Monday, March 23, 2009

Short and very sweet!

Hey! We have some 'sweet' news! Thank you all for praying for the provision of my final semester's tuition payment!! We were able to pay the sum in full this past week with just a little late fee. Praise the Lord! Thank you for those of you who donated and those of you who prayed. We are so grateful. 

Last week, I delivered a baby boy named Francis. He's very handsome and his mother is doing well. I saw Ruby and baby Bethany last week, as well. Baby Bethany is unfortunately very sick. Her first week was full of lung problems, her second week was a cold and now this week, she has a distended stomach that is continuing to grow. She cannot afford to continue going to the doctor and is quite concerned for her little one. Please keep her in your prayers. Mercy and I have already helped her out substantially, so she is not left empty-handed. But I want to pray for a total healing so that she has no need of extra money! 

Thank you again for all your prayers and continued support. We are now praying that the Lord will provide the funds to head back to the West for a month or two to tie up some loose ends, visit friends and family, take a rest, and show off our new addition. Promise is doing great these days and I can see one tooth is just peeking behind her top gums. :) That's the quick update!
Be blessed.

Saturday, March 21, 2009

A Bird In Bukidnon

I don't tell you about work very often because it all seems so routine. Meetings, emails, text messages, phone calls, meetings, texts, ad infinitum. We're having fun, getting lots of water filters to lots of people—for those counting at home, our current count is 1500 filters, 25,000 beneficiaries since our start 13 months ago. My particular job is just to keep growing this thing and find as many partners as I can. It's a great job, and I love it, but it doesn't make for gripping narrative. This week, however, was a little out of the ordinary, so I thought I'd tell you about it.

On Tuesday, I had the pleasure of bringing my family to work with me. I have been working to develop a partnership with a local organization called Catholic Relief Services (CRS). They are doing some great work with farmers in the province of Bukidnon, developing water storage tanks that assist with irrigation. They are eager to work with Impact Nations, so that the water collected in their reservoirs can also be turned into safe drinking water. This week they were having a big ceremony to officially launch their efforts in the province, and they invited Impact Nations to be a part of the festivities. It was a two day affair, which would normally rule out my participation (over night absences aren't exactly practical, given our current lifestyle), but CRS invited my wife to join us.

Early Tuesday morning, Bethany and Promise and I hopped in the truck and headed out to the shop where Jun and Toti loaded up a couple of filters. From there, we all started out for the city of Impasugong, Bukidnon. The drive is about 5.5 hours through some beautiful mountain country. Jun and I sat in the back of the truck, while Bethany held Promise in the front where Toti was driving. I enjoyed reading War and Peace while stretched out over two filters and a bunch of gear, but I got a righteous sunburn, reminding me that I spend way too much time inside these days.

Tuesday afternoon was spent in the typical fashion. We stood around for long stretches of time, trying to decipher where we were to be and when. I was supposed to have a sit down with the mayor of Impasugong, but that was canceled. In the end, we spent several hours in the local gymnasium, which was serving as the venue for the event. We were able to set up a table with our brochures, and my computer which played a slide show explaining how the filter functions. We also installed a filter for demonstration purposes.

After we had set up our booth (and figured out that the meeting with the mayor was canceled) we headed in the direction of the hotel, which was a 45 minute drive away from the venue. I think we finally checked in at around 4:30pm, which means Promise hadn't had a nice place to relax since we left the house ten hours prior. Would you believe that she didn't really fuss during that ten hour period? She's a pretty awesome little girl. Good traveler.

I was disappointed that my meeting with the mayor was canceled, but it was nice to have the rest of the day off. We relaxed in our hotel room for a while, then I joined Toti and Jun for a nice dinner at Jollibee, which serves as McDonald's Filipino competitor. Bethany stayed at the hotel with Promise, waiting to see what treats would return from the exotic Jollibee.

On Wednesday we checked out of the hotel by 7am and made our way back to the gym; but not before another stop at Jollibee for a breakfast of chicken and rice. Upon arriving at the gym we discovered that the Jollibee repeat was unnecessary, as there was a full breakfast spread for all the visitors. It's really hard to tell a Filipino that you're not hungry, so it was inevitable that we would be eating a second breakfast.

I'm giving you way more detail than you need. This is boring. Ok, I'll cut to the chase. Bethany and Promise hung out in bleachers behind our little booth, which worked out pretty well, because a white baby in Bukidnon is about as rare as an AIG executive in an unemployment line. So if the Bio-Sand Water Filter didn't draw people into our sphere of influence, the Lady Bird was sure to do the trick.

The event was attended by over 200 barangay captains, and several mayors from around the province. While they were mostly there to learn of CRS's agriculture and irrigation efforts, many showed an interest in our project. I had an opportunity to make a presentation to a large group, including some representatives from the US Department of Agriculture. We were mainly there to raise awareness and hopefully make a few new contacts—I'm always looking to expand our network. I'm not sure how successful we were, but I know that our relationship with CRS was strengthened. Some of their engineers will be receiving our full training package in April.

We packed up by 2:30 on Wednesday afternoon and hit the road again. Bethany opted to sit in the now very spacious rear of the truck (minus two filters, which had been installed at a CRS facility), while I sat with Toti and talked about work too much for too many hours. Once again, Promise was amazing, and didn't really fuss until the last hour and a half of the drive, which finally concluded around 8pm.

It was great to have my family with me for the trip. I had fun holding the Bird while explaining the filter to curious onlookers. Bethany and I were encouraged by Promise's contentment whilst traveling. Hopefully she likes planes as much as she enjoys little red trucks.

Today was a little out of the ordinary for me too, but I think I'll save that story for another day. For now, I will leave you with a bunch of snapshots from our little journey. I think they are all self-explanatory. As per usual, click on an image to see the full size.


Tuesday, March 10, 2009

"I got a guy...

...and he's tough...he's a diamond in the rough...and when I polish him up, I swear, he is a Tiffany Solitaire". Ya ever hear that song? The Ella Fitzgerald version is the best....but my guy doesn't need no stinkin' polishing. Yes, I'm talking about Tim.

Thanks for the all the kind encouraging words in response to last post. I feel very loved...and undeserved. I guess that's what truly feeling loved is all about. :)

Tim. Yes, he says he doesn't like people and he's just too practical and logical to get emotional about things, but I tell ya...I wouldn't change a thing.

This week I labor-watched a patient for 8 hours and I have to say, it was truly eye-opening. As I have shared before, most of our patients at Mercy are "puyo-puyo"...."live-in" and not married. Despite the deep-rooted Catholicism, marriage here is not always seen as the covenant God intended. There are stories upon stories of our patients not getting married because they want a big Western wedding with bridesmaids and little girls in pretty dresses, but they have no money....stories of being the mistress of a married man now pregnant with his child and now being scorned upon....or the married woman separated from her spouse because he left her for another woman....or even the married woman living with the spouse and his mistress and all of their children....sounds like some Old Testament stuff, eh? And as their midwife, I grieve for them, but say nothing. I don't know how I would handle those situations.

Meanwhile, those who choose not to get married often explain that they are really not sure they want to marry their partner....he's already cheated on them or she's cheated on him or she just doesn't really love him, and yet, she's having his child. There are so many fatherless children here as a result of such decisions.

Which leads me to my patient this past week. I will leave her anonymous, but we'll call her "D". She was having her third baby. The first was a girl, the second died just after birth because of postdates, and six years later, she was having her third baby....ultrasound showed a boy. She came to Mercy alone stating that her husband (yes, she was married) was working and her sister would be joining her shortly.

She told me how she had moved alone to Kuwait just after her first baby was born to work as a live-in helper to a rich family there. The husband there was less than friendly and at times, abusive. She told me that she learned to be quiet....she learned Arabic, English, and how to serve unnoticed. She spent two years away from her husband and her daughter to make money because her family was poor. She says that she returned a much wiser woman.

I asked tons of questions about her time in Kuwait, about the difficulty of leaving her baby and husband behind, and asked how poor she thought she was. Her response to me was quite jarring....emotionless. She told me that the first few months were hard, but she allowed her need for money to replace her loneliness and in time, the satisfaction of having money replaced her need for love. Wow. I was stunned as I listened to her almost perfect English. I was so surprised by what she was saying that I had to repeat it several times back to her to make sure I was not missing something in translation.

I asked her if she loved her husband....she's been married for over 7 years. She replied, "well, not" Ummm...okay. Why? She said, "If I do not love him, then he cannot hurt me when he cheats on me." Double wow. I then asked, "HAS he cheated on you?" To that she replied, no, but he will when he gets tired of me. All men cheat. My heart sank. Her heart so jaded by hurt....or the fear of it. I asked if she loved her daughter. She replied that she chose not to love her daughter because she didn't want to hurt if something happened to her like what happened to her second baby. Afraid to love, afraid to hurt. She said that survival replaces love. Love is unnecessary.

We talked briefly about the love of God....pure, rich, unfailing. She recognized that love, but saw no need to adopt that love for herself or those around her. We talked about how hurt God must have been to have lost His only Son for us and she remarked that God's actions did not get Him anywhere....we are still bad. Mmm.

Then she changed the subject. She asked me if my husband was a Filipino and if he ever cheated on me. I confidently replied that I fully trusted my husband, loved my husband and considered him a gift from the Lord to me. She was unfazed and mildly annoyed by that. She assumed that one day he would cheat and I would find out the truth. Unfortunately, the patient in the cubicle next to us started pushing and I needed to go chart, but my heart was so grieved. I never had an opportunity to finish our conversation...and I didn't get to deliver her baby, as I had to endorse her labor to the following shift.

All I could do was pray that the Holy Spirit would show her His love and that it would reveal how joyful and matchless the love of God faithful, unfailing, and eternal it is. And I began thanking the Lord over and over again for my Tim....his faithfulness to me and to God...his desire to honor and serve me and his (God-given) logical practicality that keeps him (and me) grounded in truth. Tim has been offered phone numbers, other mens' wives and mistresses (in front of me!!) and yet, I have no doubt of his faithfulness. What a precious gift. I feel so secure in his love for me and his love has, in many ways, revealed to me the powerful, freeing love of God.

When I think of 1 Corinthians 13, I think of Tim. I know it is a familiar passage, but read it anyway....

"1If I speak in the tongues of men and of angels, but have not love, I am only a resounding gong or a clanging cymbal. 2If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but have not love, I am nothing. 3If I give all I possess to the poor and surrender my body to the flames, but have not love, I gain nothing. 4Love is patient, love is kind. It does not envy, it does not boast, it is not proud. 5It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. 6Love does not delight in evil but rejoices with the truth. 7It always protects, always trusts, always hopes, always perseveres. 8Love never fails. But where there are prophecies, they will cease; where there are tongues, they will be stilled; where there is knowledge, it will pass away. 9For we know in part and we prophesy in part, 10but when perfection comes, the imperfect disappears. 11When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put childish ways behind me. 12Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known. 13And now these three remain: faith, hope and love. But the greatest of these is love."

Tim is so very precious to me and his love is unlike any I have ever known. He always protects, always trusts, always hopes and always perseveres. Now my mom and dad could tell you that I am not an easy gal to live with, but Tim is not easily-angered and has not kept a record of my wrongs (of which there are many!). He is patient with me as I struggle in my faith and in work and service...he knows me better than I know myself and though he may not know me fully as God knows me, he is always seeking to know me better.

It is interesting to me that God shares that the "greatest of these is love" and yet loving often causes the most hurt....however, it also stimulates the greatest healing. Freedom. To be exposed. Tim's love for me has allowed me to accept the healing love of God. Oh, the power of a husband that LOVES!

I could continue, but I feel that I just might be repeating myself over and over. I love my husband and I know he loves me.....and I know his love is an outpouring of the love of God..."I am my beloved's and He/he is mine."

Be blessed....and if you're married...go give your spouse a sloppy, wet kiss. You're loved.
PS. The bird is doing much better and the phlegm is (literally) on its way out. My cough is getting better, too! God is good. Thank you for praying. We're on the mend!

Sunday, March 8, 2009

The Lady's a Champ

You've heard from Bethany a lot over the past week or so. I wanted to give you my perspective. Things have been a little confusing for me. Life has been difficult for the two ladies in my life, and I'm not sure how to react to it. Those of you who know me, know that I am guided by reason rather than emotion more often than not. Sometimes I feel guilty for approaching our problems with logic, staring them down with cold, hard facts. But that's just my approach.

It's been interesting to observe Bethany experience a new aspect of motherhood. Especially in contrast to my response to the Bird's illness. Promise's sickness really has troubled Bethany, while my reaction to the sick child has been one of compassionate indifference. Yes, I feel terrible that my kid isn't feeling well. However, I can't help but think "Hey, kids get sick. She'll get over it." Does that make me a cold, detached jerk? Or just a level headed Dad?

Promise does seem to be improving, though she barfed on my pillow this morning during a coughing fit. I'm no doctor, but her lungs don't seem to be rattling much anymore. Bethany must be feeling better too because she's back at work today. Between her own sickness and concern for her child, she has been so worn out of late. Once again she is worried that she is falling behind in school, but frankly, I question her logic.

Let's look at the facts about my amazing spouse. She is in her last semester of a two year, intensive training program. In those two years she has faced some unique challenges, most of which have not been faced by any of her classmates. For one, her husband has a strange job with weird hours that tends to take him out of the city at inconvenient times. Not to mention that when he is home, he is useless in the kitchen.

The obvious challenge was having a baby just before her second year of schooling began. Nobody else in her class did that. Not to mention the nine months of pregnancy that preceded the baby. During those nine months, she was out of the country for 5 weeks for a trip to North America. She suffered another set back when she was diagnosed with a herniated disc and ordered to stay in bed for a significant period of time.

Promise is our first child. Everything is new to Bethany and I. Each day brings a new learning curve and a new level of exhaustion. In 2009 alone, Promise has been afflicted with an earache (which lasted several weeks) and pneumonia. Bethany then caught the respiratory infection herself, causing her to miss work and classes.

Each of these circumstances brought a fresh wave of discouragement and strife. I couldn't begin to tell you the number of times Bethany has wondered out loud how she would finish the next assignment on time. I understand this question, but my experience tells me that it is a dumb one. She always finishes on time. She even does some of the group projects by herself because her lifestyle sometimes makes it difficult to partner with her classmates.

Despite all of these challenges, Bethany is on track to graduate the academic portion of the program along with her class in June. I'm willing to bet that she'll have pretty good grades too.

Folks, this is an astonishing woman. All I know to do in the face of her discouragement is to continue to point out her ability to overcome adversity. Yes, the Lord has been incredibly faithful to both Bethany and myself. But each and every time Bethany had a choice. She could give in to the circumstances, or she could rise above them. She always chooses to persevere, and I love her for it.

Some of our readers have commented on these pages a hundred times. Perhaps others of you have never commented before. If you're reading this today and you haven't commented in a while, why don't you leave a quick note and just tell my wife you think she's awesome. Because she is.


Here are a few pics of the Bird, including the new ducky bath that arrived from Bethany's parents recently and the Peruvian finger puppets my parents gave her for Christmas.

Saturday, March 7, 2009


Greetings again....ya know, this lack of energy to do homework has made more time for blogging...not to mention that I actually feel as though there are things to blog about!

Ya know, one of the hardest things about living overseas is the (fairly) consistent feeling of your support system is miles away, over seas and across the world...sometimes that's true, but today it's not.

I was so totally blessed today, I just had to share.....after having a cry fest this morning as Promise puked up her meds and breakfast once again because of coughing so hard, I felt pretty lost. I had enough. Tim was more worried about me and my attitude than he was about Promise......kinda felt like I was losing my mind between my own pathetic coughs.

But then I got a skype message from my friend and fellow student, Serena....she wanted to know if I needed anything. I didn't feel like I needed anything, but she insisted I come by and pick up a meal she and the girls of the orange house (the girls' dorms) were making for me....Tim and I headed over to their house after getting some coffee to get through the day....

They made me the most wonderful dish of homemade mac 'n was incredibly tasty and on top of that, they laid hands on me to pray for Promise, Tim, me, and our household that God would breakthrough and give me endurance and healing for the Bird. I was blessed. So was Tim. I felt loved.

Then Tim and I came home and cooked our tasty mac 'n cheese, fed the bird (who DID NOT THROW UP!) and then I got a text message..."you at home?" was all it said....didn't know who it was from because my phone doesn't show ID all the time. So I said, "yah." and sent Tim down to the door 'cuz the Bird was chowing down. He came back upstairs shortly with a HUGE bouquet of roses, chrysanthemums, and marigolds. He said that Sarah H brought them for me but couldn't come inside as she was just on her way home....awww. I was flabbergasted...they were the prettiest flowers I've seen in the Philippines...seriously, a good bouquet here is not only expensive, but extremely rare! I was so undeservedly blessed. And for those of you who know me, flowers are such a joy to me...having had a garden in Canada and seeing God move and speak to me through it, coming to the Phils to have a yard-less, flowerless, soil-less existence has been hard at times, but Sarah knew just what God wanted to give me.

Needless to say. Today, I feel loved.

And Promise's phlegm seems to be coming out more with not as much crackling in her fever today either. Thank you, Jesus! I think she may be on the mend. She may not like the saline drops in her nose and the frequent bulb suctioning, but it does seem to be helping her breathe. As for me, the cough has subsided a bit and the stiff neck, fever, joint aches and phlegm have diminished some, so I know we're making progress.

And so, I leave you with a Tim-pic of my awesome loved-ness. Thanks Sarah H and blessed.
Be blessed, too.

Friday, March 6, 2009

A precious moment missed.

Greetings! Thank you for all your prayers and encouragements these last few days. We are definitely feeling under fire.

Promise is still pretty sick, but she seemed to have more energy today, so that's a start. Praise God! My fever broke this morning, but not until after I missed a very special event that I had been looking forward to for months.

Remember Bel, my continuity? I delivered her baby in October of 2007...a little girl I got to name Precious. She chose me as her midwife for this pregnancy as well with her due date being March 25th. I received a text message at 3 am last night from the MMC birth room, "Your cont is here in labor, will you be able to come?" Normally, I would bounce out of bed and race to the birth room, but because of Promise and my terrible cough, I hesitated.

I quickly prayed that I didn't have a's policy that if you're sick with a fever, then you can't be in the birth room and I certainly did not want to pass on my junk to Bel and her new baby! Before answering the text, I took my temperature. crap. 100 degrees. crap.

So, I wrote back saying that it wasn't safe for me to deliver her baby and another fellow student delivered her baby instead.

I couldn't get back to sleep. Angry, frustrated, sad, disappointed, I went into the kitchen and prepared a meal, snacks and a gift for Bel and her new baby waiting for update text messages from the birth room. Tim came out once wondering what I was doing up and if I would soon be coming to bed...I just couldn't.

Around 6 am, I got a text...Healthy baby boy named Roberto Jr. Bel's first boy. She's got 4 girls at home! I cried. So excited for her. And maybe a bit of self-pity in there, too.

Promise woke up to feed full of mucous and a bit weepy. I felt the same. But grateful that Bel's baby came without any complications.

Later in the morning, Tim brought the meal, snacks and gift to her for me and her postpartum midwife, Medea, took some pictures for me. So here they are. I am so happy for her. :)

Tomorrow, Tim is headed to his first Filipino wedding for a friend from church while Promise and I stay home to continue recuperating. A huge blessing is that she is no longer throwing up while she eats because of her intense coughing, so she is able to keep stuff down now. :) She is so beautiful even when she doesn't feel well. Thank you again for all your prayers.
Be blessed.

Thursday, March 5, 2009

ENT blessing, but then....

Greetings! As I mentioned a post or two ago, I had to visit the ear, nose, and throat specialist on Tuesday regarding some hearing loss in my good ear and recurring infections. Well, I have some fantastic news! The specialist looked in side my deaf ear first and said, "eww, you have a mass in there. We're gonna have to get that out." He looked at my good ear and said, "There's no hole in the eardrum and no sign of infection. Why were you recommended to come here?"

Astonished, I shared my story of spinal meningitis, tumor in the ear, and deafness, recurring ear infections and the like. He corrected me by saying, "Well, there is no sign of any problems or abnormalities in your deaf ear and I think with long-term therapy, you could hear out of that ear!" WHAT? Last doc I visited regarding this ear was about 10 years ago and he plainly stated that not even a hearing aid would help me hear due to the lack of bones and nerve impulses in my ear! But this doc said with some nerve therapy, though costly and time-consuming, my hearing would come back. Wow. This doc shared that he could see where the tumor (though he says it wasn't a tumor, it was a scar tissue mass) had been removed from the mastoid bone and how it had left a shelf where ear wax and dead tissue collects. He advised me to see an ENT once a year or so to "clean out the pantry".

He did a little minor surgery and got the cerumen mass out (a jagged ball of scar tissue and wax build up that had caused an infection at one point) and even had this cool machine that allowed me to watch his every move on a TV screen. I felt like I was on the discovery channel witnessing ear surgery! I left feeling so encouraged and thankful. I smiled all the way home and was thanking Jesus for totally healing BOTH ears. I don't think I'll go in for the nerve therapy, though. I've got better things to do with my money and time, but it was encouraging to hear! Pardon the pun.

Meanwhile, Promise has been coughing quite a bit and then yesterday, I realized that her snot was turning green and her coughing was getting so severe she'd throw up all her food. After talking with one of my peers' dad who is a family physician, I thought it was time for another doctor's visit....especially since she gave the cold to me and the insane discomfort I felt was overwhelming...I can't imagine how awful she has been feeling!

I brought her to the pediatrician she saw before with the ear infection just a week ago and he was quite surprised to see me....and alarmed at the snotty, coughing baby I was holding. Now, I am convinced she got it from a little boy in his office last week while we were waiting for her post-antibiotic check-up. He listened to her lungs and did a series of respiratory tests....I knew what he was looking for...pneumonia.

The infection had sunk low into her lower respiratory tract and he prescribed a bunch of medications to treat her for pneumonia. Antobiotics, anti-mucous, fever-reducers....I feel like I am just eliminating all hope of avoiding pharmaceutical drugs for the baby. And just two weeks after finishing her first course of antibiotics, here we are again. Unfortunately, I am fighting it, too, though mine is far less severe. I am supposed to head to prenatals tomorrow and see Ruby with baby Bethany and baby Fatima, but I just don't want to risk passing on this junk to my patients....Thankfully, my friend, Julie, is covering my shift.

So for now, homework is a lost cause, clinic duty has to wait, and I am learning how my parents must've felt when their daughter was taken to the hospital with spinal meningitis. Helplessness, concern, heartache and discouragement must have been among their top four emotions. This week has included a lot of tears ...I hate seeing the baby bird sick. I keep reminding God that she is a miracle and His gift to us, so He has to take care of her....she is a very perfect gift and every perfect gift comes from above and therefore, He must heal her. Okay, so the logic is a little flawed....

Despite her feeling like poo, she seems relatively happy....smiling and giggling with us and has even started sitting up all by herself. She's talking a lot more now, too. I love watching her grow.
We would so appreciate your continued prayers. No doubt things could be sooo much worse!

Be blessed.

Sunday, March 1, 2009


Greetings! Well, since we last chatted, I had the privilege of catching two babies!

First, Friday's day shift had me trying new things....Beverly came to Mercy shortly after 7 am and I was up to be her midwife. This was her second baby, so we were pretty certain she would go fast. Relatively healthy throughout her prenatals, all her vital signs were good upon admission. I did an internal exam - 6 cm dilated and very active.

Meanwhile, I had 4 continuities show for prenatals....first Irish, now almost 30 weeks, then Bel at 37 weeks (almost time!!), Ruby at 40 weeks (in mild early excited), and then Genelyn at 34 weeks. So in between Beverly bearing down, prenatals were had and two more labors walked in for my two classmates....getting busy.

Then in the middle of my prenatal exam on Irish, Beverly wanted to push. A few pushes and the baby's head was visible....a few more and baby's head was out - super healthy baby girl named Fatima was born at 8:17 am. Beautiful birth. Peaceful. In between postpartum checks, I did the rest of the prenatal exams and set up for suturing. Yes, I experienced my first time suturing. Just two slight first degree tears, but they needed some help closing, so that was my job. Except, my patient was unable to pee before suturing....and her bladder was excessively full...thus she was bleeding a before suturing, I had to insert a catheter to drain her bladder and then get started suturing. Birth is messy, to say the least. Suturing was awful and I hated every minute of it, but I realize it is a good skill to have and so I will persevere and suture when need be, but for the meantime, I will do everything in my power as a midwife to make sure my patients have little or no tears! OUCH! Baby Fatima was awesome, but I had to endorse Beverly at 2 pm to another midwife to insert another catheter...this time an indwelling catheter. I am pretty certain Beverly had an undiagnosed urinary tract infection making it almost impossible for her to pee. But from what I hear, she is doing great. I get to see her tomorrow for her first baby check.

Then there was Saturday. My dear, dear continuity, Ruby, texted my around noon stating that she was having a lot of pain and thought that the baby was coming soon, but that she could not meet me at MMC because she had no childcare and her bana was not home yet. Uh-oh. I warned her of the dangers of staying home and encouraged her to come into Mercy as soon as she could. I raced to the clinic just in case.

I waited almost two hours for her, praying that I wouldn't hear the honking of a taxi stating that she'd given birth in the taxi on the ride over....this being her fourth baby, I was a little concerned that she would wait too long to come in.

Fortunately, she came in around 2 pm looking mildly active, but still smiling her beautiful toothless excited to be in labor finally, but still focused during contractions. I did an internal exam to find that she was only 5-6 cm dilated and still without her bana. So we waited, labored together, walked, ate a few eggs together, and when her bana arrived around 6pm, she began to get more active. More pain, more bloody show, not smiling near as much. By 9 pm, she was tired. She had been rolling on the birth ball with her hubby and I rubbing her back and encouraging her to continue. At 9:30 pm, myself tired, I did another internal exam. Only 7-8 cm dilated. This labor was taking a long time, especially considering this was her fourth baby and her last baby was only 1 1/2 years ago!

In the midst of her labor, her bana asked, "Ruby, what will we name the baby if it's a boy?" Ruby looked at me and said, "What is the name of your bana?" (she had met Tim earlier when he brought Promise for a feed). I told her and she reassuringly told her bana it would be "Timothy". I was blessed and texted Tim telling him he might have a Filipino namesake soon.

Within about 15 minutes, Ruby began to cry. Just a quiet weeping...transition. Tired, worn and wanting to meet her baby, she released her stress with her bana, Jerson, holding her hands and looking into her eyes. To be honest, their relationship in labor was so very peaceful, supportive, sacred. Though they are not married, they labored together better than many married couples I have seen. This is their third baby together and he was so very present in the moment for this baby.

Around 11 pm, Ruby began to bear down. Quietly, she pushed lying on the bed. The baby's head was still quite high and her pushes were not yeilding the results she was hoping for. A slight trickle of blood showed there was progress, but it was slow and her legs were beginning to cramp in the position. I gently asked her if she wanted to change positions...she quickly said no stating she was tired and wanted to lay down. After a few more pushes, I asked her again...she said no...but this baby wasn't coming past her pubic bone. She needed to sit up.

I looked in her eyes and said, "Ruby, you need to stand up. Your baby needs more room to get need to stand up now." She shot me a look like, "What...are you nuts!?" My supervisor, Carmen, and I got her up on her feet relying on her bana for support and within 15 seconds, she says, "B! Baby's coming!! NOW!" She rolled right back on to the bed and the baby's head was coming out! Just like that! One change of position and that baby came down so fast!

Ruby gently pushed her baby's head out with such control. No tear. But a nuchal cord ....around the neck...around the big push and baby came followed by a fountain and river of amniotic fluid, blood and meconium....ALL OVER ME...AND THE FLOOR...AND THE BED.....AND MY ASSISTANT. What a mess! :) Covered in birth goo, I dried off this precious new baby girl and placed her on Ruby's girl named Bethany after her midwife. I cried. So did Ruby. Healthy baby.

Then things got very complicated. Ruby's placenta came looking like it had been beat to a pulp. It was black and full of dead portions, calcifications, and was missing the amnion. For those of you who don't know, the placenta has two layers of membranes, the amnion and the chorion. This inner and outer layer of membranes serves to protect the baby and is connected very firmly to the placenta. Well, Ruby's was missing a layer. That either meant that this unhealthy placenta was lacking one or that it was still inside her uterus.

Carmen and I did some observing of her blood loss and decided we needed to get the lost membranes out. I found a little piece and clamped it with a hemostat, twisting to give it some strength. The membranes were so friable that they just tore with every slight pull. Ruby was beginning to bleed more. Now over 800 ccs. Hemorrhaging. Carmen requested that I change my scrubs as I was extremely drenched with fluids...she tended to my patient while I quickly changed. When I returned, she had found some more membranes...and they just kept coming....and coming....and coming....and then a placental lobe came out followed by more membranes, blood, clots, cotyledons, like a whole new placenta coming....and yet it was so stuck to her uterus, it just would not let go.

Carmen had to do a manual removal and get it all out otherwise Ruby could bleed to death. A manual removal involves placing an entire arm into the patient's uterus and scraping the inside to remove any placental fragments. My job was to make sure that Ruby stayed coherent and didn't slip into shock. An IV was started and I held Ruby's arms and forced her to maintain eye contact while Carmen reached deep inside of her tender uterus....Ruby was turning white under the pain and pressure. She breathed with me and I started to cry feeling so heavy for her. Baby Bethany was close by being held by her daddy and Ruby and I prayed out loud while Carmen continued to dig. More clots, more placental fragments. Too much.

Carmen asked if Ruby had been to a hilot (kinda like a witch doctor). Now, Ruby was advised NOT to go to a hilot because some of their methods are very harmful to the baby and can cause long-lasting damage. Ruby reluctantly explained that she had falled twice in her pregnancy and had gone to a hilot for a massage of her uterus to ensure the baby was okay despite the fall. However, the massage clearly had separated her placenta into multiple parts all over her uterus causing her to hemorrhage and creating a less-nutritive environment for her baby that was clearly IUGR (intrauterine growth retardation). Baby Bethany was only 6 pounds and very asymmetrical, cute, but growth restricted. The hilot had put both Ruby and her baby in serious danger. I was pretty upset she had not told me sooner, but I understood that she was shy to tell me the truth. If she had stayed home to have her baby with a hilot or even a midwife, she could have bled to death!

Carmen and I decided that Ruby needed to be transported to the hospital to get her placental fragments surgically removed (called a D&C). There was nothing left we could do but control the bleeding until the physician could remove all the remnants of her unhealthy shredded placenta.

I raced with her bana and our guard, Kuya Romi, to DMC. We prayed together and I promised to feed her baby when I got back to Mercy and encouraged her bana to come back to Mercy in a couple of hours to get the baby.

I lumbered back to Mercy to give Baby Bethany her bath, exam, immunizations, and breastfeed. It was an amazing moment to be with this precious life that came from Ruby named after me. Though small, she is a good eater and feel asleep quickly next to Carmen while I finished the paperwork and cleaned up.

Around 3:30 am, Ruby's bana, Jerson came back to pick up Bethany and reported that Ruby was doing well, resting and looking forward to feeding her baby. :) I accompanied him to DMC and then arrived home at 4 am anxious to see the Lady Bird and Tim...they were sitting up just starting to feed!

I was exhausted. Promise was hacking up phlegm in cough-form and was pretty fussy. Struggling to breathe and full of snot, I tried to feed her and took out my stethoscope to listen to her lungs....bad cold. Phlegm in her lungs. I cried. Overwhelmed with emotion...sadness for Ruby, and sadness for Promise, grateful for miracles and safety. Tired. Promise and I fell asleep finally around 5 am.

I went to see Ruby at DMC around 12 pm today to find her sitting up smiling and eating. When she saw me, she started to cry....she said, "ma'am, I am so happy for you!" I kinda looked confused and asked "why?" She said, "Just so happy to see you!" I cried. We cried. She thanked me over and over again for caring for her baby and making sure she was okay. I gave her some baby clothes (thanks to those who donated!) and Munsch's book, "I love you forever" (thanks, Lisa!) as well as some food and goodies. She was so excited. I even had some old stickers that my momma gave me of teddy bears with "Bethany" written on them that I passed on to Ruby. It's good to have another Bethany in the world!

I get to see Jerson, Ruby and Bethany again on Wednesday after a day or two of rest. So grateful, so tired, so amazed. I will post pics and soon as I get them. I friend took some with her camera as mine is still on the fritz.

Be blessed.