Delivery Room One
Midwives here run the show!
(Woot! Woot! Loud applause and deep respect!) Through the course of a
normal delivery, there are no docs in the delivery rooms to assist, no
respiratory therapists, no baby nurses, no body else but the laboring woman and
the midwife. They are excellent at what
they do; they are competent, capable, loving
(in their stern sort of Caribbean way) & know how to get down to
business. Their laughter and joy allow
one to move with ease through these hot and humid days. I admire these women and hope to wander with
such confidence one day. Necessity is
the mother of invention...
These midwives each have their own proverbial bag of
tricks. I want one of these! Much like
Hermione Granger’s magic handbag, holding infinite bits and pieces to navigate
one’s way through these variations of normal.
When infinite meets the end of the road, the docs will come to check out
the situation and to offer additional guidance and support to what everyone
hopes to be a healthy end. And when it
does, the happy dance that ensues motivates a rather large smile on my
face. I have yet to encounter anything
other than the happy dance and do not look forward to the alternative.
The docs here are either ‘juniors’ (those that have not yet specialized)
or “consultants” (some have been practicing here for a lifetime according to
these ladies). They all “round” on these ladies throughout the week. In addition, they see them “immediately”
postpartum to check on their well-being, particularly if there are variations
from normal. The midwives and docs get
along well and seem to have a very collegial relationship, I dare say even
friendly and familiar. I envy them. I hope there is a day that I get to
experience this in my own professional world, from a place of collaboration and
mutual respect.
However, the autonomy of the midwives here is being
threatened, as is the normalcy of pregnancy and childbirth. I get a sense the proposed changes are coming
from some higher up place and will impact the way that these women can care for
the women in their ward. Interventions
and procedures that have historically been reserved for pathology are being
considered for routine admissions. Non-stress
tests, for example, typically utilized to monitor fetal well being in the face
of things like post-dates pregnancies, trauma, decreased fetal movement and
other such concerns, are routinely performed on all low-risk, healthy
admissions to the labor ward. Some of
these midwives have some very strong opinions about the way things are
changing. I cannot blame them.
Discussions on the ward of creating a midwives association
are reminiscent of those that have gone rounds in the states. There is a “Midwifery Interest Group” here on
St. Lucia and, in its infancy, is rather small in numbers. “We don’t need a GROUP, we need and
ASSOCIATION!!!” This coming from a woman whose passion is clear and commitment
to autonomy, deep. It is this kind of
spirit, matched with her brilliance, that will motivate change.
In other news...
I feel like a broken record here but have to give a shout
out to the midwives and Sisters on the ward that have so warmly welcomed this
brown eyed stranger replete with beaming (and perhaps foolish at times) smile,
into their world. I have been made to
feel like part of their team, to enmesh myself into the weave of their
fabric.
They look out for me, urging caution while trying to avoid
inspiring a riot of fear in my being.
Concern for my personal safety is their highest priority, followed second
by their desire for my to have an abundant learning opportunity while I am
here. These both saddled with a reminder that I must find time for “leisure”
while I am in St. Lucia as the beauty is abundant. All work and no play...
I take it all to heart.
“Work” in the hospital during the daylight hours, for now. Most evenings are spent with a farewell to the
day on the rooftop terrace, or in the pool (or both) communing with the bats as
they pass swiftly by trying to navigate a dip or two while effectively
navigating a path to avoid a collision with my head as I bob along in the cool
water.
Looking forward to enjoying a mango or three soon enough,
they are too green as yet but are blushing.
The bats have beaten me to the hanging fruit already. The trees are
robustly full and promise (or perhaps tease) a deluge before I depart. What a bounty it will be, if not for me then
for the ladies who will be arriving here in May after I leave.
Tantalizing treats!
Thank you all for your continued support, donations and enthusiastic delight!
Signing off in gratitude!
Rodney Bay
