The Midwife with Legs (among other things)

Hello friends and family!

A lot has been happening the last few months! This blog has several stories and updates, so get comfy, grab a cup of coffee and enjoy.

Ministry Activities 

In February, we started our prenatal care clinics. We decided to start providing prenatal care, even while construction was still happening on our birth centre, in order to start to build relationships with women in the community. We have a sort-of mobile clinic. We have a big rubbermaid box filled with everything we need for a clinic: medications, dopplers, blood pressure cuffs, a weigh scale, rapid tests for HIV, syphilis, anemia and Hepatitis B; we have blood typing equipment, medications (prenatal vitamins, iron supplements, antibiotics, parasite medications, TUMS, tylenol), stethoscopes, baby weigh scale slings, gloves. We have it all and it all fits nicely into our box. Every Wednesday we load it into the car and drive to Escuintla to set up the clinic. It works well!

Our clinic set-up

Little by little, our roster of patients has grown to 15 women! The earliest is 8 weeks pregnant, and we have several who are due any day now. At this time, we are still not attending the deliveries because we want to wait until the centre is completely finished. In the meantime, these women will travel by bus to the hospital to deliver. One of the concerns that women have delivering in hospital is that they may be turned away at the door. Often the hospital says there are no beds available. Other times the hospital says that because the woman never came to them for prenatal care, they won’t admit her. Last week we had two of our ladies deliver in the hospital. Both were given cesarian sections because their “amniotic fluid level was low”. This is a very typical excuse for a c-section. I’ve been told that 85-90% of public hospital births end in c-sections. This usually happens because c-sections are more convenient for the doctor. Often if a woman doesn’t deliver within 4 hours of arriving at the hospital, she is told that her “labour is stalled and it will be impossible to deliver” and is given a c-section. I’ve seen this time and time again. Four of our prenatal women are due in the month of May, and I won’t be surprised if all of them are given c-sections.

After a delivery, we provide follow-up postpartum care at the woman’s home. We will visit them every week for a few weeks, and then at 40 days.

This woman brings her baby for postpartum visits every week. David Alexander is now 3 months old and doing well, but she keeps coming every week just to chat. We enjoy her visits too 🙂

Sleepy baby at a postpartum home visit

A postpartum visit

A local health centre near our birth clinic has asked us to come and do prenatal care in their village too. According to the nurse there, “we only have one midwife left in our town, and she is very old and can’t see very well any more.” We have started going there once a month to provide prenatal care.

The woman in the blue dress is the 85-year old midwife that the nurse was referring to- the only one left in her village.

In addition to our prenatal clinic in Escuintla, there are two babies/families we are following closely here in the town where I live, San Antonio.

The first family is a single mom, Brittany (18 years old), and her 2 year old daughter. We met her when she was very close to the end of her current pregnancy. Brittany was going to give her baby up for adoption because she didn’t know how she was going to provide for her family as she does not have a job. A missionary who met the family suggested to Brittany that perhaps I would be willing to visit the baby on a regular basis after birth to make sure he isn’t becoming malnourished, and to help them with any other medical concerns the baby might have. Brittany was open to this idea so she decided to keep the baby. She was going to have a c-section at the hospital a few days after I met her. She went to the hospital on the scheduled day, but was turned away and told to wait another week. She went back the next week, and was turned away again because she didn’t have money to pay for the supplies for the surgery. The patient has to pay for anything the surgeon needs: gloves, medications, tools, etc. Brittany has no money, so she came back home. Her own mom started working extra hours washing laundry for people in order to make enough money to pay for the supplies. A day or two later I went to do another visit and found Brittany in labour at her house! They still didn’t have the money for the supplies. I drove her to the hospital that day and bought the supplies. Brittany now has a healthy one month-old baby! They are both doing very well, and I am checking in on them on a regular basis.

The second family I met through another missionary family here in San Antonio. The mom had taken 3-month-old Lourdes to the health centre and they told her that she had a tumour in her abdomen that needed to be operated on immediately. The mom, obviously very scared, came to this missionary family asking for help/advice. I came to look at the baby and discovered that she has an umbilical hernia, not a tumour. Good. Problem solved. The other problem, though, was that the baby only weighed 8lbs and was a bit lethargic. The mother was not breastfeeding but giving formula. We realized she was giving the amount of formula for a 3 WEEK old baby, not a 3 MONTH old baby. Good thing we got that cleared up! The next week, Lourdes looked much better. It can be frustrating working with local health centres because often their training is minimal. With Lourdes, her mom brings her back to us week after week with a new problem- a rash, a fever, diarrhea. Unfortunately, many of the problems are the result of the health centre’s interventions. For example, a few weeks ago the mom took Lourdes to the health centre because “her stomach was hard”. The nurse gave them diclofenac, which is a strong pain medication that should not be given to 3-month-old babies! WHYYYYYYYY. Of course she developed diarrhea! Sometimes we want to pull out our hair. We don’t want to go against or speak badly about the health centre, but it’s hard when things like this happen. No, your baby does not have a tumour. No, she does not need surgery. No, do not give your baby dicolfenac. Week after week it seems like we are putting out fires that the health centre has caused with this baby! However, despite all of that, Lourdes is now doing well! We visited her yesterday and she weighs 12lbs!

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Construction Update 

We have walls, and the roof and electrical is being done today as I write this! We are already looking for furniture, and we are all excited for when we can move in shortly!

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Comadrona Certification 

(“Comadrona” = “traditional birth attendant”)

PRAISE REPORT: Last week I received my certification to be a legal comadrona. Several people had told me that this was nearly impossible to achieve as a foreigner; they said I need to be Mayan (the native people group of Guatemala). Comadronas usually have little training and it is more a “gift” that is passed down from generation to generation. In Guatemala, the only people who can sign birth certificates are medical doctors and comadronas. I had been worried about this, because I don’t want to deliver a baby if I can’t provide the legal paperwork.

But God — He had this all worked out. I didn’t need to be stressed about this. I should have known that if God called me here, He would make a way. My God is a God of excellence, and He would make a way for me to do things correctly and legally. He doesn’t do things half-heartedly. Everything He does is with excellence!

My comadrona certification

Now I can legally deliver babies in Guatemala! I’m excited about this, but even more so, I’m excited to see God’s hand in the timing. Everything lines up.

Construction will be done soon.

Only now am I certified as a comadrona.

I have had time to built great relationships with the local health centre.

I’ve had a few months of building relationships with women already.

God’s timing is always the best timing. Sometimes it feels like accomplishing things in Guatemala takes forever (you would be shocked to see how trying to get a photocopy of my passport can turn into a whole-day affair!), but waiting is never in vain. God is always working behind the scenes, making things line up perfectly to accomplish His purposes. I am certainly learning patience :).

Let this be an encouragement to you if you’re in a time of waiting. What are you waiting for?

• a job?
• a husband?
• a promotion?
• a baby?
• school to be finished so you can do something “more important”?
• test results?
• a change of some sort?

You can fill in the blank. You don’t want to push your own timeline because God’s timeline is infinitely better.

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The midwife with legs 

Here’s a quick fun story. 

Someone told me that here in San Antonio where I live, there is an old comadrona who just had both her legs amputated and therefore wasn’t practicing anymore. (Could you deliver a baby if you had no legs? Me either. It would be difficult.)  I wanted to find her and ask if I could help her at all. 

So I found out where she lived. I walked to her house one Thursday morning, and I was planning to say something like “Hi Doña Marcela, my name is Stephanie and I’m a comadrona too, and I was wondering if I could work with you or help you since you aren’t able to practice anymore.”

I knock on her door. An old woman, with more lines on her face than I can count, answers. I say “Hi, is this the house where Doña Marcela lives?” 

“Yes, I am Doña Marcela” 

“Uhhh…” I shift my gaze downward and see that Dona Marcela does, in fact, have both legs! She is definitely not a double amputee.

Well this is awkward. Thrown off guard, I say, “Okay, well…nice to meet you. I’m a midwife…” And she invited me in. I talked with the 70-year old comadrona for a couple of hours and she invited me to visit her every week so she could impart all her comadrona knowledge to me. She said, “This is great. I will teach you to be a wonderful comadrona because I am old and will probably die soon, and I need someone competent to take over for me.” I almost laughed out loud. She is a firecracker and I’ve been visiting her on a regular basis. Except last week, I showed up to her house and she said we couldn’t meet that week because “my grandson is trying to bake cookies but he doesn’t know how. I’m afraid that if I don’t stand beside him the whole time he will not only burn all the cookies, but he will probably burn the house down too!” “Okay Doña Marcela, no problem. I’ll come back next week” HAHA. 

Now, what I don’t know is if there is still a midwife rolling around San Antonio somewhere with no legs, or if there was just a miscommunication. Either way, rest assured: Doña Marcela DOES HAVE legs! 🙂 

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That’s all for now! Thank you for reading. Thank you for your continued support and encouragement. None of this would be possible without each of you.

Love,

Stephanie