Homeward bound!

Well here we sit at the Freeport airport and the only entertainment is Divorce Court... Lord, give us the strength! We are hoping to make the last flight out of Toronto tonight but it may not happen - cross your fingers for lots of no-show ticket holders...

We went to The Rand yesterday to say our goodbyes and were thrown a surprise farewell party by the maternity staff! It was very touching. They had bought both of us Bahamian gifts that were given to us along with a speech, and then we enjoyed sandwiches, cake and drinks that were supplied by the staff. The hospital photographer documented the event for the newsletter and the staff were very sweet by telling us what they had learned by our presence.

We spent our last day visiting the Lucayan National Park which we were told about when we first arrived on the island. Pity that we forgot that the high point of the park was the underground caves... we went to the other side of the park instead and enjoyed a mangrove walk and deserted beach for a couple of hours. Oh well, I guess we will have to come back to see the caves!

We feel privileged to have been able to come here to assist the women that we met. I feel so much more confident in my midwifery skills and we both are sure that the women we helped had a better birth experience because of our help. What we didn't expect was to make so many new friends :)

Thanks to all of our blog followers - it was really nice to know that you were all with us in spirit.

We'll be back. Yea mon.

A funny "ting" happened on the way to the hospital...

Helen has now managed to secure 15 births with a huge amount of success in her outcomes all around.

We thought we would update you on several funny things (tings) that we have witnessed here :

• Firstly there is NO coffee culture here so as 2 loyal Starbucks customers, you can imagine our withdrawal...the nurses think its funny when we say we are going for a coffee
• The are literally no rules of the road...."Oh sure...go ahead...after you...." of course we have no choice in the matter
• Friday is payday so watch out for the drunks on the road and the many broken bottles they throw out the car windows
• Even though there is a seat belt law...it is not enforced and children climb all over the cars and babies leave the hospital in their mothers arms. The law was passed in 2002.
• At social gatherings, each Bahamian brings a large Styrofoam container to fill up on the hosts food first....takes it to their car for another day and comes back to eat from what is provided....make sure you make double!!!
• Each meeting that we have attended starts with a prayer and blessing
• Pickled sausage is a favorite
• Many girls are named after their fathers eg. Rogernika, Stevette, Glenisha
• Career goals for little boys..."When I grow up I want to be..." a drug dealer so I can wear gold chains and drive a fancy car
• There is NO fresh seafood available and fruits and vegetables are very expensive....Burger King is cheap though
• When it cools down....out come the flip flops with socks
• The PACE Clinic (for teenage moms) is on Young Husbands Drive

This is our last full day and we plan on saying our thank yous and goodbyes...

Wham, bam thank you ma'am

Another 2 births occurred on our watch yesterday. To say it was craziness is a huge understatement. We called in first thing in the morning to find out if anyone was in labour, and were told that there was someone in the early stages of active labour so we made our way in.
When we arrived at The Rand there were 5 women in the labour ward! Keep in mind they only have 4 beds. One of them was a "grand multip", so named because this was her 9th pregnancy (at 27 years old). 3 or 4 of the others weren't actually in labour but were there to be assessed for various reasons. There is only 1 nurse/midwife assigned to that part of the maternity ward so she was busy and happy to see us. Then she disappeared down the hallway for a minute to grab something and said she would be right back...
We turned around and all of a sudden from out of nowhere was a pregnant and obviously labouring mom in a wheelchair. I knelt down in front of her to get some information from her - I found out her name, she didn't know when her due date was (eek), I asked her if she had seen any doctors in her pregnancy and she said no (EEK). I thought she must be confused or not understand my accent so I asked for her passport (that's what they call the prenatal record that all the pregnant moms have a copy of with them) and her friend gave me her Haitian passport. So truly she had had no prenatal care - wow! And then her waters broke and they weren't clear so that can mean the baby is not happy - yikes. At that point I'm wondering where I'm supposed to assess this woman given all the beds are full... but then the nurse reappeared and we found a bed in the next hallway. Off come the pants (never wear tight pants in labour!) and she was checked - fully dilated. OK then I guess we are having a baby of unknown gestational age today! The nurse went down the hallway to set up the delivery room and Jen went out in the hallway to grab some clean gloves. Thank goodness she did because I looked down and could see a baby's head - yikes! OK I guess we are having a baby of unknown gestational age with meconium and no resuscitation gear right here, right now... and then we did. We knew nothing about this woman other than her name, no bloodwork, no history, nothing. She had a 9lb girl who came out screaming in spite of all of the chances that things could have been so different. Intense.
Shortly after that our mom with the many children gave birth...a silent labourer so that was interesting to watch. It was nice to see how much she obviously loved her 6th little boy.
We felt we should reward ourselves after our 7th birth in 3 days and drove to Our Lucaya, a tourist area and enjoyed a wonderful dinner and crazy limbo show...we are very happy that we feel like locals now and not tourists...a good plan to keep the preying men away!!

Joys and frustrations...

Yesterday I went in to The Rand after checking in by phone in the morning. I feel like the staff are finally understanding that I want to be called in, and want to be busy helping them. I doula-ed and then delivered a healthy little boy to an 18 year old first time mom in the back-up delivery room, as the main one was in use at the time by a private patient who was also delivering. I thought of my Midwifery Care instructor from SMS/Bastyr Suzy as the young girl said "The baby is coming". Indeed it was, so off to the smaller delivery room we went, her very shy partner in tow. She did beautifully of course and Nurse Dillett left me to my own devices to catch the baby. It's nice to know that they have enough confidence in me to just let me do my thing, and that is helping me to FEEL more confident. Yeah, actually I am starting to feel like I really do know what I'm doing :)
I'm still beyond frustrated with the immediate care practices here re "bonding time". They seem to think that a minute or two of mom and baby time is all that is needed, and then baby is whisked off to the nursery to "warm up and bathe" for a couple of hours... sigh. I've taken to grabbing a couple of towels (if there are any) to warm up in the delivery room so I have something to cover the baby while he/she is skin to skin with mom. There are no baby hats, and most of the time there are no towels, then in the small delivery room there is no baby warmer to put them or baby. Plus the A/C is always on (I suspect for the comfort of the staff - again, sigh...) so of course once I have used up the one paper towel baby cover thing and it is all wet and cold then I have no way to keep the baby warm... and of course the staff are by then wanting me to clamp and cut the cord and hand over the baby so "it doesn't get cold"... the first thing I will buy when I get home are some packets of cheap receiving blankets to send over here and some newborn hats that they use in the hospitals in Calgary.
Later in the day there was another mom in labour with her second. She was alone because her sister couldn't get a ride to the hospital to help her. I was in and out and helped her when I could, but was also busy helping new moms with breastfeeding in the postpartum ward. Whenever I went in to her I rubbed her back and encouraged her as much as I could. Around supper time I heard that familiar phrase again "The baby is coming" and sure enough it was! Into the main delivery room we went and I got my second birth of the day (the 5th in the last 2 days!). A doctor was watching over my shoulder but I didn't even care and just did my thing. I was surprised later when I tucked the mom into her bed and gave her a hug for a job well done - she thanked me for rubbing her back and "being nice to her". And that's the rub here - Jen and I have heard that several times from the people we have assisted. They seem so surprised and so incredibly grateful for the things that we take for granted, just giving tlc and encouragement... it feels good but at the same time makes us sad.
Funny story from the other day - a pregnant mom showed up with her Burger King dinner and Coke, her friend and her bags... no contractions, no issues. So why was she there you ask? It was "her time" she said. OK then. Apparently prenatal education here is lacking some basic information too...

Busy and crazy day at The Rand

OK so yesterday we got called in to The Rand at 6:15am as there was a mom in labour. We arrived to help her - a 20 year old first time mom. Large and loud but lovely! We had to laugh at one point because she asked us when she could have her tubes tied! Jen and I helped her all morning through her trials and tribulations and I caught her healthy boy just before lunch. Right after that we were told that the delivery room was to be transformed into an operating room (theatre) as the main OR was having power outages! Well you would not believe the commotion - first our one and only delivery room was emptied into the hallway, a cleaning crew went in and bleached the floor and walls, and then all manner of operating equipment went in there. We had to empty our other labour room (keep in mind there are only 2 labour rooms) and transform it into a delivery room. During all of this we had an 18 year old mom in active labour who Jen and I were assisting. In the middle of all this a bunch of women all showed up at once, 2 women in active labour and 2 women with pregnancy related health issues, all needing to be triaged and addressed. Chaos reigned. One of the women who came in was a multip at 7-8cm, so we assumed she would need the delivery room first. Wrong! Our little 18 year old first time mom got busy with Jen's incredible assistance and I caught her little boy in the labour room while another mom laboured on the other side of the curtain behind me. Then I went across the hallway and caught another boy to our multip, and then managed her postpartum hemorrhage, while simultaneously checking on the mom across the hallway who was getting busy too. Keep in mind there are loads of OR personnel walking by and chatting loudly in the hallway... and we hadn't even started with the paperwork, let alone have anything to eat or drink. By this time it's 8pm and I was desperately trying to catch up on the charting (making sense of all the little notes I had scribbled to myself on scraps of paper), and Jen was floating in the postpartum ward assisting the new moms with breastfeeding. While I was doing this the second of the 2 OR surgeries that had taken place in our delivery room/OR was finishing up and an elderly man lay snoring on a gurney right behind me... I was tempted to reach over and give him a push to shut him up but thought better of it. We left tired but satisfied that we had made a difference and been of invaluable assistance to the staff.

For those of you who think all we have done here is lay on the beach here are the facts:
We have yet to lay on the beach
We have had one scheduled full day off
We have attended 13 births. Of those Helen has managed 10. She has a very sore arm from protecting perineums but does not regret it.
When not attending births at the hospital we assist in the postpartum ward visiting and educating "our" moms
We phone into the hospital every morning to check in - if there is no-one in labour we run along the gorgeous beach and/or do schoolwork. Yes it is lovely and we are enjoying it.

A Day Off....

We decided to take a day off today as there was little activity at the hospital and we thought hey...we can be active right here....so...a small preview of our surroundings and where we are living.


This is a view of the beach we live on looking east.

We do get to enjoy some of it !!!

The local bus stop....no kidding....lucky we have access to a vehicle.

A pay phone in the middle of nowhere and of course it does not work.

The library down the road from us.

The beach to the west where we run each day.

Here too !!!! Yes we are in awe each moment.

Where I do yoga.

Helen trying to return a book at the jungle entrance to the library. Honestly we are not having fun.....!!!!

On call, off call

Helen and I were asked by Mary, our host, months ago if we would doula and help manage a couple who Mary was very fond of....of course we agreed and as soon as we arrived here we were "on call" for them.
She called today to say her water had broken and we were thrilled for them. This was an educated couple who knew what they wanted and hoped to have the best experience they could.
Mother nature would have her way though and after a day of augmentation, decels and little progress (I dislike that term) she went to section while her poor husband went out for a drink because he was nervous.
Here, the women are put out with a general anesthetic so he had some time.

In other news Helen caught a lovely baby girl earlier in the day to a first time mom, and then conspired with a NICU nurse to "allow" her to breastfeed the baby BEFORE the apparently obligatory bath... and the nurse thought it was so cool that the rooting baby latched herself onto the breast! No kidding... Planting seeds, planting seeds...

We look forward to seeing them all tomorrow....goodnight.