During one of my volunteer shifts at Clinica BIlwi I told Myra about Centering Pregnancy, a form of prenatal care that I am being trained in that is done in a group. Women with approximatley the same due date are all brought together for their prenatal care for 2 hours. The first part of the session involves weighing the women, having them take their own blood pressures and record it in their charts. This is then followed by an hour in which we discuss certain topics pertinent to pregnanct women: nutrition, breastfeeding, birth control, domestic violence, process of labor and delivery, etc. Its an amazing way to teach women about their bodies, pregnancy, and delivery. Historicaly, women who attend the group are more prepared for thier delivery when the time comes.
I had noticed that many young women were coming to Clinical Bilwi for their prenatal care. They were between 15 and 18 years old, and had alot of questions, many of them were timid about asking. I also had noticed from my expereince at the hospital that most first time moms entered labor y parto very scared, and without any knowledge of what was in store for them. After bringing up the idea of Centering Pregnancy, Myra and I decided to offer a birth preparation class to the first time moms that lived in the Barrio Revolution. We started informing the women of the class, and had a plan to hold it at one of the pateint´s houses on Saturday morning. The women expressed alot of interest in this opportunity to have their questions and doubts spoken to.
The previous year I had sewn a uterus, complete with ovaries, a baby, bag of waters, placenta, and cord, and had left it at the Casa Materna. I stopped by to borrow it for the class. Armed with the model uterus, I made my way to the barrio Revoultion to meet with Myra and our group of women. When we arrived at the house the girl who was hosting the talk wasn´t there. Myra and I sat in the shade of an old building that once was a corner store to wait. After about 20 minutes Alma arrived. We chatted about her boyfriend, what she´s been eating, and I answered questions about life in the US. It soon became apparent that our "group" was going to consist of Alma, Myra, and I. We spent an hour with her, talking to her about what to expect, how she could relax during the birth, breastfeeding, post partum birth control, etc. All the things that you want to talk to pateints about, but often don´t have alot of time for. We also explained to her the things that are routinely done in a hospital in Nicaragua: you are given an IV, you will most likely be given Pitocin, you will have an episiotomy because its your first baby, you will get a shot of oxytocin after the birth, your baby will be taken away to be weighed, measured, and dressed before you can hold him. We then answered her questions about basic biology: where does a baby come from? how does a woman get pregnant? is it true that if you breath while you are pushing the baby out that it will move back into your belly?
An interesting thing that I learned during our session, is that women attending high school who become pregnant are kicked out of school. They are not allowed to attend classes, and once they have had a child they are not allowed to where the school uniform. This means that they are not able to return to school after they have delivered, except on weekends, or some evenings when all of the "bad girls" go. The burden of fertility is so high in a population such as the one in puerto cabezas. o sexual education is taught, young women are not offered birth control, men will not wear condoms, and if you get pregnant you are denied the opportunity to be educated.
Even though our Centering group only consisted of one woman, I think that the education will change the trajectory of her birth. I think she will be more confident to ask questions, and will also share what she has learned with other women in her community.
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