A day in the life...

After a lovely weekend off, some actual sunshine that toasted our skin nicely, we headed back to work this week. Now that we are more comfortable with the pace and procedures of the maternity ward, we are trying our hand at working in the evenings and nights, when they are less staffed and more babies generally like to be born. (Don’t worry families! We come and go safely…)

For those of you may be wondering what this hospital even looks like, how it is set up, or who we work with, here’s a little taste…. Unlike the US, most of the babies here are born with midwives. These midwives are trained in natural childbirth (they don’t use or need epidurals except for Cesarean sections), hemorrhage management, IV’s, neonatal resuscitation, episiotomies, and suturing, as we are in the States. In fact, until about 10 years ago, some of these midwives were also performing occasional vacuum extractions! Several of these midwives also have some experience catching babies at homes in the rural areas of Efate (the island we are on) or other islands of Vanuatu. We also work alongside RN’s and nurses aides, specializing in obstetric care, who help the ward and the nursery run smoothly, administer medications to moms and babies, and assist with births.

There are two antenatal beds for mothers who come into the ward in labor where we listen to the baby, assess contractions, and perform a vaginal exam to determine whether a mother is in early labor or ready to stay. Mothers often come in with their mothers and sisters, and occasionally a partner or husband. They must bring all of their own stuff: clothes, water, food, baby diapers and clothes, soap, powder, pillows, and mats for their family members to sleep on beside their beds. There are four beds for mothers to stay in when they are in labor, which we also use for mothers who are recovering from Cesareans. Sometimes all of these beds are full and mommas are up and about strolling the hall! The general ward has another 20 or so beds of moms and babies in various stages of postpartum recovery (most stay about 2 days).

The actual delivery room has 4 beds partitioned by curtains and made up very simply with a sheet, a macintosh (plastic or rubber landing pad that the mother lays on), and a pillow. Sometimes, like our busy day on Friday, they are all full of mothers having their babies at the same time! In the times we are not delivering babies, we are admitting or discharging mothers, performing baby exams, cleaning delivery rooms, making mid bundles (our birth kits of instruments, gown, and gauze), folding gauze, making cotton balls, making up or cleaning up beds, and basically doing any possible task that needs to get done no matter how big or small.

Our team here is incredibly lovely and welcoming, interested in teaching, and very laid back. They have all inspired us to walk just a bit slower, talk a bit more softly and slowly, and approach even emergent situations with a calm, assured presence while doing everything that is necessary to secure the safety of the mother and baby. I am pleased to watch and learn their approach to these situations; if I were a newborn baby I think I would rather have someone talking softly to me, inviting me here, and explaining why there is a tube in my throat rather than people talking about me and hurriedly shoving things in my mouth. Don’t mistake the calm for inattentive; these midwives have seen babies die or struggle. There is simply more space in their life and practice for the possibility of babies not making it, and as a result, they know when a baby is truly in trouble instead of approaching the entire process with fear.

There is definitely no shortage of learning here, and I am sure the remainder of our time here will provide many good stories! Till then, Sunita