Sunday, September 27, 2009

Stink Week.

Greetings. Another week has passed and to be perfectly honest....I am THRILLED this week is coming to a close.

This week was in the top ten of poop-weeks. It wasn't one particular incident that occurred, but several heavy occurrences that made me want to throw in the towel....but alas, God got us through and the towel is still currently wiping the sweat from my brow.

I had the horrible experience of being scheduled for prenatal duty and not showing up. Yup. I felt HORRIBLE. The worst part was, Tim was sick and I had promised to take care of the Bird and keep her outta his way for the day...alas, I got a text from the director at MMC asking whether I was coming into work or not. Shocked that I was supposed to work, I re-read the schedule. Yup...I was on there. "SHOOT!" I hate being late and even moreso, I hate not reading the schedule correctly and inconveniencing all my co-workers and peers!

Then I lost a diamond out of a special, I have very little jewelry and I don't wear much anyway, but the two special pieces I never take off are my wedding ring and a ring I was given by my mom for my high school grad. It's extra special because it was a ring that my dad had bought her in Bethlehem. It has a blue stone in the middle that represents Jesus and two tiny diamonds on either side of the blue stone representing each member of our immediate family. So one of my family members in diamond form disappeared. Awful feeling and I can't replace least not for quite a while. Blast.

I was told by my director that there were too many people scheduled for Wednesday's shift and that if I wanted to stay home, I could. Eager at the chance of being able to stay home with the Bird so Tim could get some work time in, I stayed home and only dropped by the clinic to do a prenatal exam. Upon entering the birth room I noticed the patient board full. Labors, births, and baby checks seemed to line the walls. Perhaps it wasn't a good day to stay home afterall. So I did my prenatal, did a baby check, got a patient's newborn screening result, a birth certificate, and was a gopher for a few minutes....then I heard that one of my peers had just delivered a baby boy and in the process of this difficult delivery, broke the baby's arm. What a HORRIBLE situation for baby, mom, and midwife! could feel the heaviness in the birth room. While it's better that the baby's arm break than suffer asphyxia as a result of shoulder dystocia, the cries of a newborn in pain is overwhelming for everyone.

I ended up getting a text from Tim right at that moment saying, "Come home now, Promise is wigging out!" My short prenatal visit ended up being a couple hours and Promise was hungry, tired and wondering where I was! I raced home feeling very sad and somewhat guilty....

Lunch time also bred some bad news. Our sister-in-law in Canada was miscarrying and hemorrhaging. She was taken to the hospital for a D&C and had lost a lot of blood. We were told to pray. Everything in us wanted to be home. As a midwife, being so far away from her was very difficult.

Thursday I headed to shift 30 minutes early in order to make sure I wasn't around when Promise woke up so that she wouldn't freak out when I had to leave for work so early in the morning. Fortunately, I entered the birth room to the sound of, "Hey, B, wanna catch a baby?" The patient in bed 5 was pushing and I was the first one on duty. Shift starts at 6:00 am and I delivered a healthy baby girl named Leisa at 6:07 am to Theresa, a 20 year old first time mom. I sutured her slight labial tear and enjoyed a fairly busy shift...the baby with the broken arm was still in transition as MMC was trying to find an orthopedic doctor in Davao that could help him as soon as possible. The baby had also developed a fever. We had a time of prayer for him, his family, his midwife, and the doctors who would soon be treating him. His midwife, despite many other patients she had to tend to, worked tirelessly to help his family out.

The week started to get a little better. Then Friday night came. Promise threw the MOTHER OF ALL TANTRUMS for over an hour in the middle of the night. Thrashing about and not responding to any comfort or touch, she screamed until her voice was gone, she was coughing and nearly throwing up. She has done this a few times before, but never in the middle of the night to interrupt her sleep....maybe a night terror...? Tim and I kept praying over her and her crib while trying to find clues as to why she was acting so erratic. She then slept in 20-minute increments waking with screams. We didn't sleep.

Saturday, exhausted, confused and weary, I started a long-awaited period which unfortunately confirmed I am not pregnant. Sigh. I waddled 30 minutes early to swing shift for another crazy shift. A full birth room, I jumped into admitting two patients, one I transported for fetal tachycardia, the other we sent home for early labor. Then I received Adith. She was endorsed to me at 3:45 pm and it was time to do another internal exam to find out her cervical dilation. She was almost 8 cm and looking very tired. Her cervix was a bit swollen, so we did a lot of position changes and focused on getting her well-hydrated. At 6:30 pm, she was ready to push and while she was 9+ cm, her cervix was not wanting to let the baby's head pass without a fight. So we fought back with position changes and me holding the cervix up during contractions to maneuver it over her baby's head.

After a meconium stained rupture of membranes, baby Carla Trisha was born at 6:47 pm, perfectly healthy and WIDE awake. Adith was amazing....patient and very controlled. She didn't tear and began breastfeeding immediately. We were all very thankful for a healthy delivery. And though she was very anemic, she only bled 50 ccs total. God is good. I was thankful that the week was closing on a positive note.
Adith and fam with baby Carla. :)

I was reminded of all the ways satan tries to steal our joy or get us distracted from the things that God is doing or the things that truly matter. For example, October starts a new chapter for Ate An-An, my dear friend, and me. We are starting a Bible Study specifically for MMC patients. Every Thursday, we are getting together to pray with, discuss and get to know the patients that come in everyday for their prenatals. We wanted to meet them on a very REAL and spiritual level.....and be able to show them the way to Christ....we will keep you posted, but please be praying for us as this is our give Christ impacting body, soul, and spirit.

What satan meant for harm, God was turning for good....our sister-in-law is healing well. The baby with the broken arm is being treated. Tim is feeling a bit better, though very fatigued. And Promise has been happier the last two days. AND, an old patient of mine came in with her six-month old baby, Bethany. Remember Ruby?
Well, here's Ruby and baby Bethany...growing up so fast.

So that was my busy week. We covet your prayers. Really, we do. Thanks for reading.

Be blessed.

Sunday, September 20, 2009


Greetings! Thanks for reading!

So this week involved another full load of birth shifts, prenatals and life with Tim and Promise.
On Wednesday, I had the pleasure of delivering a baby boy, named Raven to "Chubby". Yes, my patient's nickname is "Chubby", though she is far from it!

Chubby's birth story is one of somewhat confusion. She had multiple bantays and when asked to bring her "bana" (husband/boyfriend) in, a very boyish person came in, though there were very feminine aspects about her/him. Confused at who this person was, my supervisor inquired..."This is her boyfriend". Oh...not the father of the baby, but her boyfriend....okay. But we were still confused. She/He didn't look too much like a boy. Mmm.

Chubby's chart indicated that she had a very low pubic bone and that her pushing stage would be very difficult. When she desired to push, we tried several positions.....she pushed with every piece of her making very little progress. After almost 2 hours of pushing in different positions, the baby's head popped out from behind the low pubic bone...we all sighed a sigh of relief and Chubby slowly and carefully pushed her Raven's very large head out....unfortunately because of the position we'd chosen for birth and because of the size of the baby's head in comparison to her outlet, she a huge way.

I won't go into details, but my supervisor graciously assisted me in suturing, teaching me new techniques and how to repair such a large and complex tear. Chubby was amazing. Quiet, but amazing. Upon moving her and her handsome baby boy to the postpartum area, it was time to do the birth certificate....still confused at who her bantays were, my supervisor went in to get the FULL story communicating strictly in Visayan. Her "boyfriend" was a girl and they were partners living together. In the Phils, a "tomboy" is a lesbian and her boyfriend is a "tomboy". Upon learning this, we asked further questions as to if she wanted the biological father on the birth certificate and where he was currently. Chubby clearly communicated that he was NOT to be a part of any paperwork or processes.

I left shift feeling sad...Chubby's Raven was having trouble breastfeeding and his respirations were high. Chubby's pulse was rising and she was running a low fever. I was concerned. She seemed so hurt and her birth experience was less than ideal. I later found out that the next shift had to transport Raven to the hospital for high respirations. Chubby was encouraged to come back to MMC for baby checks and post partum care, but she never returned. The cell number in her chart does not exist and has been changed multiple times. Her address is vague and I am not sure if I will be able to track her down. I am concerned for her health and well-being. Please pray that I will be able to find her home or that she will come back to MMC for follow-up care. This is her first baby and what should be a joyous time in her life, has turned out to be one of great cost in many areas.

Thursday's shift was interesting, as well. I was not first up, so I got to assist in an insane birth! Well, actually, at the start of the pushing stage, I was first assist. By the time baby was out, I was fourth joke. So Ate May (AMAZING supervisor) took a continuity who was in labor with her very first baby. She was accompanied by her husband and his mother....both were amazing labor supports, praying and thanking Jesus for every part of the evening.

However, Ate May knew that her patient would have a difficult delivery because the baby's head was ENORMOUS, but she felt strongly as though her patient could do it. She started pushing on the bed, then on the antipolo, then in supported squat...Ate May tirelessly provided pelvic floor pressure and tried to usher the baby's head down....her patient continued to push....I was simply assisting in position changes, retrieving supplies and keeping the area clean of fluids (there were a lot flying around). Then Ate May's hands started to cramp (she had been in the same position for over an hour). She called Ate Susan as reinforcement.

Ate Susan (AMAZING supervisor #2) continued, but felt strongly as though an episiotomy needed to be cut to make room for the baby's head....she called for Ate Estef (AMAZING supervisor #3) who came in to prep the episiotomy area and start an IV stat. Again, I become the gopher..."Beth...go get gauze....Beth go get Betadine....Beth...MORE GAUZE!...Beth...go get the vacuum extractor." Yes, with episiotomy cut and the vacuum extractor on the baby's head, oxygen given to the patient and prayers being lifted up from everyone, the baby's head started to come down.....There were 3 supervisors, 4 students and 2 bantays in her little cubicle, but that baby came out...and what a HUGE baby boy he was!!! HUGE! We all cried and cheered after 2 hours of pushing and a grueling and risky labor. Praise God. And May's patient did fantastic despite her pure exhaustion and multiple interventions! Had Ate May desired, she could have transported her patient early on to the hospital, but she knew that her patient could do it...God was there and gave her incredible strength. He rewarded her with a beautiful, huge, healthy baby boy, named Joseph. :) What an experience that was for all involved. I learned a lot.

Then Saturday's shift came and somehow, it was busy enough for me to have 2 labors! My first labor, Ivie, was in labor with her fourth baby. Her baby was taking his time and she was coping well, though very frustrated that he was soooo delayed.

My second labor came in at 7 cm dilated. Lyn and her hubby, Noel, were expecting their second and were hoping it was a girl. She was a Samal (an island off the coast of Davao) patient and had been seen multiple times by Heather, a supervisor here. Heather had said she sadly could not make the birth, but said she'd be praying.

Lyn was a fantastic patient...she asked questions throughout her very painful labor regarding how to cope effectively, how to breathe effectively and when to push.....she was great to work with and totally responsive to instruction. She wanted to know exactly what was going on in her body with each stage of labor. I enjoyed rehashing all my midwifery education with her. we had a GAS despite her pain growing worse with each contraction. Less than two hours later, she was wanting to push. I texted Heather to give her a heads up and just 15 minutes later, Heather arrived to assist me. It was great working with Heather again.

We agreed that Lyn needed some position changes to get the baby's head from behind the pubic bone and her bana was a huge help in assisting. Lyn was fascinated by the process, though exhausted. The baby's heart tones began to rise abnormally and we were a little concerned that the baby was undergoing intense stress. We brought in a mirror so that Lyn could see her baby's head slowly coming towards the outside world...we had her feel her baby's head....she started to cry and with that, she gave all that she had to push her baby's head...she pushed HARD....seriously HARD, each time wanted to see the progress she had made and little by little, her baby's head made more of an appearance. Her husband never stopped praying to Jesus out loud so that Lyn could hear it. He would tell the baby's head, "Jesus loves you, baby! Come and meet your family, baby". I cried. It was so intensely beautiful.

Lyn, with such control, pushed out her 8 lb. 8 oz. baby girl whom she named Zchara. Cries of joy bursted out as well as 500 ccs of blood from Lyn...she was hemorrhaging. We had to manual control the expulsion of the placenta and with that, 500 more ccs of blood followed. She was bleeding fast. We told Noel to pray and he prayed with all his strength. We inserted an IV, gave multiple injections of oxytocin, placed and ice pack on her fundus and continued to monitor. She gradually stopped bleeding and though she was tired, she was able to smile and breastfeed her baby.

Her dear friends came to visit despite the late night for everyone and we all prayed thanking Jesus for a successful birth of a precious baby.

I was able to see her the following day to check on her recovery and both mother and baby are well. We had an amazing time talking about the faithfulness of our God....I even got to share Promise's story and we shared in an amazing time of gratefulness. After the heavy week of emotion and struggle I had, talking about the faithfulness and sovereignty of God refreshed me...and gave me hope.

I have a few more stories of God moving in BIG ways, but I will save them for another post. So I leave you with Lyn, Noel, baby Zchara and Lyn's friends. And two pics of what Tim does when I am at work...and Promise's "joyful" (?) expression when I return.... God is faithful.
Be blessed.

Sunday, September 13, 2009

Website Stuff

This is just a short little thing to say hi and tell you what I've been up to. Really short. It's almost over.

Last week when Bethany went back to work, Promise and I got to spend lots of time together. That's code for "the Bird was high maintenance". Nevertheless, I had fun working with Doug, Impact Nation's director of operations, on the new website. It's still a work in progress, but I was pretty amazed at how much he got done in a week (I wasn't that much help). The site now has two "levels"; one that is purely information, and another that welcomes people's participation in specific projects.

Our project in Gatungan that you have read about here was a pilot project of sorts, and it went really well. We are just in the beginning stages of a new follow up project in the neighboring village. If you'd like to get regular updates on our progress, please click here and join the group. We've also set up a page that will provide general updates (about twice a month) on what Toti and I are up to as we travel around Mindanao with our water filters. I encourage you to join that group if you have been a regular reader of this blog.

That's it. Told you it would be brief. Here's a fun picture of Promise that I took when we were playing together last week.


Thursday, September 10, 2009

Welcome Back, B.

Greetings! Thanks for reading and commenting on the last few posts. The encouragement and wisdom has been such a blessing.

Wednesday morning I had the opportunity of returning to the birth room. With peers from my class missing and new ones present, I jumped into a fairly quiet birth shift and caught up with all the changes made while I was away as well as some of the highlights of summer from other midwives. AND, my first shift yielded my first delivery back in the saddle.

Grace walked in at 9:45 am and was sent to the CR (washroom) by my new friend, Mary. I was just finishing getting some meds dispensed for another patient waiting, when Grace decided that going to the CR was NOT going to be a good idea. I took one look at her and another at Mary and we decided it was time to get Grace into the birth bed.

Gloves donned, birth cart set, Grace knew her part....she rolled on to the bed and began to push. I laughed...Grace had done this before and was quite ready to meet her baby. No instructions needed. We exchanged names and stories between contractions. This was her second baby and she had a little girl at home....she was hoping this one was a boy. Vital signs were normal....38 weeks and 2's head became visible with next contraction. Grace smiled as I reported what I was seeing on my end.

Head was slowly coming as I instructed Grace to push only a little and breathe through her contractions.....a little more head came....and then a bit of a pop...

9:54 am, Ivan Jay was born with his hand glued to his head. He used his little man-hand to pop a small split into his mom's perineum. But he was strong, healthy and a good 7 lbs. His cry was immediate and alarming as though he was reporting on HIS birth experience. Grace smiled gracefully and without words, immediately brought Ivan to her to breastfeed. She knew the drill. Awesome.

Grace bled....a bit more than normal. We had to manage a small hemorrhage, but the bleeding subsided after some oxytocin, breastfeeding, and massage. Her small tear needed suturing and Ate Susan allowed me to sew Grace up. Ate Susan is a remarkable and patient teacher. Grace was good as new by the end of it all...and she was ready to go home. But we had to monitor her bleeding and urine output a while longer.

A great birth. Perfect. An awesome welcome back gift from God. And Grace got her baby boy. :)

Thursday ushered in another birth shift. This one was quite a bit different. Quiet came 4 labors. Two patients active and another two high risk. My patient, Liza, was having her third baby, but was significantly overdue. After two treatments with Evening Primrose Oil and labor stimulation, Liza was not having strong contractions.

Together Liza and I went through a regimen of labor induction that, unfortunately, did not pay off. We tried one more dose of Evening Primrose Oil and a stripping of her membranes....she was 4 cm dilated, then one full glass of natural laxative (I took it, too, just to be kind...that stuff sucks.) and together we ate a whole papaya. Her labor picked up....contractions were was doing well...then it was shift change and I had to go...not to the washroom, but shift was over and I had to pass her on to the next set of midwives.

I went over to the clinic that night to check on Liza's progress....after 5 hours, she was now 5 cm and her BP had risen to the point where IV fluids were necessary. I prayed for her and reassured her that her midwife would make the right call whether to transport or allow her to stay. I am not sure the outcome, but I imagine that she was transported. I will update you on that later. Please pray for Liza.

The laxatives worked. Nuff said.

And currently, I am on my way to shift number 3 for this week. I am excited to be back, though I am reminded of the physical and emotional exhaustion from an intense week of work.

Promise is still struggling these days....mostly from teething, but she now has a pretty nasty cold and diarrhea....oi. Please be praying for her. She has been such a trooper trying to adjust to all the newness. What a joy she is. Please also be praying for Tim, as he hangs with her while I am working and vice versa. Thank you all again for your prayers and encouragements. I leave you with two pics of Grace, her bana, Al, and baby Ivan. Be blessed.

Monday, September 7, 2009


Greetings! I was going to give you all some pics of our time in the West, as there were many cute moments of Promise, but things are moving ahead so fast here that I guess the pics will have to wait.

This passed week, Tim has been quickly setting in place new contacts and sites for water filters. I will let him update you on that.

Last Tuesday, I posted that I'd had a wonderful meeting with Raani and Ivy, two patients of mine. Thursday turned out to be a great day of visiting, too. Do you remember Lenita? She was a continuity of mine that had to be transported as a result of high blood pressure. Well, the two of us have been desiring to get together for some time now. So Tim, the Bird, and I traveled about an hour outta the city to Lenita's house in Calinan. Situated just off the highway up a very rocky road and into a small village, Lenita's place was a very nice Filipino home. Her sister and brother-in-law live with her and her 4 kids while her husband's work takes him all over the Philippines.

Lenita prepared for us a huge merienda (snack/small meal) and watched us intently as we ate it...Buko salad...YUM! While she had been delivering her baby boy, AJ, Lenita had missed her graduation from college. She had received her accounting license. So in honor of her graduation, I had made a cake and packed a small gift of some Canadian items picked up on our trip.

We shared stories, Promise tried to play with her little ones, though they were quite shy, and watched some Filipino television....the ever-popular "Wowowee" game show and had an opportunity to pray for her and her family. We were blessed. And upon our departure, Lenita gave us a GIANT basket of native fruits....mangosteen, pineapple, lanzones, and rambutan. She invited us back as often as we could come. I was so thankful to see how healthy her family was. God is so good.

Friday was equally exciting! Tim, Toti, Promise and I had an opportunity to head to the village of Gatungan. Impact Nations recently installed 100 filters there, so we went to check it out. We had fun visiting with filter recipients and praying for them and their families. Of course, Promise made new friends everywhere she went.

Tim put together a little video of our trip if you're interested. In fact, you can follow the project from its inception to completion over at the Impact Network site. On the Gatungan project page, there are five pages of feedback and discussion between the donors and Toti as he implemented the project. You can find the video there too.

Be Blessed!