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I Am Woman Hear Me Roar! Vocalizing during labor!

The sound of a woman roaring and vocalizing during birth is one of the most beautiful sounds to my ear.  The sheer strength and power in her voice radiates through her body and helps to let her baby out.  S was such a woman I met in the Dominican Republic. She was my favorite mama hands down because she defied the status quo. Beautiful, tall and strong S was dealing with some serious back labor, which I recognized early on as OP, and despite the fact that this wasn’t her first birth she was having a hard time. She did everything we encourage mamas to do to encourage their babies to turn. Before I share what some of those things were here are some important things to remember. About 15%-30% of babies present posterior at the onset of labor (Posterior Labor: a Pain in the Back, Valerie El Halta). Upwards of 85%-90% of posterior babies will turn before birth when given the opportunity. Posterior, or OP, means the back of the baby’s head is resting in the mom’s spinal area so during labor the contractions concentrate on her sacrum and back causing tremendous pain. So what did this young lady do right despite being told to get back in the bed? She stood; leaned forward on the bed and side table; got on her hands and knees in the bed (with my coaxing and support using sign language); vocalized-a lot; rocked; received a lot of counter pressure from me; many hip squeezes; and she did it over and over again. I WAS SO PROUD OF HER! Even when she was fussed by the staff she stood up for herself and continued to do what she needed. I knew when her baby had finally turned around because she dipped into that intense sleep mama’s fall into between contractions and her contractions appeared to be more manageable. This took several hours but she did it. I had to leave but when I returned the next day she was recovering nicely in the postpartum wing with her delicious son. We gave each other a warm tight hug and I took pictures of them. I was so proud of her and she will forever have a place in my heart.

 

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On the Ground – an American Doula in the Dominican Republic

Prior to traveling to the Dominican Republic I read another participants blog about her experience and what to expect in terms of the hospital conditions. I can honestly say that all the reading in the world did not prepare me for the working conditions (more about that later). The staff was absolutely wonderful and welcoming. They were kind and gracious in sharing their space with people who did not have a working command of their language. During some down time they helped Lynn and I (a student midwife) translate the labor progress chart into English as well as commonly used reproductive terms. It was really a fun learning experience. Here is a picture of the ladies (there were men too but they weren’t there when we took the picture).The lady in the yellow scrubs is one of the doctors who was gracious enough to teach me how to correctly say “I like your shoes” (she had some cool rainbow Crocs, and she let me observe a cesarean birth with her and another physician.

They taught me the value of resourcefulness by putting to use the various supplies we gave them, sometimes in ways we had never imagined. One thing that stuck with me was their patience with “Americanos” who spoke in broken Spanish. How many time have I heard people complain about people who don’t speak English in this country and they say mean things including learn to speak English this is America. Thank goodness no one said that to me as I walked through the hospital with my dictionary, phrase cards for labor and postpartum, and memory from HS Spanish classes and language immersion as an adult. In the labor and deliver section I met abuelas (grandmothers), tias (aunts), hermanas (sisters) and other women who came to support the mamas in labor. I witnessed grandmothers praying for their granddaughters as they labored and vocalized in Spanish. I held hands with women and rubbed their backs knowing that just like at home sometimes the biggest part of being a doula is about your heart, your touch and your eyes. We used gestures and single words to communicate when they needed a drink or support to get to the bathroom. They made me step out of my comfort zone as a woman and labor support person. More than once I thought to myself if that were me what would I want this stranger to do…and so I did it. Watching babies being born is a blessing that never grows old for me. Every single hospital in the US could learn from these women and the staff…100% breastfeeding rates at birth and upon leaving the hospital. My Spanish comprehension is much better that my speaking. One family member told a new mama whose baby was crying “when your baby cries you give him your breast, you let him suck.” Formula was not an option and did not exist. No cute baby bags that read Similac or Enfamil. Lynn helped a mama who had a c-section get her baby to latch on. She was having a hard time with her incision so Lynn took the baby and laid her sideways across her chest. The baby latched on instantly. Mama’s were up on their feet and out of the hospital in less than 24 hours heading back home. IV’s were standard; induction was not. A couple of mama’s received Pit after being in labor for over 24 hours, there was no epidural, there were no narcotics. While some may see this as not providing options what the seven births I watched proved was that women can and still do give birth without drugs. Except for one baby (which was premature) all were born robust and alert, latching on fairly soon. Here are a couple of pictures of some more families. The second picture is not the mom, but a relative holding the baby.

 

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We’ve arrived – Traveling with Midwife-To-Be to the Dominican Republic…One Doula’s Story

Day One: December 31, 2011

We arrived safely in Santo Domingo landing at Las Américas International Airport. The flight left over an hour late due to lots of luggage being loaded in the plan and on board as carry on. One of our suitcases didn’t make it on the flight. The rest of the team traveled down on December 27th so it was very exciting to finally meet everyone. The ride from the airport was pretty long; in fact it was about two and half hours or more with two quick stops. Our final destination being Palmar De Ocoa.  Along the way we dropped off Donna (one of the team members) and her husband at a hotel in Santo Domingo where they would spend some additional down time before heading home. We then picked up Jessica from the hospital in Bani. When we arrived at Pastor Veronica’s villa it was beautiful. Upon driving through the gate the driveway led us straight to the front door with the sea just yards ahead. You could hear the waves lapping at the shore.

Villa

 

Sea steps away from patio

 

Sunset

Being that it was New Year’s Eve day we simply settled down getting to know our surroundings. This involved changing into swimsuits and heading into the water. The rest of the team was already on its way to the hospital. They wanted to be sure they got in and out and missed the craziness of traffic because it was New Year’s Eve. Traveling to Ocoa was really different. The land in this southern region is desert so we also passed a multitude of cactus tress. Most of the road was well paved, but some areas were extremely rocky. The drive through the capital and even on the local roads was harrowing with motor bikes everywhere. Sometimes there were up to three people on a bike and goods of all types. What I later learned was that many of these bikes were taxis. My top three motor bike sights: a man, woman and baby (about six months old) with the baby being held in one arm by the woman; a passenger sitting backwards on the motor bike while holding his own motorbike; and two bikes traveling together with the driver on the rights left foot on the other bike while he carried some large household objects.

New Years Eve dinner consisted of an outdoor barbecue. It was delicious and ended with watching fireworks. Each person shared something they were looking forward to receiving in the New Year. What a way to end a year and begin a new one. I don’t recall if or when I last rang in the New Year so far away from home. Let me tell you a little about the team: Jessica is a nurse from New Orleans. She enjoys traveling and is returning to Haiti on January 3rd permanently, to provide clinical care along with a friend. Her enthusiasm and joy at this opportunity was obvious. Lynne and Al, a couple from Canada are on their first mission trip together. They have a blog called adventures with Al and Lynn. Lisa is the group leader and the owner of the school Midwife To Be in South Carolina. She has been leading groups to the DR since 2008 and working overseas since 2004. Pastor Veronica owns the Villa where we are staying and Pastors in the Haitian Village and Azua. Yeremi is a 16 local teen from the church home where Veronica pastors. The entire trip you heard Veronica calling…YEREMI!

Day two: January 1, 2012 – Feliz Ano Nuevo

Today’s weather was just as beautiful as yesterday. The New Year’s Eve music in the village didn’t stop playing until somewhere around mid-morning. The Villa is about a 10 – 15 minute leisurely walk from the village so you can imagine how loud it was. After lunch and some quiet time the team headed to the Haitian Village. During my quiet time I sat at the beach just taking in the scenery and meditating. Along came Estella, a local woman who was taking a walk and looking for pretty stones. No she didn’t speak English, but with the little I knew we shared names and ended up walking the beach together. She found some sea glass for me (using my gestures I was able to ask if she had seen any) and she gave me one of her finds. A pretty purple piece that seemed like it might have been a piece of pottery or something smoothed out by the sea. The Haitian Village is a section of a village where Haitian families live. The homes are what we would classify as shacks. Made of wood with sheet metal roofs numerous family members share a very small space, maybe one or two rooms. Veronica told us about how an area had been bulldozed by the local government because it was endangering some indigenous trees or plants. Apparently they had been warned for some time, but where were they to go. The families that lost their homes ended up taking the remains from the homes and the church and rebuilt. We took some pictures with the children and look forward to being able to share copies with them. Pastor Veronica also began a feeding program for the kids with Vitamin Rice. From what I understand the children are to get this special supplemented rice a few times per week and then the Pastor will report on their growth and development after some time. Only the children are supposed to eat the rice, not the parents or other adults in the household. Shoes were also discreetly given to children observed not wearing any. They might have shoes they use for going out and special occasions, but we wanted to be sure they had the option of having shoes all the time. People in general like “free” and especially when they are disadvantaged so when things are being given out in the village it must be done with discretion. No hospital visit scheduled for today.

Haitian Village

New friends

 

Just the right size

 

Day Three: January 2, 2012

So here’s the crazy thing. We didn’t go to the hospital yesterday and eight babies were born. That is proof positive that birth is unpredictable. Today we caught the 9am bus to Bani to work at Hospital Nuestra Sra De Recla. I laughed to myself during the ride because the driver was playing the radio rather loudly. That’s something that would never happen at home. The ride was about 45 -50 minutes then we walked several blocks. The hustle and bustle of early morning reminded me of Washington Heights, a large Dominican community. The sound of Spanish being spoken, lots of traffic, shoppers browsing the items for sale on the tables outside of stores and clothes for sale hanging overhead on display. I had already begun to see how the customs and culture have been transferred over to the states, New York in particular. It’s like that with every culture, but it’s great to see it firsthand. At the hospital the team pretty much dropped their bags and quickly dispersed. In the time it took me to use the restroom I found myself standing alone among the staff, not knowing if anyone spoke English, or what to do with myself. I roamed for about 10 minutes, tried to speak to a pregnant mom and her mother, and then resumed looking for everyone. After being reunited with them I was able to get a brief tour from Lynn and I went back to the laboring room and tried some of my Spanish on two moms who were in early labor. Me llamo Tamara. Yo Soy Doula. Not sure if they knew what a doula was but my next sentence explained that I was there to help them with their labor. I found it was easier when communicating with the staff to say that I was a midwifery student, partera, because I didn’t have enough of a command of the language to explain I was there as a doula. At one point I did explain to one staff person by demonstrating that I rub backs, hold hands and say breathe – respirar. We ended up leaving to catch the bus early because the two moms were about 3 – 4 cms. Before leaving we gave out gifts of flower pens to various hospital staff on the floor. Lisa made the pens and also redecorated the bulletin board in the staff room in labor and delivery. Back at the villa we had a delicious dinner, hung out and I prepared for the next day.

Team

My first day

 

 

 

 

 

 

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Traveling with Midwife-To-Be to the Dominican Republic…One Doula’s Story

Counting down the last days before I hit the road. Most of the members of my group left today and they should all be settled in barring any flight delays. I finally found white Crocs for the trip.  I can honestly say there is nothing as unattractive as white Crocs in a woman’s size 11. I packed over the weekend which means I am going to repack tomorrow, don’t ask. That’s why its important to pack early so you can leisurely make changes. We will be staying in the Azua Province. Wikipedia lists the population in 2008 at 2,061 so it’s a far cry from Santo Domingo. I found a website that gives the history of the Province, but it’s in Spanish which means it will take me a while to translate it. From what I do understand it seems to be primarily agricultural. I look forward to learning about the the location and the people first hand.

 
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Posted by on December 27, 2011 in Childbirth

 

Traveling with Midwfe-To-Be to the Dominican Republic…One Doula’s Story

It’s a little more than 24 hours before Christmas Eve and I have boxes and bags in my dining room. My neighbor stopped by briefly the other night laughed and commented that it looked like I was moving. I’m going to take some time tomorrow to start packing and weighing my supplies. Continental Airlines you get one more chance to do something good and waive my airline luggage fees.The boxes are full of medical supplies and I figure if God provided them He’ll make them fit. Today I picked up some gifts, and arts and crafts kits for projects with the kids. I bought some adorable shiny necklaces for the little girls. Originally I was going to order them from Oriental Trading, but after shipping costs I realized the Walmart party section was a better investment. Thank you to all who have generously contributed to this trip. Your donations and sponsorship have lightened the load and made it easier to focus on filling the need. One special doctor is even sending me scrubs. Being a doula is an incredibly fascinating world.The way you are woven into one of the most intimate times in a woman’s life. It’s amazing when get to that place where you are in sync with her rhythm and rituals. Despite the language differences (I didn’t practice my Spanish quite as much as I would have liked to) I know that birth is about so much more than words. It’s about looking into that’s mother’s eyes and feeling her emotions. Watching her, listening to her breathing. That doesn’t mean I won’t have my flash cards with Spanish phrases for birth, but its good that I know what birth looks and feels like and I’m not afraid of it. I hear things will be different from what I am accustomed to, and I’m asking God for guidance. Part of me wishes I could just pack a knapsack and jump on the next flight. One day I look forward to being able to take those type of road trips. You know, you read about a need and you’re out the door. In the meantime I take what I can get and I’m grateful. Merry Christmas and Happy Hanukkah!

 

 

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Traveling with Midwife-To-Be to the Dominican Republic: One Doula’s Story…Nearing the 30 Day Mark

As the days are winding down and the departure date is quickly approaching I feel both the tension of preparing and the excitement of traveling converging within. I am confident that all of my donation needs will be met; otherwise I wouldn’t be called to make this trip. I am expecting great things to be accomplished through me and prayerfully by me, and more importantly I expect to be transformed by this journey. I am already feeling humbled at the prospect of being able to serve the women and share the grace that I have received. While I am donating my time there are still areas where I can use help. My Trip Expenses: Just Us Women Productions has paid my airfare. The remaining trip cost of $550/trip, food, lodging and transportation is being sought from sponsors and donors. Sponsors and donors can make payments via PayPal at http://JustUsWomen.org . No donation is too small, $10, $15, whatever you are capable of providing. Non-Monetary Needs: I still very much need sterile and non-sterile gloves, and for the newborns onesis and hats. Checks or money orders can be mailed to Just Us Women Productions, PO Box 744, Harriman, NY 10926. This is a personal endeavor so you won’t be able to write it off, but I hope that won’t be an obstacle. If you have material donations they can be mailed to the same address or you can contact me at 914-595-2065 to make alternate arrangements. I want to once again thank Earth Mother Angel Baby for their product donation and Americares for its donation of over the counter supplies (i.e., prenatal vitamins, gauze, etc…). I will continue to keep you posted.

 

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Walking the Talk: Knocking out Your Goals to Reach Your Vision

This week I accomplished two very significant goals. I submitted my final documents for my doula certification (Birth Arts International) and I completed the Biggest Loser Live training (AFAA). One of my VIA top five strengths is my love of learning. In my world this has the potential to propel me forward or pull me down, as I am always looking for the next opportunity. In any event, as I submitted the final documents to BAI I jumped for joy. Then I remembered I had not finished the AFAA training I started this past spring, so I set out a plan to complete 4 modules in a week, one per day. How does this help my birth work? The doula certification has been an unexpected journey of introspection about how my beliefs shape my birth work. The Biggest Loser training (while sounding sensational) taught me how to work more professionally with clients dealing with weight issues from a more holistic and compassionate position. I do definitely feel more knowledgeable and better equipped to apply my lessons learned.

 
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Posted by on November 3, 2011 in Childbirth

 

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Traveling with Midwife-To-Be to the Dominican Republic: One Doula’s Story…The Donations are Arriving!

I have begun to sit down and treat gathering donations like any task I would take on in my business. I received a financial donation from a friend and a corporate pledge for supplies from Earth Mama Angel Baby. They will be providing samples of Mama Bottom Balm. I’m very excited about their pending donation and encourage you to try their wonderful thought filled products. They go beyond selling and really support the pregnant and parenting mom.

 
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Posted by on November 1, 2011 in Childbirth

 

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Traveling with Midwife-To-Be to the Dominican Republic: One Doula’s Story

After two years of watching from afar I am ready to travel with Midwife-To-Be on a clinical trip to the Dominican Republic. I am a labor and postpartum doula trained in different birth specialties (I guess that makes me a birth specialist). My role will be to provide birth support and general help in labor and delivery, including donating supplies. Right now I am collecting donations for the women we will be serving, enough to fit into two suitcases 50lbs each. I’m also collecting school supplies and clothing for a local school for Haitian children (in the DR). As I embark on fundraising I’m finding its somewhat a learn as you go process. It doesn’t make sense to host a big fundraiser because there’s a 50/50 chance you will spend more than you earn. I’ve received some good suggestions which I will be reflecting on and implementing as I go along. My website includes a donation button and my wish list. I’ve decided to post the wish list here and as I go along update and perfect the process. So here it goes, here’s my wish list:

Tamara’s Wish List

  • Sterile Gauze 4 x 4
  • Non sterile gloves
  • Bulb syringes
  • Blood pressure cuff
  • Stethoscope
  • Alcohol prep pads
  • Lubricating jelly
  • Sanitary or maternity pad – no thin sanitary pads
  • New and gently used scrubs
  • Receiving blankets
  • Newborn hats
  • Baby clothes 0 – 12
  • Disposable wipes
  • Breast pump
  • Urine test strips
  • Umbilical cord clamps, plastic, sterile
  • Thermometers
  • Two regular sized suitcases – not to be returned
  • Summer children’s clothes
  • Children’s shoes/sandals
  • School supplies
  • Small toys and gifts
  • Plastic cups and bowls
  • Spanish bibles

I’ll soon be adding the cost of the items to the list so that it makes it easier to know how much of a donation is needed for each item. Here’s the good news! I’ve already received my first donation. I think the next thing  I’ll work on is getting the airline to waive the luggage fee. I’ll keep you posted. Pray for me…Pray for us.

 

 

 

 

 

 

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ASK THE DOULA!

Tuesday, November 8th from 8:30 to 9:15pm. FREE Doula Talk. Join this free monthly call to have your most basic questions about professional labor support answered.

For registration information visit http://justuswomen.org/DoulaCarePackages.aspx


 

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