More colaborating with the doctors and working out details

Today found us hashing out the details of necessary labs, transport to hospital and how to locate a birth center friendly doctor, what to order for birth kits and about certain health conditions that make a mom not a good birth center candidate.  Whew!  That is a lot to cover in one morning. Communication was via an interpreter named Google Translator.  Thankfully, one of the doctors speaks a bit of English, with my little bit of Spanish.  She also reads medical English. She cannot converse in conversation, but could read my protocols with some help. They were absolutely thrilled with the Protocols Dr. Camber and I hammered out this last year.  They were like gold to them.

Conversation goes slowly, but that is not necessarily a bad thing for me, as I talk too fast anyway.  I think that they were happy that we were going to be honoring a good set of protocols that were practical (They kept called them that.)

There are actually a lot of differences in the way they practice here in Oaxaca.  It is all about what can be financially afforded.  Social health care provides the bare minimum and that does not include things like glucose screening unless you are spilling sugar in your urine. It also does not include blanket antibody screening, unless you are already proven negative in blood type.  They are not terribly concerned about future pregnancies.  Just keeping you alive for this one.

They also do not test AT ALL for Group B Strep.  Not at the beginning or at the end of the pregnancy.  Not an issue.  They just watch baby in the nursery for a day or two.

The hosptials are very ready to do a c-section and many of the women do not know why they have to get one.  Several of the women I have interviewed or listen to talk, say that the doctor just told them, "Your baby will die if you do not get a c-section."  So they did.  Now they are angry, sad, grieving, remorseful, and adamant that something should be done to warn other women.

There may be legitimate reasons for some women to get c-sections, but honestly, 85% is a huge number of women unable to vaginally give birth.  The women here do not feel that it is because of the inability to give birth, but that doctors are very overworked and it is more expedient to plan the c-section, that to wait for a mom to dilate to 10.  It is not an issue of being sued.  No one sues here. (Or at least very few, and certainly not the medical system.  They are no lawyers angling for damaged parties here.).  It is simply a matter of convenience.


We got our first patient today!  The woman is 24 weeks along.  She came with her husband.  They do not drive, so someone went to pick them up.  They live in a 2 room very small hut/house.  One room, plus a cooking room.  This is their first baby.  They are a Christian family that attend a baptist church  along with our Mexican retired OB nurse who is volunteering her time at Casa Compasiva.

She was totally enamored with the teaching aids.  She had never seen a picture of a baby inside a mom, with the placenta and all.  She was fascinated and you could see the lights of understanding come on.  It was totally sweet.

Lila did a great job with the prenatal and the Mexican Doulas (Birth Assistants) were all fairly confident with all the role playing we have done all week.  Nothing like a real live patient to get all the bugs worked out of the system.  I think everyone felt good about how it went.  The pregnant woman was very impressed with all the personalized attention and teaching.  She happily paid her down payment of 50 pesos and said she'd be back in 2 weeks.

I have been enjoying skyping with my family.  It has made the evenings full of fun here in my room.  This evening I took my computer into the kitchen while I made Curry Chicken and ShaHannah took her computer into the living room on the floor where she was putting together a puzzle.  We watched each other and talked for about a 1/2 hour.  I think it helps both of us.

I leave on Sunday for home.   I will be taking a piece of Oaxaca with me in my heart and know that with satisfaction, I have worked successfully in sharing midwifery (and the love of Christ) with about 15 women.