It's official! I'm a team leader and my first trip is up on the Habitat for Humanity Global Village Website!!!!
Please check it out:
My build info page: click here to see it!
Chiang Mai, Thailand
July 31 - August 14
Tuesday, March 16, 2010
Weekend in DC
This past weekend I spent in DC. Christina (my roommie) and I drove down Thursday for a Doctors Without Borders information session. I've had this organization at the back of my mind since I decided to apply to midwifery school. They have a strong presence in Haiti (before and after the earthquake... Click here to donate to keep funding their international efforts) and recently I've started thinking more about the possibility of joining. Trouble is that you need 2 years post-graduation experience (a good idea, frankly) and you can't go with a spouse or children. So, those timelines don't work together very well. But, placements are generally 6 months to a year, so it wouldn't be as long as the Peace Corps committment. It was a great information session and gave me something to think about.
Otherwise, I spent the weekend at Natalie and Andrew's house, playing with "my" sweet little Audrey. I've posted about her before. She's 10 months now and is mobile - crawling everywhere and even starting to pull herself up into standing. Soon that little chica will be walking - heaven help mama and daddy then! Here are some great pictures of that gorgeous girl:
This week is Natalie's 30th birthday. I was happy to be able to go down close to her day to celebrate. Of course, I had to bake a cake and sing a round of "Happy Birthday". :)
Otherwise, I spent the weekend at Natalie and Andrew's house, playing with "my" sweet little Audrey. I've posted about her before. She's 10 months now and is mobile - crawling everywhere and even starting to pull herself up into standing. Soon that little chica will be walking - heaven help mama and daddy then! Here are some great pictures of that gorgeous girl:
BATH TIME!
This week is Natalie's 30th birthday. I was happy to be able to go down close to her day to celebrate. Of course, I had to bake a cake and sing a round of "Happy Birthday". :)
Weekend in Chicago
The weekend before last, I traveled to Chicago for my Habitat For Humanity team leader training. I'm so excited to start the journey as a team leader. After participating in builds in Tanzania (2002), India (2005) and Romania (2009), I will be leading my first team to Thailand this summer (watch for an additional post on this trip). The training this weekend outlined the responsibilities and procedures of being a team leader. It was a great training with lots of similarly minded people. Here's a picture taken at the end of training.
One of the perks of attending the Chicago training was that I was able to stay with a good college friend who is a Physician Assistant in Chicago - Jackie. She took took care of me for a couple of days while I was in Chicago and took me into her little (mostly furry) family.
Another really exciting pice of this trip was seeing a highschool friend who I had not seen in nearly eleven years!! (Since highschool). It was just thrilling to see this boy-turned-man who was a best friend of mine through much of highschool. We remembered quickly why we'd been such good friends. (Thank you Facebook for reconnecting us!)
All around it was a great weekend!
One of the perks of attending the Chicago training was that I was able to stay with a good college friend who is a Physician Assistant in Chicago - Jackie. She took took care of me for a couple of days while I was in Chicago and took me into her little (mostly furry) family.
One evening, we took a stroll along the lake. The edges are still crunchy and frozen, but most of the lake has thawed. It was simply beautiful to walk along the half-frozen beach with the Chicago skyline behind us. Such a beautiful city!
Another really exciting pice of this trip was seeing a highschool friend who I had not seen in nearly eleven years!! (Since highschool). It was just thrilling to see this boy-turned-man who was a best friend of mine through much of highschool. We remembered quickly why we'd been such good friends. (Thank you Facebook for reconnecting us!)
All around it was a great weekend!
Sunday, February 07, 2010
Houston sunshine bikeride
Haven't written in a while, but the last week has brought about great change - I am headed back to Connecticut to finish my integration semester there. I had some beautiful births here at the birth center and learned, invaluably, how beautiful natural birth is. But, the birth center here was not a good fit for me and my learning needs.
Here I am again packing everything back into my car to set out on the journey back to Connecticut. I'm glad that the snowstorm/blizzard of the NE is this weekend - hopefully it will be under control by the end of the week when I arrive in DC...
As for my last days here in Houston, I am enjoying them immensely (and particularly enjoying turning my phone ringer off at night - didn't turn it off once in the previous 4 weeks!). Yesterday, we were blessed with a gorgeous sunny (warmish) day. So, mom and I spent as much time as possible outside. There is a new bike trail going from the Heights to Downtown Houston, so we used the gorgeous day to take a ride. Here are a few pictures:
and the bridge is over
a Bayou (Houston is
Bayou City)
The sky was perfectly blue - not a cloud in sight and the weather was warm enough to don a tee-shirt for the ride. Perfect way to end my time at home. Spring in February makes me so happy!
After the bikeride, I headed off to a baby shower for one of the babies I caughtThursday night (two baby boys that night). He was born early, so got to be present for the shower. His mom was a young Salvadorian girl - sweet as can be. I was flattered and honored to go to the baby shower - and felt so "official" when I was introduced as "the midwife who delivered the baby". Wow, that's me! What an amazing feeling!
with mom and baby (#15 for me) at the shower
(her face has been blocked to protect patient privacy)
I guess after such a great day in Houston, I'm able to head back north into the blizzard....
Monday, January 25, 2010
Tacos at 1am: surviving midwifery school one night at a time
Friday started I started out exhausted, after several nights of poor sleep. I was hormonal and emotional so I drove an hour to the coast (Galveston , TX
My phone rang.
We expected a slow weekend, but off to the birth center I went....for a 17 hour labor ride.
My preceptor should have sent her home – she said so herself: Friday 8pm – Saturday 1pm with two 20 minute naps at some point in the middle of the night while I played the hypnobirth CD for the patient and she was able to rest.
Admittedly, I was really glad that I was there for this woman – she struggled through labor, even during "prelabor"…the time she "should have" gone home before the contractions were at their strongest and before they were really causing cervical change. I wouldn't trade anything for sitting with a woman in labor - doing laps up and down the hall, rubbing her back, looking into her eyes and breathing with her to help pace her breathing. Running her bath and slowly pouring water over her contracting belly - hard as a rock every 2 minutes or so. It's beautiful and I do it happily. But by 6am, still no baby, I thought I might fall over head first into the tub where she sat. Fortunately, I stayed up right and present somehow. I have no idea how I. Your energy changes when you're in the presence of a woman in labor. Your peace and patience increases and your senses become more acute.
But, by 7:30 I was struggling. Now, with my preceptor up, I suggested that I go take a nap for a while. "No" she says, "there is another woman coming in". Someone else in labor. By then my energy stores seemed depleted and I didn't think I had it in me to support two laboring women after 24 hours without sleep.
But the woman who came in was in active labor – it was her third child and she'd stayed at home until she knew she was getting close. She arrived at 8am, we gave her IV penicillin and she and her husband began to labor together beautifully with complete concentration and connection. I returned to my first patient who begged me to do *something* to help things along.
9am – we broke the bag of water for the first woman. A painless procedure, it removes the padding of water below the head, so the head sits directly on the cervix and helps it dilate more quickly. The hormones created by the "rupture" also speed up labor and create more painful contractions. I told her to try and walk again – that combined with the ruptured membranes would surely move things along.
Back to room number two – laboring well, baby healthy (good heart rate). I don't want to disrupt/intrude into their focused energy, so I leave the room.
Woman one is in tears in the hallway – it hurts SO much! I can't walk. Ok, back to the tub (for the third time) – it does wonders. I support her down the hallways her tears falling onto my scrub top. Encouraging words. Quickly run her bath. In she goes. I get her husband to kneel by the tub and look into her eyes to help her breathe. I'm summoned to the other room
9:30 "She needs to push" – run into room 2 calling for my preceptor and quickly put on some latex free gloves – this woman has a latex allergy. We rush in soon after she's climbed into bed and is determined to get this baby out.
She's powerful and focused.
9:32 "It's a girl" we sumersault her out because the cord is tight around her neck – too tight to pull over her head, so we keep it close to the mom's body and "sumersault" the body around it. Cord loose, it can be removed. She goes onto mama's tummy with a healthy cry.
Baby's cry in this room is quickly followed by mama's cry in the next room. "Don't do anything and stay here" my preceptor says as she runs out.
Boy it worked to rupture her membranes – we should have done it at 1am!
9:35 "It's a girl" Baby 1 is born in the water in the next room. I missed it! I'd labored with her for over 13 hours and I was stuck in the other room for the birth of her baby. My preceptor caught it. I was sad and consoled only by the fact that the mama told me that she wished I'd been there. *smile*
3.5 hours of post partum vital signs, baby temps, baths, breastfeeding and bleeding monitoring. I alternated between rooms and tried to get everything done on time for the two women who delivered nearly at the same moment.
Somehow, I made it through. Adrenaline during birth removes all weariness, but as tasks are finished and mothers are left to bond with their new treasures, exhaustion (re)sets in. I fought off renewed nausea and delirium.
1pm – we send both mama's home. My preceptor is out the door before they are even packed up. I'm left with the doula. So, we make sure both families have been given all the necessary information, have car seats that work and we walk them down to their cars (both moms' turn down a chauffeured wheelchair).
1:45: Home – 4ish hrs of sleep - trying to pace myself so I would sleep that night and get back on a regular schedule. Get up and eat and start a movie before heading to bed for a well deserved full night of sleep.
Psych!
9:15pm Saturday - called in again. I cried when I hung up the phone. I sat on my bed with my head in my hands and cried. I was sure I couldn't do it - sure this would push my body and mind past what it was capable of. Still, I took a deep breath, donned my scrubs, packed a sandwich and apple and got back in my car. I cried in the car too, but pulled it together by the time I arrived at the birth center.
9:30pm - 4am - labor, birth, post partum. Strong, beautiful Mexican woman – I got to practice my Spanish. Gorgeous experience. I hardly noticed I was awake - second wind kind of thing, I guess. Beautiful baby girl was born just after midnight. But, I did everything myself. It was a pretty small baby and I maneuvered her easily from perineum to abdomen. Cord cut. Blood collected.
I pulled out the placenta without even a thought of being woozy. This is a first. Twelfth placenta and the first time I didn't feel scared. Wow. Maybe I really CAN be a midwife. Isn't that nice!
We always want the mama to eat before she gets up to toilet and bathe after giving birth. This was my lucky midnight. No fast-food for these lovely people. Home made Mexican fajita soft tacos. They appreciated me – labor support, attempt at Spanish and love – and offered me to share in their meal.
Tacos at 1am have NEVER tasted so good.
They wanted to go home. I wanted to go home. I woke my preceptor at 3:30 to discharge them. She was gone before I returned from walking them to their car and I was not far behind.
Slept from 4am - 11am. Not well once the sun came up, but I was in my bed, my precious bed – didn't even both to remove the clothes that were scattered on top of it before climbing in.
Went for a run Sunday and for the first few blocks my body cursed me with every step. My joints, my muscles and all the surrounding cells screamed at me. But, I pushed through and the endorphins kicked in. After the run, yoga and some delicious home-made tortilla soup, my body felt almost normal, though still tired, again. The newly grown bags under my eyes give me away, but that's what cucumbers are for, right?
This journey into midwifery is intense!
Saturday, January 16, 2010
A report of the situation on the ground in Haiti
report from Amber Munger in Port-au-Prince
PLEASE DONATE DIRECTLY TO KONPAY.ORG TO ASSIST OUR EFFORTS! WE NEED
YOUR HELP!
Visit the Konpay website and rightsbasedhaiti.wordpress.com for updates
The gunfire spread last night to our zone. At 1 am it started. It was off in the distance a ways when it first started but got closer and closer up until about 2:30 and then it seemed to stop. All of the homeless on the streets and in the refugee camps again met the chaos with loud singing, clapping and prayers.
I am at the Matthew 25 house in Delmas 33. Here we have set up a triage hospital with more than 1,300 refugees on a soccer field. The people at Matthew 25 have been traveling all over the city trying to figure out what clinics and hospitls are operational, what services they can provide and what the needs are.
There is no visible coordination effort from international agencies on the ground. There were no planes coming in yesterday. One of my coordinating partners, AMURT-Haiti, worked to find a plane of 30-40 doctors and supplies that could come, but the plane was not allowed to land in the PAP airport. We have teams in the Domiican Republic with truckloads of supplies, but they were stopped at the border and were not allowed entry.
The situation here is desperate and getting restless. The John Hopkins Students who were visiting Rights based Haiti and AMURT when the earthquake hit, have been doing surveys and assessments of the clinics and refuggee camps in the nearby zones. The surveys that they conducted two days ago show that none of the people in the camps had food or water to last them more than a day.
Here at Matthew 25, we have been doign amputations, and other painful surgeries, with no painkillers, no anesthesia, nothing to work with. There are no tools for our doctors. We have numerous Haitian doctors
and nurses here but no supplies! We have run out of antibiotics twice but then found them by searching at nearby clinics run by missions and NGOs.
We have heard nothing from MINUSTAH. I have not seen any of the international agencies on the ground. I have seen belgian doctors and cuban doctors all doing amazing work - but we have not seen or received any contact or assistance from higher agencies ourselves.
The city has run out of water and food - but the biggest problem is gas and diesel. The little that trickles in to the one or two gas stations is the subject of fights that will soon become rioting. At matthew 25, there no diesel to run the generator. We are using the last power that the inverter has that may cut out at any time. Our vehicles are all on their last ounce of fuel. I have sent one of my trusted staff and friends who worked closely with me during the gonaives emergency in 2008 to find gas this morning. I am afraid for him. There is no way for him to communicate with me because there is no phone service in the country. Now we are also running out of money. I gave my last cash today to pay for gas, a little bit of food, and a spare tire for one of our vehicles to replace one that was stolen. The nearest western union is two hours north in St. Marc and
we are not sure if that is still functioning.
An added pressure on the city right now is that, due to the lack of communications, many people from the provinces are coming to search for their loved ones. They then add to the numbers of people stuck in PAP with no way out, no food, or water.
All of the problems that exist in catastrophes, we are expereinceing now. how to dispose of the bodies, the human waste, how to move people out of the city. Everyone here is fearing rain because they think that the first rain will move the earth under the standing houses causing those buildings to fall as well. Each day more things fall.
I am coordinating with AMURT, KONPAY, Beyond Borders, Matthew 25, and many other partners on an integrated response that will help us get through the next week as well as prepare us to deal with the coming
months of insecurity. We have coordinated the shipment of diesel from the open port in cap-haitian, the use of a shipping company to haul fuel from the DR to PAP, the use of a large protected storage compound to store the fuel. We have Haitian volunteers working with the John Hopkin team to conduct the surveys to provide us important data on the numbers and locations of people who are in need of medical care, so that when help and supplies arrive, we are able to efficiently get people to where they need to go. We have worked with grassroots leaders in Commune Anse ROuge to gather information throughout the commune on family names and locations in PAP so that each village can send on e or two people to serach for loved ones in PAP rather than everyone from the villages going into the disaster zone.
in general, we are being used as a place for information exchange. journalists, and organizational representatives are checking in daily to give updates and share information which i then share with my
contact at KONPAY who then shares the information with the larger network of NGOS that we are coordinating with. until MINUSTAH is able to re-establish a coordination base, we are making the MAtthew 25 house the coordination headquarters for our operations.
Haitians are helping each other in glorious acts of compassion and kindness every where you look. These people have endured so much unspeakable and unnecessary suffering. I am today, as always, blessed to be walking with them in their struggle to overcome their awful and unfair circumstances, and am even more blessed to be sharing in the strength of spirit that makes each one of them my hero.
Our partners also need your help! AMURT-Haiti and Beyond Borders are helping us to coordinate our efforts. We are all working together to share resources to assist haitians during this disaster. Please send
your donations to Konpay, to AMURT-Haiti, or Beyond Borders to help us!
Amber Lynn Munger, J.D.
"Everyone has duties to the community in which alone the free and full
development of his personality is possible."
- Universal Declaration of Human Rights, Article 29(1)
"Chak moun gen yon seri obligasyon anvè kominote kote li ap viv la.
Paske kominote a se sèl kote li kapab alèz pou li devlope pèsonalite
li tout bon vre."
- Deklarasyon Linivèsèl Dwa Moun, Atik 29(1)
PLEASE DONATE DIRECTLY TO KONPAY.ORG TO ASSIST OUR EFFORTS! WE NEED
YOUR HELP!
Visit the Konpay website and rightsbasedhaiti.wordpress.com for updates
The gunfire spread last night to our zone. At 1 am it started. It was off in the distance a ways when it first started but got closer and closer up until about 2:30 and then it seemed to stop. All of the homeless on the streets and in the refugee camps again met the chaos with loud singing, clapping and prayers.
I am at the Matthew 25 house in Delmas 33. Here we have set up a triage hospital with more than 1,300 refugees on a soccer field. The people at Matthew 25 have been traveling all over the city trying to figure out what clinics and hospitls are operational, what services they can provide and what the needs are.
There is no visible coordination effort from international agencies on the ground. There were no planes coming in yesterday. One of my coordinating partners, AMURT-Haiti, worked to find a plane of 30-40 doctors and supplies that could come, but the plane was not allowed to land in the PAP airport. We have teams in the Domiican Republic with truckloads of supplies, but they were stopped at the border and were not allowed entry.
The situation here is desperate and getting restless. The John Hopkins Students who were visiting Rights based Haiti and AMURT when the earthquake hit, have been doing surveys and assessments of the clinics and refuggee camps in the nearby zones. The surveys that they conducted two days ago show that none of the people in the camps had food or water to last them more than a day.
Here at Matthew 25, we have been doign amputations, and other painful surgeries, with no painkillers, no anesthesia, nothing to work with. There are no tools for our doctors. We have numerous Haitian doctors
and nurses here but no supplies! We have run out of antibiotics twice but then found them by searching at nearby clinics run by missions and NGOs.
We have heard nothing from MINUSTAH. I have not seen any of the international agencies on the ground. I have seen belgian doctors and cuban doctors all doing amazing work - but we have not seen or received any contact or assistance from higher agencies ourselves.
The city has run out of water and food - but the biggest problem is gas and diesel. The little that trickles in to the one or two gas stations is the subject of fights that will soon become rioting. At matthew 25, there no diesel to run the generator. We are using the last power that the inverter has that may cut out at any time. Our vehicles are all on their last ounce of fuel. I have sent one of my trusted staff and friends who worked closely with me during the gonaives emergency in 2008 to find gas this morning. I am afraid for him. There is no way for him to communicate with me because there is no phone service in the country. Now we are also running out of money. I gave my last cash today to pay for gas, a little bit of food, and a spare tire for one of our vehicles to replace one that was stolen. The nearest western union is two hours north in St. Marc and
we are not sure if that is still functioning.
An added pressure on the city right now is that, due to the lack of communications, many people from the provinces are coming to search for their loved ones. They then add to the numbers of people stuck in PAP with no way out, no food, or water.
All of the problems that exist in catastrophes, we are expereinceing now. how to dispose of the bodies, the human waste, how to move people out of the city. Everyone here is fearing rain because they think that the first rain will move the earth under the standing houses causing those buildings to fall as well. Each day more things fall.
I am coordinating with AMURT, KONPAY, Beyond Borders, Matthew 25, and many other partners on an integrated response that will help us get through the next week as well as prepare us to deal with the coming
months of insecurity. We have coordinated the shipment of diesel from the open port in cap-haitian, the use of a shipping company to haul fuel from the DR to PAP, the use of a large protected storage compound to store the fuel. We have Haitian volunteers working with the John Hopkin team to conduct the surveys to provide us important data on the numbers and locations of people who are in need of medical care, so that when help and supplies arrive, we are able to efficiently get people to where they need to go. We have worked with grassroots leaders in Commune Anse ROuge to gather information throughout the commune on family names and locations in PAP so that each village can send on e or two people to serach for loved ones in PAP rather than everyone from the villages going into the disaster zone.
in general, we are being used as a place for information exchange. journalists, and organizational representatives are checking in daily to give updates and share information which i then share with my
contact at KONPAY who then shares the information with the larger network of NGOS that we are coordinating with. until MINUSTAH is able to re-establish a coordination base, we are making the MAtthew 25 house the coordination headquarters for our operations.
Haitians are helping each other in glorious acts of compassion and kindness every where you look. These people have endured so much unspeakable and unnecessary suffering. I am today, as always, blessed to be walking with them in their struggle to overcome their awful and unfair circumstances, and am even more blessed to be sharing in the strength of spirit that makes each one of them my hero.
Our partners also need your help! AMURT-Haiti and Beyond Borders are helping us to coordinate our efforts. We are all working together to share resources to assist haitians during this disaster. Please send
your donations to Konpay, to AMURT-Haiti, or Beyond Borders to help us!
Amber Lynn Munger, J.D.
"Everyone has duties to the community in which alone the free and full
development of his personality is possible."
- Universal Declaration of Human Rights, Article 29(1)
"Chak moun gen yon seri obligasyon anvè kominote kote li ap viv la.
Paske kominote a se sèl kote li kapab alèz pou li devlope pèsonalite
li tout bon vre."
- Deklarasyon Linivèsèl Dwa Moun, Atik 29(1)
Thursday, January 14, 2010
My new favorite poem
Written by my favorite 11 year old, Happy.
This is what it is to feel loved!
Sent with a Christmas thank you note, written by my favorite 11 year old who I have taught, lived with, traveled with and loved for the past 7 years!
Just wanted to share
From a class room to a hospital
I know a young person who did the world a big favor
and taught in Thailand for two and a half years
to school again to help people in one more way
may she give every little baby a way to be born
a midwife of course
thank goodness you are here Emily
This is what it is to feel loved!
Sent with a Christmas thank you note, written by my favorite 11 year old who I have taught, lived with, traveled with and loved for the past 7 years!
Wednesday, January 13, 2010
Help for the Hatians - donate now! Every little bit helps!
Here is a message written by a dear friend of mine. She is doing her PhD on the Hatian government and situation and is quite close to the country and the people there. I visited her in Port Au Prince a couple years ago for a week. As someone who has seen varying degrees of international poverty, including India and Tanzania, I was truly surprised and saddened by the "normal" situation in Haiti. My heart hurts for their current situation. Please read the message below and help in whatever way you can. Feel free to also pass along or "borrow" the note and links to forward to others. I have added in a couple additional sites to those she sent me.
We are citizens of the world! Don't let the relative calm bubble surrounding us here keep you from helping your brothers and sisters in Haiti who are hurt, scared, homeless, hungry and truly in despiration! Remember, even the smallest donations, if made by each of us, add up quickly and will help save lives.
Under 'normal' circumstances, the level of need is persistently high and in the wake of this natural disaster, I cannot begin to explain the nature and extent of the consequences.
Not having done initial assessments of the impact, most relief organizations have not yet planned their medium-term response; for the moment trained emergency first responders are needed to administer medical and humanitarian aid.
Since many of us do not fit that bill, let us do what we can in the short-term. Let us donate.
Please choose the organization you trust the most and give as much as you can.
If you are yet to make Spring Break plans, this may be among the best uses of your time and money.
Dear all,
By now, I suspect that most of you have heard about Haiti's being hit by a 7.0 (magnitude) earthquake yesterday afternoon.
You can get the latest reports at:
As some of you know, I lived and worked in Haiti for most of 2008.
Not having done initial assessments of the impact, most relief organizations have not yet planned their medium-term response; for the moment trained emergency first responders are needed to administer medical and humanitarian aid.
Please see a list below of the many organizations who are seeking donations as they either collaborate with other organizations or construct their own response efforts. Each has a hyperlink, so just click on the organization's name and it will take you to a website where you can donate.
Habitat for Humanity - Haiti Partners
- International Medical Corps
- Direct Relief International
- World Vision
- International Relief Teams
- Yéle Haiti
- American Red Cross
Operation USA - CARE
- Catholic Relief Services
- World Food Programme
- World Concern
- Save the Children
- UNICEF USA
- Mercy Corps
- Operation Blessing International
- Shelterbox
- Americares
- Doctors Without Borders
- Medical Teams International
- International Committee of the Red Cross
- The Salvation Army
- Heifer International
For those of you who wish to give of your time and energy, I will be vigilantly keeping up with the efforts and working on ways that we can volunteer in the medium-term.
Until then, let us give as best we can and keep on praying for the people of Haiti.
Thank you,
Sheree
Emily and Sheree in Haiti 3/2008
waterbirth: first birth in Houston, first boy, first birth center all-nighter
Happy early early hours of Wednesday. It's hump day, but just barely. My "hump" is actually making it through this all-nighter here at the birth center. (And most of you know that all nighters and I are generally not friends)! Then of course, I need to make it through a full clinic day tomorrow before a blissful night of sleep tomorrow night. . . Anyway.
A woman came into the clinic today claiming she was in labor. Well, there are different types of "labor" and she was in the very early kind that is mildly painful, but not too much, and doesn't cause any real cervical change. So, my preceptor sent her home and told her to call at 10pm or sooner if she felt that things were really picking up.
I rushed home from a ACNM (American College of Nurse Midwives) meeting at 8pm and scarfed down some dinner in attempt to jump into bed for a nap before getting called into the clinic. Alas, it was not in the stars.
At 9pm, as I was eating my last bites of dinner, my preceptor called and told me to meet her at the clinic at 10pm - we were in labor, but it was going to be a long night.
The dreaded night labor - somehow (aside from the still birth that happened at 11pm after evening induction and which was filled with so much emotion and processing that I hardly noticed it was night) I have avoided middle of the night labor and birth until now. Admittedly, I took as few night call shifts as possible and somehow was lucky enough not to be called in for those I had taken. Of course, sleepless nights are part of this profession I've chosen. It's never been something I've been able to do easily and usually leaves me rather nauseous. But, this summer, with the outbreak of H1N1 at summer camp, I made it through about 4 days on around 8hrs sleep if I'm being generous. So, I know I can do it. Still, I was disappointed and nervous about what lay ahead of me this evening.
10pm - birth center. The patient is clearly in more serious labor than she was this afternoon. Her cervix is still only about 4cm (as opposed to 2cm around 4:30 when we sent her home) and it looks like we have a long night ahead of us.
But it's her second baby and things were getting moving, so by 11:45, she'd progressed to about 7-8 centimeters and was really wanting some pain relief. We broke her water to speed things along, got her in the bath with the jets going and (begrudgingly .... perhaps only because they threatened to go to the hospital) gave her some IV pain meds...which pretty much knocked her out right away. She became really groggy and was practically asleep in the tub.
12:00....12:15 - baby stable, mom groggy but stable, water warm, dad present, grandma (well, frankly she had a knack for thinking of, and verbalizing, just about anything that could possibly go wrong....not.helpful.)
Every 10 minutes or so listening to the baby's heart rate and using a flashlight to check to water for signs of imminent birth (only small lamps and candles on in the room).
12:45 - a short vocal "oooohhh" from the mama which prompted a "flashlight check"
A HEAD!.... well, not the whole head, but the crown of it with beautiful hair.
Two pushes...well, two contractions...mama was still a little asleep from the pain meds...and baby smoothly entered the world - from one water world into another... then dry land. It's nice to transition smoothly then land in a hug!
Amazing - nothing happens so smoothly and gracefully in the hospital....there it is always dramatic - voices, lights, counting, urgency. Here just life - easy and delightful. It was (finally!) one of the most beautiful things I've ever seen.
I pulled the baby out of the water and put him on the mama's chest, continued to pour warm water over him to keep his temp up and helped daddy cut the cord.
After a few minutes, we helped mama out of the tub and to the bed to take care of all the "after birth stuff" that is the least favorite part of my job. But, I didn't get woozy (which, unfortunately, has been quite a challenge for me when placentas are involved) and sat on the bed with the mom while we took care of her. I was a little unsure - this was so different from doing these things in the hospital - but my preceptor very patiently guided me through them and it was ultimately a success.
Believe it or not, this was the first boy that I have caught. Nine girls up to this point. Now, the magic 10th was a sweet little boy with very good lungs - started crying just as soon as I brought him out of the water.
What a different experience. I loved it!
click here for more information on waterbirth -articles and information
A woman came into the clinic today claiming she was in labor. Well, there are different types of "labor" and she was in the very early kind that is mildly painful, but not too much, and doesn't cause any real cervical change. So, my preceptor sent her home and told her to call at 10pm or sooner if she felt that things were really picking up.
I rushed home from a ACNM (American College of Nurse Midwives) meeting at 8pm and scarfed down some dinner in attempt to jump into bed for a nap before getting called into the clinic. Alas, it was not in the stars.
At 9pm, as I was eating my last bites of dinner, my preceptor called and told me to meet her at the clinic at 10pm - we were in labor, but it was going to be a long night.
The dreaded night labor - somehow (aside from the still birth that happened at 11pm after evening induction and which was filled with so much emotion and processing that I hardly noticed it was night) I have avoided middle of the night labor and birth until now. Admittedly, I took as few night call shifts as possible and somehow was lucky enough not to be called in for those I had taken. Of course, sleepless nights are part of this profession I've chosen. It's never been something I've been able to do easily and usually leaves me rather nauseous. But, this summer, with the outbreak of H1N1 at summer camp, I made it through about 4 days on around 8hrs sleep if I'm being generous. So, I know I can do it. Still, I was disappointed and nervous about what lay ahead of me this evening.
10pm - birth center. The patient is clearly in more serious labor than she was this afternoon. Her cervix is still only about 4cm (as opposed to 2cm around 4:30 when we sent her home) and it looks like we have a long night ahead of us.
But it's her second baby and things were getting moving, so by 11:45, she'd progressed to about 7-8 centimeters and was really wanting some pain relief. We broke her water to speed things along, got her in the bath with the jets going and (begrudgingly .... perhaps only because they threatened to go to the hospital) gave her some IV pain meds...which pretty much knocked her out right away. She became really groggy and was practically asleep in the tub.
12:00....12:15 - baby stable, mom groggy but stable, water warm, dad present, grandma (well, frankly she had a knack for thinking of, and verbalizing, just about anything that could possibly go wrong....not.helpful.)
Every 10 minutes or so listening to the baby's heart rate and using a flashlight to check to water for signs of imminent birth (only small lamps and candles on in the room).
12:45 - a short vocal "oooohhh" from the mama which prompted a "flashlight check"
A HEAD!.... well, not the whole head, but the crown of it with beautiful hair.
Two pushes...well, two contractions...mama was still a little asleep from the pain meds...and baby smoothly entered the world - from one water world into another... then dry land. It's nice to transition smoothly then land in a hug!
Amazing - nothing happens so smoothly and gracefully in the hospital....there it is always dramatic - voices, lights, counting, urgency. Here just life - easy and delightful. It was (finally!) one of the most beautiful things I've ever seen.
I pulled the baby out of the water and put him on the mama's chest, continued to pour warm water over him to keep his temp up and helped daddy cut the cord.
After a few minutes, we helped mama out of the tub and to the bed to take care of all the "after birth stuff" that is the least favorite part of my job. But, I didn't get woozy (which, unfortunately, has been quite a challenge for me when placentas are involved) and sat on the bed with the mom while we took care of her. I was a little unsure - this was so different from doing these things in the hospital - but my preceptor very patiently guided me through them and it was ultimately a success.
Believe it or not, this was the first boy that I have caught. Nine girls up to this point. Now, the magic 10th was a sweet little boy with very good lungs - started crying just as soon as I brought him out of the water.
What a different experience. I loved it!
click here for more information on waterbirth -articles and information
Sunday, January 10, 2010
a poem by Hafiz
You carry
All the ingredients
To turn your life into a nightmare-
Don't mix them!
You have all the genius
To build a swing in your backyard
for God.
That sounds
Like a hell of a lot more fun.
Let's start laughing, drawing blueprints,
Gathering our talented friends.
I will help you
With my divine lyre and drum.
Hafiz
Will sing a thousand words
You can take into your hands,
Like golden saws,
Silver hammers,
Polished teakwood,
Strong silk rope.
You carry all the ingredients
You carry all the ingredients
To turn existence into joy,
Mix them, mix
Them!
-Hafiz, the Sufi master poet
Reflections - my Christmas letter
December 2009
Happy holidays! It’s hard to believe that we will soon be in the year 2010. I still find myself writing a 19 instead of a 20 occasionally and yet it’s been a decade since we feared the big Y2K. Would the computers crash? Would the world end? Neither happened and we kept truckin’ through life’s adventures. As I reflect back on the first decade of the 21st century it is hard for me to even begin to process how many experiences I’ve had and how much each has changed me. Ten years ago this month, I was finishing my first semester of college at Oglethorpe in Atlanta – I pulled my first all-nighter (which caused me to be very discombobulated and physically quite ill), was beginning to fall in love for the first time, made my first multi-state drive without one of my parents and experienced for the first time how “home” can be simultaneously intimately familiar and strangely foreign. How my self and global understandings, heart, faith and knowledge has changed since then! Adulthood: joyful lessons, painful ones; acute experiences, subconscious processes; life. For better or for worse, till death do us part, this beautiful chaotic world and I play a game of chess with God as our referee.
Five years ago, December 2004. This month five years ago, I was anxiously awaiting my Peace Corps deployment for Thailand
Two years ago I sat in this same computer lab trying to figure out how to convey the overwhelming experience of my first semester in grad school, nursing school and time adjusting to being back in the United States
December 2009, today. I can’t say that my fears and doubts from two years ago have totally disappeared – they still resurface now and again. But, here I am finishing my last few assignments of my last classroom semester at Yale School of Nursing. It seems surreal that in a short five months, I will yet again don the black cap and gown, adding a hood this time, and walk across a stage for the third time in my life. Soon there after, I will wear the catcher’s mitt alone, without more experienced and confident hands covering mine as new life after new life enters this world from the love of couples, powers of women, creation of God and the guidance of my two hands. These very hands that have dug in the mud, cramped from holding a pen, held crying babies, clapped with joyful children, turned pages of a musical score, felt for fever, struck piano keys and spoken the common language of gestures and humanity when I had no words that would work. I don’t know how these chapped, nail-bitten, well-used hands can be deserving of such honor. I often doubt that they will know what to do when I instruct them to work on their own without guidance from more experienced hands. And yet, I am assured that every novice midwife has these same thoughts, worries and pride that her own hands can guide a new life into existence.
In the past year, I have helped guide eight babies from water world to dry land – seven alive and healthy, one stillborn at 22 weeks. All beautiful. I have learned to blindly measure the diameter of a cervix using only touch and the movement of my fingers. My accuracy of identifying fetal position in utero with my hands outside the belly continues to improve and each time the fetus tries to kick my hands away as I push and prod, I can’t help but laugh with the expectant mother. I have hugged women in joy and in sadness, in comfort and in pain. I have helped women slowly lie down and held others up through labor pains they thought they surely could not endure. I have counseled, taught, guided and encouraged. Midwifery is not a profession for the weak – it enters your soul, ruins your sleep and occasionally takes over your mind. I am daily challenged and rewarded. Moreover, I can’t believe it is I who is taking on this journey. And as this nearly fatal academic journey comes to a close, the real journey is just beginning. I have great hopes for my Christmas letter next year!
The experiences of this year are not all held within the context of midwifery, however. In April, I took the national nursing certification exam and am…wait for it…officially a registered nurse. That’s right: Emily Lawson, RN. After receiving this license, I worked as a summer camp nurse at a camp in the Texas Hill country. I was the only medical professional for around 200 hundred people at a rustic camp 30 minutes from the nearest hospital and at least 10 minutes from cell phone service (we did have land lines). We had some scorpion stings, sprained joints, burns, ingrown toenails and multitudes of cuts, scrapes, bruises and splinters. I am now officially an expert tweezer! We also had the swine flu.
Yes, we were confirmed H1N1 recipients. It hit us 10 days before the end of camp in a sudden wave that went from one to twelve over night. On the worst day – before sick campers started going home for their seven day quarantine – I had 23 sick campers with at least 10 spiking fevers over 103F. I was rounding on them (in protective mask for those confirmed cases) in three different cabins (boys and girls quarantine bunks) every four hours taking temperatures, icing hot foreheads and armpits and distributing Tylenol/Motrin and meals. I think I got eight hours sleep in four days. My adrenaline kept me going. And despite living with fifteen of the invalids for several days I never got sick. Man, eating that street food in India really paid off. Go, immune system, go! It was an exhausting, challenging session and first nursing “gig”. But, for once I felt like I knew what I was doing, was appreciated (the directors, staff and campers made sure of that) and had something to contribute. It was such a meaningful change from my two years of feeling incompetent that I didn’t even mind that I wasn’t sleeping – and that’s a first!
As most of your know about and helped fund, my last month of summer found me building houses in Beius, Romania with Habitat for Humanity and then traveling in both Romania and northern Turkey. It was a perfect ending to a fabulous, and much needed, summer. The build in Romania was the most productive of the international builds I have done – we were working on a group of duplexes for former soviet orphans, now adults without support systems and often with very little education. The future home owners were fun and friendly, many with pretty good English. I learned that Romanian is the fifth Romance language, but alas, that connection didn’t help me speak it! Inspired by this build (and my past two International builds) I applied to be a Habitat International team leader and was accepted last week! In the upcoming months, I will attend team leader training and then begin to plan a build to Thailand for this summer. Let me know if you want to join the team – I deeply believe there is no better way to experience this diverse world in which we live.
So, as I finish up my last days in New Haven before heading to Houston for the holidays and next semester (will be at a Houston Birth Center for my full time midwifery integration) I simply take one assignment, one emotion and one interaction at a time. I am thankful for your continued support and love through this journey we call life. I could not keep dreaming up my wild plans without being surrounded and cared for. Thank you. Have a joyful and blessed holiday season.
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