Love what you do.

Over the past year I have met so many doctors, nurses, and therapists that do what they do because they WANT to make a difference. Their jobs are not easy and the work that they do in Guatemala is even harder. Maybe they're so awesome because they've come to Guatemala to help and aren't looking to be pampered. Guatemala is an amazing and beautiful country that is overflowing with culture but by no means is it a safe country and the medical system has a terrible reputation.  For over a year I have walked around with pepper spray(thank goodness I've never had to use it) and everywhere I go I am targeted for being a white women, the cat-calling and grabbing is a reality of the machismo that exists here in Guatemala. Also the government is very corrupt and the longer that I live here the more I learn about the outrageous things that are happening, but something about THESE doctors and medical personnel who have come here to make a difference makes me remember that there is hope!  Things are changing, its getting better and the doctors and nurses that I have befriended have given me an overdue dose of faith.  Some days I feel deeply sad, frustrated and outraged by many things in this country. But that doesn't help me or anyone for that matter. I have found that the best way to combat those feelings is by doing what I feel is my purpose and putting everything into my work.  I am so excited to to be on the path of midwifery, its rewarding, challenging, and I am constantly reminded what a gift life is.

 

This week in the birth center I attended six births, one with Dona Ana's daughter who is my age, we really bonded. She is a nurse and has attended hundreds of births with her mom. While Dona Ana and I attended the births, she took pictures and videos for my future website. I hope to be able to do some publicity and grant writing when I am in the states. They have really adopted me into the family and they continue to  lovingly teach me new skills with each birth.  The births this week reminded me to use my intuition and think with intention. Although, I wouldn't consider myself religious I am deeply spiritual.  Dona Ana is an Evangelical Christian and prays constantly during births and I really like this about her, it keeps me present in what we are doing.

(I'm burning the umbilical cord with a candle)

My night at the clinic has just started.  I arrived to find Dona Ana in the kitchen and we sat and chatted for an hour or so while eating mandarin oranges, that I had brought as a treat. We both love to talk and though we know we should sleep we don't.  Why would we when the company is good and the night is young?  Eventually, we both shuffle off to bed and she tells me she'll wake me when a patient comes. I love the chaos of my work. It is so unpredictable, I never know when a birth is going to happen and I think that is why I love it so much. 

My days in Guatemala are numbered I leave on the 12th of December which isn't far off.  Though I will be sad to leave I am so excited to go back to school and work on my degree.  I'll be taking a grant writing class and working hard to find Dona Ana the assistance she needs to get more equipment for her clinic.  Then this September I hope to start Midwifery school in El Paso Texas.  Next week watch out for my blog on the Faja! (the wrapping of the abdomen to support the uterus and help bring the pelvis back together)  

My experience apprenticing with a Mayan midwife

  

                                                                                                                                                                                                                                                                                                                                                                                                        
I am one of those lucky people in life that always knew deep down what I wanted to do with my life.  When I was four years old I asked my mother where babies came from.  She, being a open and forward thinking 90's mom, decided to rent a VHS video on home birth from the local library and show it to me one afternoon after coming home from my YMCA daycare.  I remember lying on the couch with my eyes wide and when the baby was born I cried.  My mom had left the room and when she saw me on the couch with watery eyes she asked me what was wrong and I remember saying to her "It's just so beautiful mom".  I feel so lucky to have a mother who had the courage to show me the truth about birth at such a young age.  I found myself becoming obsessed with babies and baby animals.  The idea of pregnancy fascinated me and I remember starring at pregnant ladies in the grocery store floored by the fact that they were carrying life.

 15 years later, by the time I graduated high school, I didn't feel ready for college just yet so instead I studied herbal medicine at a school called Vitalist School of Herbology in Ashland Oregon (my hometown), while there I met an aspiring young herbalist named Lauren.  We bonded quickly over women's health, herbs and our passion to drink mate and knit!  A few months into the class, Lauren discovered she was pregnant and we geeked out together over her pregnancy, the things she was eating, what herbs she was taking, her emotional state of being, just everything.  Lauren had never seen a birth and neither had I so we decided to take a doula training class together.

Definition Doula:
The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.  Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.

During our 30 hour training Lauren and I continued to bond and she even asked me to be her doula!  I was so excited and honored to help her through her birth process.  She wanted to have a water birth in her home with a midwife and she did.  On a cold December morning in 2012 she went into labor, Lauren was so strong and at one point even played us a tune on the piano.  I love to tell people about that birth because it was so much fun and Lauren remained confident throughout the entire process.  At around 4 in the morning Mary Twyla was born and the whole family serenaded her with a lullaby that Lauren and her husband Sal had been singing to her throughout the pregnancy.  It was a beautiful birth to watch and it deeply inspired me to continue on the path of midwifery.  I was 19 when I attended my first birth and I knew it would be the first of many to come.

Seeing my first birth really opened some interesting doors.  I knew that I wanted to study midwifery but wanted to make sure I could handle emergency situations first because I DID NOT want to be a midwife who couldn't react quickly when she needed to.  So I enrolled in an EMT training program and studied for six months.  I learned some very valuable medical skills and had the opportunity to work in the ER and on an ambulance.  It was fun, fast paced and I especially loved the patient interaction, but I knew in my heart of hearts that the birthing room was where I needed to be. (I almost became a Paramedic because we had a hospital rotation in labor and delivery!!)

On a whim I decided that being bilingual was another component missing in my education so I packed up and moved to Xela, Guatemala to study Spanish and hopefully find a way to study midwifery.  I enrolled in an intensive Spanish immersion program where I took five hours a day of Spanish and lived with a host family.  I spoke as much as I could, watched movies and read books all in Spanish.  I felt like an idiot for the first three months.  Then, like I've heard people say before I felt a click and one day it happened, I could speak Spanish!  As my confidence grew in my ability to express myself, I began my search for midwives or clinics to volunteer my time.  I didn't find anything and began to lose hope.   Then after about 8 months the midwives found me and through a mutual friend I was invited to participate in bi-weekly classes. In exchange I worked in their clinic recording the births and health reports of the 30 different municipalities of Xela. 

About a month ago I was invited to translate for a medical brigade (The mission of Medical Brigades is to provide comprehensive health care services in rural communities with limited access to healthcare) with a very dear friend of mine Meghan (super spunky Peace core volunteer). It was the most fun I have ever had "working" I had the opportunity to work with a doctor and translate private consultations!  I love to talk about medicine and it was so refreshing being with such caring medical professionals.  One of the clinics we visited was run by a Midwife named Dona Ana.  She was held in very high regard (that's why they called her dona) so Meghan and I decided we would go talk to her about attending a birth.  We spoke to her on a Thursday morning and she happily agreed to let us sleep over and watch her do her work.  We received a call about five hours later and giddily hopped on a VERY crowded bus and made our way to a little aldea called La buena vista about an hour away.  We were welcomed into the clinic (which is actually Dona Ana's house) by the laboring mother's family and Dona Ana instructed us to sleep in a small room that shared a wall with the labor and delivery room.  We didn't sleep much and stayed up for most of night listening to the sounds of labor and counting time in between each contraction.  I remembered very clearly from Lauren's birth hearing how her moans changed as she got close to fully dilating.  At 4am Dona Ana came down and things started to speed up.  

Meghan and I watched her closely as she checked her dilation.  She announced that it was time for the mom to start pushing so she instructed the soon to be mom, who was on her back, to grab her knees and pull them back and push with each contraction.  Within five minuets of pushing a beautiful baby girl was born to a first time mom of 22.  We watched Dona Ana clamp and cut the cord then weigh the baby who was 6.5lbs.  Dona Ana instructed Meghan to dress and swaddle the baby while she taught me how to find the placenta (it felt like a ball about the size of a softball) then push it as far down as I could and while using her clamp to guide (not pull!) the placenta out.  Then we checked the placenta to see if it was intact because she informed me that if it was not the mother would need to go to the hospital for an internal cleaning of saline solution.  Luckily it was intact and we could start dressing the mother.

Indigenous women in Guatemala use a type of traditional dress called traje.  It consists of a blouse made of thick material a long piece of cloth that they wrap around there waist and a faja or belt to secure the skirt.  The faja is cinched very tightly around their waist and they attest to it for their hour glass form.  In Xela where I live 80% of women wear traje.  In a later post I plan to explain in depth about the significance of traje and how the process of fajar (wrapping) is something that was should practice in hospitals and homebirths in the States.

We put a new skirt on her sliding it under her back and used her faja (belt) to cinch up her waist again.  The faja is very important after birth in Guatemala because it helps keep the uterus in place and helps bring the pelvis back together and into its position.  We barely had time to fajar the new mom before we were informed that another laboring mother had arrived.  Dona Ana then burned the cord with a small white candle, re-bundled the baby and handed him off to Meghan to tuck him in with his tired mom, while we cleaned up the room.  The next patient that came in and was already dilated to 8cm and I  knew when I looked at her that she needed some serious labor support for her contractions.  I put pressure on her lower back to help with her back pain and and used some acupressure points.  That really seemed to help and she was fully dilated in 30 minuets.  She was a champion during her delivery and at about 6am she had a beautiful little boy (un Baroncito) that weighed 4.5lbs.  Everyone was worried about him because he came a month early but he cried quickly and we knew he would be ok.  He was just so tiny that when I picked him up I barely felt his weight.  Then he looked up at me I really felt like he was trying to figure out if I was his mom and I knew in that moment I had soooo much to learn from Dona Ana.

Dona Ana has attended over 11,000 births and learned the art of midwifery like most women do here, from her mom who was also a midwife, Dona Ana started when she was 14.  In Guatemala the role of comedrona (midwife) gets passed down to each generation through their daughters but unfortunately that custom is changing and less young women are training as midwives.  Also women are using hospitals in place of midwives more and more and cesarean rates are through the roof.  But Guatemala has a very strong indigenous culture and many women, the majority in fact, still use midwives. Women come from hours away to be attended by Dona Ana and on average she attended 2 births a day or more in her clinic.  

After the two births I saw I was sold.  Dona Ana and I really hit it off maybe because her name is also Ruth (but everyone calls her Ana) or because even in the middle of attending births we would laugh like old pals with my friend Meghan over little jokes about being gringas or trying to speak Mam (one of the native dialects in Guatemala).  Overnight I became a midwives assistant.  The next time I showed up I attended four births over a period of about 20 hours.  I was instructed to clamp and cut umbilical cords, help guide the placenta out with massage and pressure, I learned how to wrap/bind the stomach to put the uterus in in its place after birth, checked dilation, examined placentas, learned abdominal massages to prevent hemorrhaging and dressed tiny babies.  She wanted to teach me and in those first few births she guided me through the process having me do more and more with each birth.  It was a long day and night and though I took catnaps in a chair with the patients by my side I was exhausted from the lack of sleep but content with the work and support I had given.  At 6am the fourth baby of a long night was born and after we burned the umbilical cord, swaddled it, and wrapped him up in blankets with his mom we climbed the stairs into the kitchen.  Dona Ana poured me a cup of Atol (corn meal drink), we sat ourselves next to the wood stove and warmed our hands.  When she told me "Espero que hayas aprendido algo la practica es la maestra y por eso debes estar con las pacientes alli tu vas a aprender" (I hope you have learned something, the practice is the teacher and so you should be with the patients, there you will learn).

Over the past two weeks I bounced back and forth between Buena vista and Xela spending nights in the clinic and days studying for a very prestigious Spanish exam called Dele.  During the weekend I don't have class so I have been buying ingredients for Caldo de res y pollo (beef or chicken soup) and hanging out in the Dona Ana's kitchen with all the women and we make the family who all come over on Saturday's lunch.  Among them are a band of small and large children who love to ask me words in English and teach me Mam while we go fruit hunting in the garden.  Saturday's they light a fire in their chuj (or sauna) and two people at a time enter and receive massages, bathe, and relax (I have even seen a one year old accompany her mom!).  I still haven't gone in yet but I hope to this next weekend.  I have so much to learn about the Chuj!  In the Chuj Dona Ana gives massages to postpartum moms.  In the next few weeks I will be sure to write a whole post on it.  However, for now the Chuj remains a mystery.

I am so excited to share my experiences with my friends, family, and future homebirth mamas.  What I am learning in Guatemala I will lovingly utilize in my midwifery and doula career.  I am planning on going to Midwifery school in Texas next year and working on the border with Latinas who cross the boarder with laser visas and give birth in a birth center so their children have American citizenship.