A Birth Story

Posted by on December 25, 2011 in Blog, Uncategorized | 0 comments

If you didn’t already know, I’m a Master’s trained Family Nurse Practitioner and practiced for 5 years in the States before returning to school once again to attain my Midwifery licensure.  For the past 2 years, I’ve been slowly chipping away at my midwifery academics as well as attending prenatals and births.  A few weeks ago, I attended my first birth here in Madagascar.  As could be expected, it was different than the lovely home births I had with my own children.  Here’s the birth story.

A 22-year old Muslim woman in labor arrived at the clinic where I was working that day.  She was in early labor and 4cm dilated.  Given the option of returning home, she chose to stay at the clinic.  In attempts to find some sort of privacy, she paced back and forth in the shade behind the clinic.  Her mother, mother-in-law, aunt and grandmother surrounded her, speaking what I assume, were words of encouragement to her.  She drank tea.  It was time for the evening Islamic prayers, the older ladies lay down their mats and faced them toward Mecca.  Prayers spoken.  The Koran read throughout.  A few hours later, her husband arrived.  He mostly sat and watched but as labor progressed, he joined in walking with her.  She held on tightly to him and swayed her hips as labor intensified, her moans were just faint whimpers.  Her eyes had the glassed over glaze of transition as a result of God’s natural painkillers.  As day turned into night, the air remained hot and humid with threats of lightening in the distance.  Sweat trickled down her face and mosquitos and other “bugs of the night” were swarming all around.  She was now 10cm dilated, it was time to bring forth this baby into the world.  The delivery room, a bare stark room, where she lay flat on her back on a table with a rubber mat underneath her.  Her bottom elevated on a bed pan… a position completely contradictory to both gravity and birth.  A strip of white cloth tied around her right thigh, the symbolic meaning in the Karana (or Indian) culture, was known only to the family.  Pushing.  Working hard.  Finally, in a moment just before 8pm, a baby born, a little girl!  The grandmother’s, aunt, and great-grandmother, talking excitedly and kissing each other with joy and thanksgiving.  The parents with a flat look on their faces.  ???.  A shot of oxytocin in the mother’s thigh within minutes of birth, followed by controlled cord traction and uterine massage in order to prevent postpartum hemorrhage… a condition that literally kills hundreds of thousands of women every year in the developing world.  Retained placental fragments…. I’ll spare you the details.

An extensive repair was needed.  No additional lights were available to see better.  No ice for the mama’s perineum.  No pads to catch the postpartum blood.  Just strips of cloth.  No cameras for pictures of the momentous day.  The whole time, I was a learner.  Soaking in every detail, every difference, every learning experience.  Throughout I wondered, “how do I effectively communicate in another language plus in an additional culture?”  The Karana culture is really a culture within a culture… a people group completely separate from the Malagasy, yet have lived in Madagascar for generations.  It is a culture I know nothing about.  Can I congratulate the parents?  Can I say the baby is beautiful?  Can I ask the baby’s name?  Lots of questions… no answers.  The extended family arrives along with the 3-year old big brother.  Lots more excited talking and kissing and congratulating between family members.  The parents still with blank stares.  ???.  The baby laying on a table, swaddled up, but not in the arms of anyone.  Finally the grandfather arrives.  He picks up his new grand-daughter.  Lovingly gazes upon her, kisses her, he’s proud, happy.  Everyone rushes around, confirming the baby’s name, Wazifa.  Immediately once the baby is named, the grandfather murmurs long unidentifiable words into both ears of the baby, a prayer perhaps.  Two hours after the birth, the immediate post-birth ceremony complete, the mother takes her baby in her arms for the first time and begins to breastfeed.


*photo taken from Stanford

proud mamas and their babies….

Maybe you’re ready to join me … “the ants go marching two by two, hurrah, hurrah…. the ants go marching two by two, hurrah, hurrah…. the ants go marching two by two, the little one stops to tie his shoe and they all go marching down to the ground to get out of the rain….” You can thank me later for this little ditty in your hea


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