Oxy-casera

After last Sunday´s experience I made two decisions: 1) to return to the pile of used clothes to search out some scrubs, and 2) to return to hospital Nuevo Amanecer Bilwi to work in the labor and delivery department in the evenings. I was successful and found two pairs of lavender scrub pants, both of which were worn out in the crotch that I later repaired on the sewing machine at the Casa Materna, and one green and one blue scrub top. I excitedly donned my mismatched outfit, feeling quite professional and ready for any action that the hospital might show me. My first day at the hospital Cody dropped me out front of the locked chain link fence that encircles the teal blue painted hospital. My scrubs were the lock to the door as the watchman ushered me through. I walked through the maze of open aired halls, peeking my head into the various rooms filled with 4, 5, 6, or 8 beds in which whole famiies languised with their sick loved ones. I kept walking until I found the aluminum framed glass doors of the Labor y Parto wing, the only part of the hospital aside from the surgery suite that is air conditioned. Just inside the door I met Julia, who has been an obstetric nurse for a hundred years at Nuevo Amanecer. Within two hours my first scrub clad birth took place, as a slight twenty something year old woman pushed her third baby out into the world. The birth was fast and the contractions fierce...later I came to find out that the girl had been drinking a birth promoting tea that many women in the community are known to consume. It is compared to the hormone Oxytocin, a synthetic version of which is given in the labor room to stimulate birth, both concoctions are known to increase the strenght and frequency of contractions. At the hospital the tea is refered to as oxy-casera...casera means homemade! After the birth I quickly scooped up the baby and did all the basic Puerto Cabezas nursing practices including Vitamin K injection, Antibiotic eye cream, weight, temperature, and measurments of head, thorax, and length. A very exciting day at wrok indeed!

Even more exciting was my next day at the hoispital. I worked with nurse Clara who is reknowned in the community for her years of service to birthing women. She trains the new resident doctors and is often called on at home by poor Miskito families that don´t have the money to reach the hospital. She told me stories of being called to homes when a girl had been convulsing for two hours, due to bad spirits per the family, but due to eclampsia for those who beleive in western medicine; of breech babies with their legs dangeling out of their mothers, and babies so big that it took all her strenght to pull them out; and lastly of her baby that she adopted when a young mother abandoned her child in the labor and delivery wing thirteen years earlier. When I arrived to the hospital one of my patients, Luciana, from the Casa Materna was dilated to five centemeters and pacing in the Labor y Parto room. Swipe from your mind any image of a high tech labor ward, and replace it with concrete floors often covered in blood spatters as the cleaning crew has yet to clean up the remnants of the previous birth, imagine two cots in one room with a curtain as a door rather than a private room with sweeping panoramic views of the san francisco bay, and then picture the birthing room as a concrete floored operating suite with three brithing tables from the 1950s with leg supports, but no foot supports, lined up side by side in the event that three women are in labor all at the same time...its a bare bones kind of birthing center if you get my drift. Although the birthing room lacks certain comforts there is something about its simplicity that seems to traslate to the births that I have seen. Granted, I´ve only seen three births in that room, none of the women had any pain medication, because its not an option, but the women were so elegant and graceful in their birthing. No moaning, no crying, no hours of pushing. There would simply arrive a moment when the women would climb up onto the birthing table, ask for their dilation to be checked, be at 10cms, and pushing their babies out 5 minutes later. Quite striking! Well, back to Lucianas birth...the obstetric nurse Clara was checking Luciana and said that she was 9cms. She told me to glove up, that I was going to attend to the birth. I told her "uh-uh, I don´t know how to do that"...then she said "there´s only one way to learn" and thats how I ended up catching my first baby! She had me check the neck to see if there was a cord and then pull down and then up on the babies head (with alot of force which was unexpected!) and then grab under the babies arms as I pulled him from his mother and laid him on her belly! It was totaly exhilirating! Its wonderful to be in a place like Puerto Cabezas where I have the opportunity and freedom to learn in this hands on way.

There are so many things that I want to say about birth at hospital Nuevo Amanecer...but I´m still putting words to my thoughts...right now there is a lot of blood, dirty floors, stoic mothers, legs agape, arms akimbo on the birthing table, and then there´s me drying off the babies, bringing them to their mothers, and feeling so much hope and very low expectations all at the same time. I think that as I spend my evenings at the hospital my feelings will become more articulate....right now I´m still riding the wave of having caught my first babe!