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Sunday, July 10, 2011

7/7: Butuan Delivery!!

At 8:30 AM, a runner came and told us that Lauralen was having really strong contractions and in labor, and that the Helot was there.  (Helots are massagers who often deliver the babies, but have no training besides just doing it.)

At 9:30 AM, we did visitations, starting with Lauralen and Jane. Not sure if she had her baby yet, all 8 of us decided to go to her house to check on her. Her labor was definitely progressing, but still latent (not active). Her contractions had also lessened, so we gave her some more labor stimulation techniques and then left.
The piglets were SO cute!! The runt was not bigger than 8" long, and the others were about 1.5' long.
One thing I should mention is that Lauralen's sister gave birth last year in the H/C with a 'midwife' helping her. Her baby had complications during the birth, and was stillborn. Reminded of this, Lauralen decided against giving birth in the H/C (in case there was some "repeating reason" there), and asked to have her baby at home.

It was so precious, because her twin sons were playing vigorously. They kept running around the 'house', shooting their 'finger' guns with a 'chug-chug' sound. Then, the one would lay down on the ground, and the other one would lay on top of him in the form of a "T". Then, they'd get up and do it all over again!!! So adorable!!
Here's a video of the one chug-chugging his twin (who is behind the door inside):

After leaving, we split up into our respective teams again. Our team went to check Baby Jane, while Balong's went to visit other homes. Jane was doing good. She had had a few contractions, but nothing permanent.
While talking to her, many of her neighbors came over with questions and complaints of their own, asking for b/p checkspb checks, and so on. One little girl we were asked to check (one of the 6-girl family), had a HR of 136, which is quite abnormal for a 6 year old. They thought it might be due to allergies. Another had a baby with a continual cough. We advised both the best we could.

When we got back, we had lunch and a siesta, and then everyone except Makayla and I went to the Elementary School again to show the Jesus Movie to the next bunch of kids.
Sylvette was supposed to preform "Tuli" on this little boy last year, but it didn't happen, and when we came back this year, we found out that it had been done on him already, via Katie!!
Only thing was, he didn't want to get anywhere near Katie now!! (Good reason too! :D)
So, we bribed him with candy, stickers, and play time with us, INSIDE the H/C....
At first, he viciously attacked Katie with rubberbands,  but....
pretty soon, they were best buddies!!
Making Lunch
This kid got a bloody nose from something during siesta time, so we took good care of him.
Meanwhile, Kay and I went to check on Lauralen. She was definitely still progressing, with contractions every 3-5 minutes apart, but still had a ways to go. She also had slight hypertension (138/90), so we advised her to Left Side Lie.

On our way back, we were surprised to meet Sylvette and Balong standing next to a booth, where there was a large rubbermaid container filled with muffins. I asked Balong what they were doing, and he replied: "Selling stuff."  Playing along with it, I asked "How much??" He replied "Um....500 pesos." I acted shocked and horrified, and said "Too MUCH!! Will you take...180 pesos??" We haggled for a little bit, and finally I agreed to buy the whole container and muffins for 350 pesos. I think he thought that was an outrageously high price for me to consider paying, because his eyes got really big. So I countered again and wailed, "No money!!" (pretending to show my empty pockets), and started walking away. He called after me, "You can eat them now and pay for them later!!" I came up with some lame counter to evade 'buying them', but the whole scene was so backwards-cultural, that we both started laughing heartily.

I then learned the real reason they were waiting, which was simply that they were locked out of the H/C. (I had the key. ;D) We should have thought of it before, but we still had no electricity, and no electicity = no movie. By the time I got back (it was a good 10 minute walk), the Barangay Mayor had unlocked it for them. (They had borrowed them earlier in the morning for a town meeting.) So, I walked really fast for nothing...oh well!!

Unfortunately, everyone was sleeping back at the H/C, and I was pretty energetic from my haggling and walking back so fast, and wanted to do something... Balong suggested that some of us go get some water from the Spring, since no electricity also equals no clean water!! And so Balong, Sylvette, and I went.

I decided to leave my camera at home (which was a stupid idea), and so so don't have any of the amazing pictures I would have if I'd brought it!!! The Spring was about a mile walk, including the detour we took, because we originally were going to get it from the river. Sylvette and I, and eventually Balong, had a blast teasing each other about 'Jack and Jill', and started making our verses up, and having too much fun, as we slipped in the mud, etc. We finally found the Spring in the opposite Purok, we had to go down a very steep hill and muddy path to get to it.

Bringing the full containers of water were a challenge for all of us, because there were 25 gallon containers (and a smaller one which Sylvette took). So, we had fun trying to make the biggest face when resting every 15-20+ steps up the very steep hill. I weigh more than both Filipinos, and I don't weigh a whole lot, so it wasn't that they weren't strong or anything, it was just that we were all small!!! :)

There was a carabao (cousin to the water  buffalo) in one of the watering holes (not the drinking spring :D), which we had fun laughing about, since all that was showing was his head. On the way up, I cut my hands some, not deep or anything, but in the creases, and so they didn't feel good at all. :) Oh well! This is the life!!!

Sylvette went on ahead of us, to hail a driver, since we unanimously agreed that we were NOT going to carry them ourselves back to the H/C. Praise the Lord!! While waiting, we saw 4 boys (ages 10-12??) who had dressed themselves in banana leaves, pretending to be natives. They had wooden swords, and were literally covered in leaves!! (Now I know how Adam and Eve were dressed!! :), except their's were fig leaves, which are tiny, comparatively!!) They pretended to have sword fighting matches, and took turns rolling down a steep embankment.

When the driver came to bring us to H/C, he loaded the buckets on his SkyLab, and then instructed for me to ride on the side, while Balong rode on the back. A SkyLab is a motorbike with a removable wooden slats apparatus attached to the sides, where you can put people and baggage. Balong expertly guided me on how to get on/off and stay on the SkyLab, for which I was very grateful, and what fun it was!!! Basically, as a person, you sit with your feet in front of you the whole length of the wood, whereas, a bag would be tied down to the wood. ;p LOL

I think the Filipinos got a kick out of the whole thing, from a very small Americana and 2 Filipinos leaving with these giant black water containers, and then returning on this SkyLab....it was pretty funny. :) I only wish I had pictures!!
A picture I got from Mr. Google. :)
On our way up, we met Sylvette who informed me to hurry back down with the Birthing Supplies, because Lauralen was in active labor. I think the driver was nervous then, because he zoomed off, and all I could think was "Baby on the way!! Baby on the way!!" LOL As soon as I walked into the H/C, I called out, "Active Labor!!" That woke all the girls up really fast, and Makayla asked "You're kidding, right??" I answered "Nope!!" I didn't mean to startle them, but I guess I did (in my mind, it only started to get them back for last night's scare ;p)...anyway, it got them up really fast, which was what I needed.

Grabbing the medical supplies, we all hopped onto the SkyLab again (he waited for us). The men followed 15 minutes later, after running the water through filter, filling our water bottles up, and putting the water away properly.

That was crazy!! There were 7 of us on the skylab: Jordan and I were behind the driver, who had his 4 year old son in front of him, and Makayla and the Trio were on the "wings". (Riding on a SkyLab was on Makayla's bucket list to do, but she never dreamed that it would be accomplished like it was!!!) Again, I got the feeling of "Baby on the way!! Baby on the way!!" driving.... I guess Etienne tried taking a picture of us, because it was so hilarious, but the driver drove away too fast. Crazy Americanas!! :)

When we got there, we found that though she was 'active', it was early active, so there hadn't been such a need to rush. Oh well! We were all there now!!! :)
Waiting.......
Midwife is Waiting Too....
After half an hour or so, everyone besides MKK and I went to Rocky's house for Bible Study. Rocky had asked the team last year to come for a Bible Study, but they had been so busy, they'd been unable to. This year, however, when he asked again, we made sure we were able, and guess what? 5 people got saved!! Rocky, his son, and then remember the guy who got saved 2 days ago??? He brought 3 of his friends, who got saved too!!!! Praise the Lord!!!

When someone gets saved here, there is almost always a dramatic change in their lives, unlike many dominantly caucasian areas, were there is often much passivity and apathy afterwards. As a new believer, they need discipleship, which NT really tries to do when they are here.

Deserting us...oh well!! MKK and I had some really good talks, so encouraging talking to like-minded believers!!
Back to the Labor:
We did another IE at 4:45pm, which showed some progress: 3 cm dilation, and 40% effacement. Head was still -1 station and not well applied, which gave an explanation for why her dilation was slow. MKK couldn't feel any BOW whatsoever, so we assumed it must have ruptured already.

During labor, she did a lot of standing, squatting, and hand/knees positions. By 5:44pm, after doing labor stimulation, her contractions were getting stronger and more painful, and then got even stronger at 7:13pm. There were 2 times where she felt really dizzy and had heart palpitations, which could be an indicator of pre-eclampsia again, so we had to watch for that as well. (Praise the Lord, it was okay.)

This whole time, Makayla had been walking Lauralen through her labor, while I charted everything. It was really precious, because the bana made us coffee and bought crackers for us to eat!! He also supplied blankets for sleeping.

At 7:53pm, Lauralen moved into the transition stage, and had contractions every 3 minutes for 42-46 sec. long. She was feeling sort of pushy sometimes, and so MKK asked for a runner to go to Rocky's house and inform the team. Unfortunately, no one knew where it was, so they didn't come until later, (which was actually quite okay, since she didn't have her baby right then anyway.)

At 7:59pm, the helot came. Interestingly, she started delivering babies at the tender age of 14, including 4 of her mother's babies!!! She is now 62 years old. MKK really wanted the helot there, so that hopefully, she wouldn't feel like we're taking over her job. We did have some trepidations over how it would work when she came.... Praise the Lord, it went really well. The helot appreciated our presence, and had no problem with MKK handling the birth, and verbally said that she'd be MKK's "assistant".

It was interesting some of the things she did, and some of the beliefs they have about birth. Here are a few examples:
1) If the windows are open or someone is standing in the doorway, the baby won't come out.
2) As soon as the head is out, the like to push the abdomen down really hard from the top, in order to get the rest of the baby out. A lot of damage is done doing this, and it can cause severe hemorrhage and even death.
3) Uterine massage is majorly done here, during pregnancy, and before, during, and after birth. They also like to pull the cord (not CCT), which can cause severe hemorrhaging, and possible prolapse.

MKK was so gracious and calm, and was able to help dispel a few of their myths. They actually had quite a good conversation about some different things. Some things though, we kind of just shook our heads, and left it at that.
Tired Team!! Still waiting!!
Making good use of the blankets!!
Our Captain-Etienne, using his time wisely
Both 'Translators' were SO glad to have like-minded Filipino company!! 
The rest of our team got there soon after 8pm, and at 9:12pm, Lauralen tried pushing a few times, to no avail.  At 9:16pm, the helot did some "abdominal stimulation", and at 9:30, she ate some food. I had needed to use the CR since 4pm, when we got there, but needed to be there to help. At 9:30pm, Sylvette was there, as well as the team, and since Lauralen was eating, I figured I could probably take 20 minutes to go back to the H/C safely. Some more of our medical supplies were back there as well, and so a couple of us headed out.
Family and Friends, waiting in the dark
Balong-watching labor and birth from the doorway.
A teenage boy (unrelated), watched the entire birth. He was very interested.
While waiting, Katie and Hannah did some stargazing--such a clear sky too!!
We had barely gone 40 feet (9:44pm), when Sylvette yelled out "Sarah, 2 cm head visible!!!!". My first thought was "Shoot!!! Just my luck!! Of course, as soon as I leave, the baby is born!! I should have done this a few hours ago!!!" ;p . We hurried back, and to our shock and surprise, found that she had a bulging BOW now as well!!! That was pretty interesting.... MKK did an AROM (artificial rupture), and found it was filled with thick vernix.

9:53pm, baby went from 4cm head visible to fully out, and it was a BABY GIRL!!! Despite thick mec. staining/vernix, her APGAR Scores were 9 and 10. The EBL was 150 total, and the placenta was complete. There was no tear, though her cervix prolapsed, which we were able to get corrected.
All 3 H/C girls cut the cord-together, at one time. It was priceless.
Baby Kylie!! Minutes old.
First Birth for All!!! They were on Cloud 9!!
Taking it all in
Measuring the length of baby
Reading the Tape Measure
I charted the entire birth, by flashlite...what fun!!
Birth Team (minus picture-taking Sylvette): Katie, Jilian, Hannah, me, and Kai with baby Kylie
It was priceless to see the men of our team with baby Kylie
Upon examination, the baby (whom they named "Kylie" after Makayla, who's main nickname is "Kai"), was slightly preterm: evident by her thick vernix, and scarce foot creases. She was 50.5 cm long (20 4/5 inches).

Despite probable/possible complications of VBAC, Pre-eclampsia, hypertension, hemorrhage, tearing, high mec staining, cervical prolapse, uterine rupture, etc. Mom and baby were fine, with only mec. staining, slight prematurity and cervical prolapse happening.

All in all, this was a miraculous birth....there were so many complications that could or should of happened, and much shortage of supplies (we had given the major supplies to Lizzie's team, and so had no bulb syringe or many other necessary-ities) but God allowed for it to be without hardly any problems!! Praise the Lord!!!

Did I mention that that it gets dark at 6:30pm, and so the whole birth was by candle and flash light??? Did I mention that I went through 2 of my 3 flashlights??? WOW!!

We all finally got back to the H/C around midnight, which left me 3 hours to sleep before we had to get up to go do a postpartum exam on them, before catching the jeepney at 4. I slept out in Barangay Hall again, and boy, were the stars beautiful!! This time, I slept like a log.
What I Learned:
- No matter what the possibilities might be, God is a God of miracles, and can overcome any odds with ease.
- God is Faithful, and I know that even if some tragedy had happened, He would be there--right there with us!!!
-Something I have come to realize through this week, is that God is there at each birth, and all we have to do is ask Him for help, for strength, for grace, for wisdom, for comfort. I can picture Him there, tenderly wanting to help us, if we will only but ask Him!!!
- Another thing, is that the both mom and baby were totally fine after birth. If anything really bad had happened, because of past experiences, it is very possible that the village would not welcome any "midwife" again. We serve an Awesome God.

O Lord GOD, Thou hast begun to shew Thy servant Thy greatness, and Thy mighty hand: for what God is there in heaven or in earth, that can do according to Thy works, and according to Thy might?
~ Dueteronomy 3:24 ~

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