Anger. Frustration. Confusion. Fear. There's an overabundance of emotions as I try to contemplate what I witnessed yesterday, and what I know has been a world-wide issue that needs to be transformed. We need to protect our women and their children. We need to protect all humans in the health-care system and, I suppose, little by little this is what we are trying to do, "little by little" being the key words there. I'm unsure of my words to write, unsure of where to begin, so I suppose the very beginning is the best place... I'm still working at FreMo in Nairobi, Kenya, a humble hospital with barely enough supplies to run efficiently but a friendly, welcoming, and educated staff that makes up for their lack of supplies. These past couple of weeks have been filled with shadowing the midwives, offering my services to laboring women, and I've been blessed with the opportunities of presenting babies to their mothers for the very first time. We've hosted a "Mothers Day", which is an event for new mothers to come together as a community and share their birth stories, I've taught yoga and offered prenatal massage. We've also been working on the making of a documentary to help raise $100,000 for the center to buy their own land, build a conscious and sustainable hospital, and provide women with the care they deserve. I'm learning and growing, as an individual and within my career, and I couldn't feel happier. I do realize, however, that I'm living in this sweet, comfortable little bubble and that the majority of large medical institutions offer an entirely different (negative) story. Yesterday, I saw first-hand exactly what this meant.
We had a laboring mother come in around midnight and when I woke at 7am I ate breakfast and immediately started asking the midwife questions about her status and if I could assist in any way. As I entered the room, I was thrilled to see who it was - a woman who I assisted during her prenatal visit and got to offer her some massage. We had already established a relationship and she was an absolute delight, so I spent the entire day with her, breathing with her, massaging her, and reminding her that each contraction was the necessary shift of her uterus to bring her sweet little baby to the world. She was fully dilated with the urge to push around lunch time, and I was sure this baby was coming at any moment. 4pm rolled around, she had been in labor for 17 hours and pushing for several, but still no baby. The baby ended up passing meconium and it was then that the pressure of getting the baby out became crucial. We did everything we could to allow this woman to stay at our center by encouraging her to push, but still no descent. The doctors on staff knew it was time to take her to the nearest hospital that would have the medical supplies necessary to induce labor and keep mom and her baby safe.
We quickly loaded up our "ambulance", which is actually just a SUV that the center uses as their school bus, their ambulance, and a taxi to pick up laboring mothers or anyone in need. We raced through traffic with our hazard lights blinking, hoping this would inform other drivers to get out of the way, the mother in total discomfort, leaking fluids, and worried for the safety of her baby. I looked into her eyes at any moment that I could, intuitively telling her that everything is okay, rubbing her leg to let her know that we were in this together...not knowing how out-of-our-control the situation would end up being.
We arrived to the hospital and the midwife ran inside to get assistance while I sat with the mother. Once she came outside, we both knew something was wrong. She was arguing with the staff and there was no one coming to assist the mother out of the car. When the mother asked me what was happening, I promised her I would go to find out. It's quite challenging to find out what's happening, when everyone is arguing in a mix of Swahili and English, so I stood there frustrated, fuming to find out answers. I wanted to stomp my feet and yell, "what the hell is going on and why is no one helping this mother?!", but there was already so much chaos and confusion, there was little I could do. Basically the hospital was refusing to take her because they said they didn't have enough staff. We had called on our way, and they gave us the go to come, but on arrival they said, "No, she's not our problem. She belongs to your institution. You are putting her life in danger by not taking her to another hospital!" (What?! Really?! We are here at a hospital, in an emergency, you are refusing to take her, and WE are putting her life in danger?!). We jumped back in the car and rushed her to the next nearest hospital. Pulling up through the emergency drive through, I was shocked that no doctors or paramedics came out to assist, so Magdaline, the midwife, ran inside to find her own wheel chair to get this mother to the labor ward. The wheelchair was pathetic, with a tire missing on the right wheel and both foot pedals missing, only a white piece of fabric tied to either end for us to maneuver the mother's feet onto so they didn't drag on the floor. We raced through the waiting room, which was filled with about 20 people lying ill or injured on stretchers, some with IVs, others with family members crowded around. As we ran through the hospital maze to the maternity ward, I feared this chair breaking at any moment, having mom fall to the floor. It seemed where we needed to be was the furthest unit away. My arms were filled with her clothes, along with a bucket of emergency supplies in case we had to deliver this baby in the car...or in the hospital because we couldn't seem to get any assistance. My stomach was filled with fear. We continued to run past several doctors who didn't pay any mind to the emergency, who didn't offer any assistance whatsoever. Upon arrival to the unit, they refused her service until we registered her, and the nurses made it known that we were an inconvenience to them. I noticed three staff members sitting at their desk laughing together at a YouTube video, and I was furious. Someone please help this mother. She deserves better than this. We finally walked her into her room, which was actually an open room for all women in the second and third stages of labor. I couldn't imagine being in labor, lying next to a woman screaming during delivery. There's no privacy, about 5 women in their own discomforts of labor, and here we come rushing into the room in need of an immediate delivery. I was absolutely appalled. There was no privacy for the women, their dignity completely wiped away as they strive through their own personal battles of delivering their babies. How can an institution put women in a situation like this?!
The happy ending to the story is that the mother delivered a healthy baby boy, but I'm disgusted by the events that transpired in those hospitals. There was another birth story yesterday, that I was not a part of, but was taking place in our center and soon to the hospital. It's ending did not end up to be so happy. We had a laboring woman arrive to FreMo in the early morning. She had eclampsia and a still-healing scar from a cesarean she received only a year prior. Because FreMo is a low-risk hospital and we do not have the supplies necessary for interventions, she was not a candidate to have a safe delivery here. The staff supported her by taking her to the nearby hospital and waited with her to receive care. Of course, the hospital would not handle the emergency, until the insurance passed. They would not care for a laboring, eclamptic woman and because of their lack of concern, she waited...and waited...and waited, up until the point that her baby died. This should not be happening! How can a hospital turn away an emergency? How can we arrive to a hospital and receive little to no assistance? ....and the biggest question of all .... How can we change this?! What power do we have to change this system? I know this is not just Kenya. I've heard stories similar to this from women all over the world. I spent most of my day today talking to the doctor, the midwife, and the administrator of FreMo. They informed me even more of the corruption in the hospitals here. I was taken back to hear stories like how the main governmental hospital of Kenya will keep four babies in one incubator. There is only one oxygen tube for all four of these babies, and the nurse will sit there passing the tube from baby to baby for five minutes at a time. Babies are dying, babies are ending up with cerebral palsey for lack of oxygen. THIS IS THE GOVERNMENTAL HOSPITAL!! This is just one of many discouraging stories I was told, and I can't help but feel absolutely helpless.
Birthing your child is the most sacred and spiritual moment for a mother and how can we establish the education necessary to provide her with the physical and emotional comforts as well as the medical support that she deserves? How can we change the institutions that have been running their systems so backwards for so many years? My mind races as I try to consider change. I dream of building my own birthing center, a sacred and safe place for women, with soft lighting, comfortable pillows, birthing pools, and educated midwives and doctors to provide women with the support that they deserve. So many things to consider, so many institutions at fault, so much passion to create change. Us advocates for proper birthing procedures, we cry together, wishing for change. Is this something that we can see in our lifetime?!