Missing Home

Okay, okay, I think I am officially homesick...I have been here for 2 ½ months, but it seems like 2 ½ years!(okay maybe not that long, but still)...the whole medical emergency involving my dad, made me realize how far away from home I really am, and how much I really do miss my family. Then there was a scary typhoon, a twister in the city right next to me...and this is only the beginning of rainy/typhoon/stormy season here in the Philippines. When I wake up in the morning to my clothes still wet from being washed the day before, a cockroach in the middle of the bathroom and a cold shower with a worm crawling out of the crack in the tiled wall, I just want to drop everything and catch the next plane outta here! Living in a third world country is like camping 24/7 and my family knows just how much I enjoy camping, not! LOL! But then when I am sitting around the table with the Filipino midwives eating original Filipino food right after a wonderful birth, or when I am with the labouring women being able to give them love that most have never received in their entire life, or when my hands touch the baby’s head as it is being born...those are the moments I cherish, that’s when I think for a second I could live here my entire life...but then it’s gone in a flash, when I am here in the clinic alone lying in my bed at night, I am counting down the days I have left till I come home. Mom, Dave, Dad, Kelly, Darby, Colten, Dayten, Kacie, Jason, Jeremy, Brandon, Shannon, Jenna, Jessica, G-ma, G-pa, all my sister in-laws, uncles, aunts, and nieces and nephews (did I mention I have a big family) I miss you guys so much! 171 more days till I come home...I think I can, I think I can, I think I can...

 This birth was so fast, my preceptor didn't make in time...

Brand  new mommy and baby

"Rain, rain go away, come again another day"

Look how safe I am in this area, the water level everywhere else were waist to head high! 

Philippine Culture

Every day during my time here in the Philippines it seems I learn something new about the culture here, and I love it! Here are some things I have learned/observed during my time here...

when you go to ones house they will serve you a merianda(snack), even if they are dirt poor. It usually consists of a packaged snacky food like a brownie, muffin, crackers, ect... and coca cola to drink. It is considered very rude to refuse this merienda, so when we go on postpartum visits to do checkups on the moms and new babies, we really can’t plan to see many people on the same day, because if we did, we would get fat! When one is eating a meal they should always ask everyone who is there if they would like to partake in the meal, saying “lets eat!” One should be asked at least 2-3 times before actually partaking in this meal though, or it is equally polite to say, “no thankyou I am full.” Also, when eating the meal, never take the last “bite” like the last spoonful of rice, or piece of chicken ect... because there should always be enough for one more person to eat. So, in America parents often say to their children, "you are not getting down from this table until you eat all that food that is on your plate, you know there are starving children in Africa who don’t have any food to eat!" But here, there is always some food left on the table for that starving child just in case he walks through the front door during suppertime. As far as everyday mannerisms go... the Philippines is a fairly modest country, despite the extremely hot and humid climate, jeans and a t-shirt is what most Filipinos wear on an everyday basis. Short shorts are considered very risqué here, and spaghetti strap shirts/tanktops are rarely worn by the local women and girls. Now the people here are used to seeing foreigners wearing tanktops and shorts and do not judge them, but since I have been here for 2 months now and am trying to fit into the culture more, I am becoming more aware of my clothing choices everyday. But, it is seriously way too hot to wear jeans!!! So I am trying to stick to skirts, and Capri’s. Some other things I have learned is to never point with my index finger, if you are calling someone towards yourself, reach out the whole hand pointing all fingers downwards and wave them towards yourself. To point to something, you use your whole hand, or more commonly by pursing your lips. And of course I am now used to drinking a coco cola/all soft drinks out of a plastic bag with a straw, eating all meals with a spoon and fork only, and of course getting used to eating rice with every meal!  I never enter ones house without first standing outside, asking if anyone is home, and being invited in. Always taking off my shoes upon entering a house, even if the floors are made out of dirt, and stay standing until invited to sit. I am not going to lie, being a foreigner here is challenging at times, like...

-Being literally stared at by everyone around me wherever I go with people yelling after me things in tagalog, and the abundance of questions I am asked on a daily basis like... where are you going, where are you from, do you know how to speak tagalog, how long are you staying here, are you single, can I take a picture of you? Ect...

-When shopping, being stalked by the store attendants, they follow me like little children wherever in the store I go repeatedly saying “yes, maam?” –I think this is probably my biggest pet peeve here, I just want to shop in peace, and it is always very awkward shopping for feminine products when I have at least 3 male attendants standing around me...therefore, it takes me double the time to get what I need!

-Getting used to bargaining because since I am American EVERYONE tries to charge me more money when buying something

-Being followed by the starving street children begging me over and over again for money-now this is the hardest thing for me, everyone who knows me, knows that my heart goes out to children, especially ones in need, but when I can, I try to buy them some food, instead of giving them money.

-Making friends with the reptiles and insects that live with me because there really is no way to get rid of them no matter how hard I try, and I have had to come to terms with that...maybe I should start naming them, what do you think? hehe!

-Throwing away toilet paper, never flushing it

-Hand flushing the toilet with a bucket full of water

-Cold showers

-Living an ocean away from my family and friends, I miss you guys!!!

Now, could you survive in the Philippines?...I know my mom would definitely not, LOL!! Comment and tell me what you think? 

What could be better than drinking a coke out of a plastic baggy:-)

"Here we are children, start pecking...now!"

That poor mama dog looked like she was starving, but her pup looks nice and plump!

What are you looking at?! 

 

This is an older pic of me doing a prenatal on one of the moms
 who lived in the landfill area in Olongapo 

Shoulder Dystocia

Here in the Philippines, the biggest fear among the doctors, midwives, and mothers during pregnancy is growing a big baby. As some of you who are reading this might know after 20 weeks gestation the fundal height(measurement of the baby in the uterus) is supposed to match up with how many weeks the mom is pregnant, so if she is 28 weeks pregnant her fundal height should be 28cm. Well, it is different here in the Philippines. The mothers fundal height needs to be 2 cm less than her weeks gestation or else the baby is considered too big, meaning if she is 28 weeks pregnant her fundal height should be 26cm. And at the time of birth if her fundal height is more than 34cm everyone is worried about the baby being too big and there being a shoulder dystocia at birth. (this is supposed to be a very rare occurrence of when the head of the baby is born but the shoulders are stuck, it is a true obstetric emergency and the baby can become brain dead or die after only a few minutes). I have always believed that God created a woman’s body to give birth, and he created the baby inside of her, therefore the baby is usually the perfect size it needs to be to fit through its moms pelvis, I really didn’t believe in baby’s being "too big" to be vaginally delivered until maybe now... just 3 hours ago we delivered a baby girl who’s head was out for 12 minutes before her body was finally born. When the baby's head was coming, it took a long time, it was like the head was stuck as well, but when the head was finally born, and the baby's shoulders did not rotate and come out with the mothers next contraction, we knew right away that this was a shoulder dystocia. We got the mom on her hands and knees while I called the other staff midwife to come help who lives just right across the street, I asked Gerlene to go in and reach for the baby’s posterior shoulder/arm to manuever out, when that didn’t work we flipped the mom on her back putting pressure on her pubic bone to try to get the babies shoulder unstuck, then again on her hands and knees ect...apparently the baby had her arm twisted behind her back as well... finally we got the babies posterior arm born, but the baby was still stuck for 2 more minutes until with 2 midwives hands maneuvering and pulling that this baby girl was born. At birth she was totally flat, no heart beat, no respirations after stimulating, I immediately gave the mother an injection of pitocin to prevent hemorrhage and initiated neonatal resuscitation, I was giving breaths while the other midwife gave chest compressions, 1-2-3- breathe, 1-2-3 breathe... was the only words being spoken, other than the prayers that were being whispered throughout the room. For 3 minutes this little baby girl didn’t breathe, cry, or move...but miracousely she slowly started coming around, she would gasp every once in a while, her heart tones started coming up to the normal range, and she finally started breathing on her own, but it was only once she cried for the first time 15 minutes after birth that us midwives let out a deep breath and knew she would be okay. As crazy as this sounds this is the 2^nd shoulder dystocia we have had during the 2 weeks I have been here, the first one was a little baby boy who’s head was out for 9 minutes before his body. During a shoulder dystocia, you really only have 3-5 minutes to get that baby born, any longer than that, and there is a high chance of the baby having damage to the brain from lack of oxygen, and after 10 minutes it is a known fact the baby can die. We only have God to thank that these babies are okay, with no signs of damage to the brain, or body. Its after births like these when sitting in the silence of my room that I wonder, now why am I choosing to be a midwife again? But with birth the good much outweighs the bad, and even in the bad times just one look at that mom and new baby I know its meant to be...

We are made to do this work and its not easy...I would say that pain is part of the glory, or the tremendous mystery of life. And that if anything, it's a kind of privilege to stand so close to such an incredible miracle.
~Simone in Klasson 2001

You gain strength, courage and confidence by every experience in which you really stop to look fear in the face.
~Eleanor Roosevelt

There she is, all 8.6 lbs of her, which is considered huge here in the Philippines,
I thank God that she is okay!

And 2 hrs later I wake up to another woman at the door in labor, she had her baby 15 minutes after she got

here, and the baby just slid right out, I think it was just God reassuring me, in most cases birth is normal, and that I 

can do this :-) oh the life of being a midwife!  

Pictures!

All of us(my preceptor and her family)at the coconut house...everything is made out of or from a coconut

The Malls here are crazy!! 

Its weird to see all of the poverty here, and then walk into a huge busy mall realizing that
the people here are either dirt poor, or rich, there is rarely any middle class. There has to be somewhere for the wealthy
people to shop

So sad, this is supposed to be a playground

When it rains, it floods. This is taken out of the window of a taxi I was riding in 

The delivery room here at the clinic

The waiting room

The kitchen, now mom you have no room to complain about your "small" kitchen, LOL

My room/the midwives room 

Our lovely bathroom with the toilet you flush using a bucket and water

The prenatal area, we pull down the curtains for patient privacy

What the clinic looks like from the outside, "Daughters Of Faith Lying-In"

The clinic

Bathing a lil baby girl before they head home

My first "catch" here in the Philippines, have delivered 3 babies since then