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I'm not sure why I can't get any pictures to upload. I'll keep trying. The Internet has been so sporadic that I finally started writing in word, so I'll paste my writings in:


A nice busy night at the birth center. As soon as I walked up for my shift this mom says “hi Joyce” Of course I couldn't remember who she was. Turns out I had seen her for a prenatal and told her to come back on my shift to have the baby. So she said she was waiting for me to come on shift. They were a sweet couple that thankfully spoke some English. When I was planning this trip I had heard that most people speak English. All the people that work here speak English, but their accent is strong and they talk a language called cebuano. Most of the patients do not speak English, but usually can understand a little. It’s hard when a midwife cannot communicate with her client. Especially for someone like me that likes to talk! :)

When I came on shift there were 3 moms in labor. My mom delivered first, with a little girl wrapped in her cord. Usually in that case you can somersault them out, but it was a short cord and this poor baby was all tangled in the cord. We finally got her all untangled and she did great.

At the same time there was a mom pushing loudly behind another curtain. It’s unusual for them to be loud. Most of these women are very quiet and you have a hard time telling when they are getting close because they are so quiet. Well 20 minutes after my birth I was checking vitals on my mom, when I heard nothing at all, then a soft “breath baby”. Those are always scary words to hear. I quick went in to have a chart thrown in my hands, while they efficiently gave PPV (like mouth to mouth but with a hand pump ventilator). Heart rate was good, but it was a very limp baby that didn’t look like it any strength to breath. He finally did breathe, but they were very labored breaths even with oxygen. He never did cry, and he was still very limp when they transported. Thankfully we don’t have to wait for an ambulance. We have a guard here 24 hours. He is our ambulance driver; he screens for new clients and gets the charts for anyone in labor. . Then he comes in and says, “labor mum”. It’s very nice to have him always there. He also answers the phone, but it rings only about once a day. Telephones are not part of this culture. But the text phones are everywhere

So this baby was transported and them mom stayed here. I felt so sorry for her as she barely even saw her baby. We still had one more in labor; she was a 3rd time mom already dilated 8 so we thought she would go fast. About 3 in the morning I finally finished with my newborn exam, the baby bath, taking enough vitals that I could leave her for 4 hours so she could get some sleep and I was caught up on my paper work.
I was asked if I would like to suture the mom whose baby was transported. She said it’s just a little 1st or 2nd degree. I said sure and got all set up, when the supervisor who was going to help me began by assessing the tear. It turns out it was a 4th degree tear. She was wearing a blue glove, and I won’t be gory here, but you could see the glove where you shouldn't be able.
This means we had to transport the mom too. A 4th degree needs a surgeon. The reason she tore so bad though was to save her baby. Turns out during the delivery the Heart tones jumped up to 200 just as baby was crowning. So at that point a tear is the least of the worries. They had her get that baby out fast and the placenta came right after, meaning it was probably detaching before the baby was born. This baby was born sucking in blood because the placenta detached too soon.
I volunteered to go to the hospital with the supervisor to transport her. She still wont is able to see her baby. The hospital is a chaotic very sad place. Outside there are benches full of people sleeping, and all their stuff. Inside there are rows of beds, sometimes without even spaces between them. People everywhere, because not only are their sick people everywhere, but also the patients family is all with them. This Is at 3 am. That’s because the family has to take care of the patients. I even saw one baby with a little girl using the Positive pressure ventilator, breathing for the baby. She was just constantly pumping it every few seconds. They have no machines that I saw. Everything is the old way. They take blood pressure and temperature with an old mercury thermometer when they walk in the door, then they sit on a bench and wait their turn. On the way out we saw the baby in a side room. It was sharing the bed with another baby. It has oxygen and an IV, but only the young aunt was with the baby. This was the room for urgent care, but I don’t think there was a nurse or doctor in the room, just family and the patients. The nurses wear old-fashioned hats and most wear masks too. I saw one nurse go in to collect blood. She was using a syringe and the needle was never covered. She drew the blood and walked to another room with the syringe and needle open not even carrying it very careful.
When we did get back to the clinic the other mom had just had her baby. I was able to sleep for 2 hours before it was time for vitals and paperwork. 2 hours is just enough to make a person really groggy.
We hardly ever find out what happens to the moms after we transport.
We had to transport another one last night. Again I noticed children pumping the amubags, to breathe for maybe their dad? I brought the mom into the room that they will check her, and the bed was still bloody from someone else. I was really grossed out. In a country where they have so many people all working hard, and usually so clean, why is the hospital so opposite. The hospital is the dirtiest place that I have seen since being here. People everywhere, no matter what time of the day you go in.
It's so hard to bring people there.