse, inserted the ear pieces, and then laid the rounded bell up against her belly. Transported through the tubing to my ears was that familiar fast paced tick-tick-tick of her baby’s heartbeat. One after another I passed the earpieces to expecting mother, cousin, expecting grandmother, and auntie while carefully holding the bell in place which later left a small circular impression on her skin. We counted her contractions: every five minutes, but short and light.

Two weeks earlier Anhet had an ultrasound. Her mother, the midwife, felt that the baby was in an unusual position, and the ultrasound showed Anhet’s little girl seated in the pelvis rather than head down. I wanted to assure myself that this little girl had flipped into a head down position to ensure a safer labor and delivery. I laid my hands upon her belly, grasping one side of the fetus as I palpated with the other hand.

“Feels like feet over here,” prodding against the upper right quadrant.

I moved my hand above the pubic bone and grasped a hard round globe. The baby’s head. The aunties and Anhet’s mother with their years of experience agreed that the baby had back flipped, nestling its head into Anhet’s pelvis. To double check what I really was feeling I recommended a vaginal exam. My fingers felt along the soft, fleshy cervix, and I was able to insert two fingers side-by-side through the cervix to feel the familiar round hardness of bone and skull.

So I went home, to try to sleep with my cell phone tucked up against my ear, waiting for the call. At 6:00 am when my alarm went off I still hadn’t heard from Anhet. I hopped under thee cold spray of water in my shower then donned my scrubs, downed a cup of earl grey tea, and finished off a bowl of fresh fruit. Off to the hospital.

When I arrived at the hospital I found Anhet in the maternity wing, a stuffy room hot from the midmorning sun streaming through the wall of windows. Mattresses line the perimeter of the room, each one filled with a woman awaiting her time. My friend sat at the edge of her bed, freshly bathed, her moist dark hair curling into rings. She wore a pastel floral house dress. She still smiled, but looked tired, and her contractions now caused her to pinch her breath off shortly. The matriarchs of her family surrounded her, each one advising and consoling her in lilting Miskito. Soon enough Anhet would be ushered back to Labor and Delivery where her contractions would mount in number and intensity.

A couple of hours later the double wooden doors clacked open, and in shuffled Anhet, eyes red and moist with recent tears. She was at that moment in labor when women realize that those early contractions were just the warm up and that things were just going to get heavier. I helped my friend to the bathroom where she scooped cool water from the fifty gallon barrel with a cut off plastic jug, rinsing her body. She changed into the hospital gown, opened to the front as is the custom, but which always gapes open precariously at the right breast.

I settled in for the next couple of hours to support my friend through her labor. The contractions swelled up inside of Anhet who found it most comfortable to stand, bracing her palms against the wall, fingers splayed open, her legs firmly planted underneath her hips. With each fresh wave I reminded Anhet to breath deeply, to let the pain drift out with her exhalation.

“Wind cum, respira profunda (breath deeply).”

During the break between contractions I found my mind drifting back to those days in Daukura when Anhet and I first met. I thought of the stilted house, painted white and trimmed in green, the rocking chairs lined up in rows on the terrace. Mostly, I thought of the night when I bathed in the kitchen. Anhet had brought a bucket of water with a plastic bowl into the wooden room, setting a cake of soap on the windowsill. She closed the door behind her telling me she would stand guard. I had stripped off my sea-salted cloths and began to throw water onto my head, letting it drip down my shoulders to my feet. The cool water cut through the thick heat of the night. Anhet and I whispered through the slats in the wooden planks of the wall. We discussed boys and birth control. Our friendship was solidified in those moments talking through the wall as the water formed a moist puddle at my feet, dripping through the cracks into the earth below.

The contractions came and went, coming closer and closer, like the tide riding the shore. The labor and delivery room was empty aside from the midwife, Anhet and I. I allowed her family to come in one at a time, the midwives eager to see Anhet’s progress and pass on words of wisdom. Her aunt’s arms embraced her during contractions, the fingers of her left hand open wide, browned and wrinkled, expertly cupping the uterine fundus as she must have done countless times to other laboring women. She asked whether we should give Anhet some herbs to speed her labor. I thought she was progressing fine, so better not to intervene.

I examined Anhet: 7 centimeters. I felt disappointed as she had been 7 centimeters two hours ago when I had examined her. This was the first labor and delivery of a friend that I had attended as a midwife. I wanted everything to go smoothly for her, but also knew how labors can stall and problems can arise. The baby’s head had dropped significantly into the birth canal though, giving me hope that she would make her appearance soon enough. Thirty minutes later Anhet complained of increasing pressure, saying she felt like something was going to fall out.

I donned a glove and examined my friend once again. She was completely dilated and my fingers braised up against her daughter’s head just millimeters from the mouth of her womb. With two courageous pushes her little girl’s head crowned and extended into the world. A tight cord around her neck held her back for an instant. I set two clamps and cut the pulsing cord that had transported oxygen and nutrients to this being for the last nine months. Her body came slipping out with the next push as I raised her up onto her mother’s abdomen. 4:13pm February 28th. She had arrived.