The Haitian birth experience

I thought that I would take a moment today to write about the amazing experience of birth for Haitian women. I've noticed that every culture has their own 'way' of birthing and this culture is definitely keeping me on my feet!

The first time moms here tend to have very long labours, most of the time they are at the dome for at least one day. One woman yesterday was 7-8cm dilated for pretty much the whole day. But the brilliant thing about being nowhere near any interventions, is that you just get to sit and watch and listen to the women labouring and there are no timelines. The mother yesterday had her contractions completely stop at 7cm and then she had a nap, and then they restarted. But they were never regular contractions, nor were they very long, and then all of a sudden, there she was pushing her baby out! The same thing happened today, I went up to the birth dome at 5am to check a woman who was 3cm dilated and having her first baby. She was having irregular, short contractions, and then the next call I got from the night nurse, was that the head was crowning at 7:45! I ran up the hill as fast as one can in flip flops on an uneven street surface, and got there in time to find one of our translators catching the baby. The brilliant thing is also that there seems to be a correlation between the fact that we don't interfere, and the fact that these women do not have tears. Maybe it's just that they have incredibly healthy perineal tissues, or smaller babies, or they just seem to know that perfect positions to push in... who knows, but I have not sutured once since being here, and I've been to something like 12 births now. Even when I have had to coach them to push really hard as the baby is coming, because of the baby's heart rate dropping, they still have not had a tear! Anyway, I digress about the tearing...

Women who have had babies before are a whole other story! We've had many women just walk in, have one contraction that we've seen and the baby's out. Or some have given birth in the street on the way to the birth dome. The usual story is that they have some contractions that look mildly uncomfortable at best, for awhile, and then one or two strong ones and the baby is coming. Births here have been nothing like back home, and my mind is trying to wrap itself around the possible reasons why. Definitely there is a peacefulness in being a midwife here, just laying around in the excrutiating heat with a fan pointed at you, reading a book and listening to the women's songs echo through the dome. They surround themselves with their mothers, sisters, cousins, husbands, and my job has really just been to give them the best care I can and catch their little babies - they are amazed to have anyone cleaning their bedpans. I haven't really done a lot of midwifing the way it seems I do in Canada, or maybe I am realizing that even though I like to think that I don't interfere in birth, I actually do! I love not cutting the cord, and just letting the placenta come when it does. The great thing about the way things work here, is that we also don't seem to have complications. Despite our lack of intervention, virtually every woman so far has just pushed out their placenta with no oxytocin, in a reasonable time frame, then not bled a drop after. I laughed when another midwife from Canada was afraid to tell anyone that she had to open the birth instruments and use them to help get a placenta to deliver! The ol' birth instruments package had a fine coating of dust on it...

I'm sure that I won't be able to apply what works for these women's bodies in this culture, to our situation in Canada, but I hope that I've learned some tricks about investing in an even greater degree of patience and faith in women's bodies and in babies to just find their way.