Se Fue La Luz

Birth in Puerta Cabezas resembles birth anywhere in the world. Women breath hard between pursed lips, sweat beads above their upper lip, moans turn to grunts when the baby's head descends deep into the birth canal. The final pushes are accompanied by disbeleif and "no puedo mas"s. And then the head emerges, shoulders slip forward and the baby has arrived. The same languid looks are exchanged between mother and child...a regal look filled with pride and unconditional love.

The other day we had five laboring women crammed into the one room with two beds used for this purpose. Two women worked sillently through their labors, letting their fingers lite across their bellies as a contraction envolped them. Two other women struggled with their powerful contractions. I began massaging one woman's back as her contraction gripped her. One of the nursing students asked if that was helpful. I instructed her to ask the laboring woman who shook her head in agreement. The nursing student told me that she had never learned that massage could help a woman in labor. Later that evening I glanced into the labor roon as one of the older nurses bent over the same patient letting her hand trace circles across her low back. maybe I will have an influnce here.

All but four of our patients delivered on that day shift. Two of them back-to-back as the clock wound its way to 7. One woman was an adolescent girl, who often have fast and furious labors, who began pushing minutes before the lights went out [se fue la luz]. We waited for the back up generator to come on, but never heard its engine begin to roar. The labor and delivery suite without windows was pitch black. Sounds of the young woman breathing heavy and moaning as contractions built up once again filled the dark room. Two nursing students pulled out their cell phones with sterile gloves on and aimed them at the perineum. A docotor joined the team with green flashlight in tow as they hurried to force this baby out into the world. A light was finally fixed to a portable battery, and the baby was welcomed. I perfomed the newborn examination and began bundling the baby into its first clothes, as is the practice here. As the adolescent patient was being repaired, the next midwife on call had arrived and yelled 'tambikes', she's pushing, and ran into the room to help a woman who was about to have her fourth baby onto the birthing table. I wrapped the newly born baby into my arms to free the one newborn warmer, and aimed the green flashlight aloft. Four more pushes ushered her son into the world.