Bungie Jumping Baby
It was her third baby and first home birth and she had created a beautiful warm cave for herself in her bedroom. Dim lights. Birth pool. Candles. Lovely burning oils. Hypnobirthing cd playing in the background. Safe and warm and cosy. But labour had slowed down since she had gotten to fully dilated and we waited patiently for labour to pick up again. And it just didn’t. And so the difficult decision was made to move to the nearby hospital to seek assistance. I packed the car while Marianne stayed with the labouring mother and once we were ready to go, we made the slow shuffle across the much colder and starker open plan kitchen/dining area/sitting room to the front door. The slow shuffle of a labouring woman. A few slow steps forward and then stop to swing her hips as a contraction surges through her. After a few steps, the baby’s head was suddenly on her perineum. BOOM! Plans changed…baby was going to be born on the kitchen floor. I ran to get our equipment out of the car again and then knelt down behind the mother who was standing and rocking her hips. Marianne and I sat, to the back and either side of the mother, averting our eyes so as not to make the mother feel observed, waiting for the head to emerge. But then out of the corner of my eye I saw the entire baby shoot out of her mother in one big push. Reflexes I didn’t know I had dived to catch the baby, centimetres before she hit the floor. Old classmates will attest to the fact that I was no good at catching balls at school. But catching babies…well…I think this particular birth was certainly an initiation of...
Read MoreHelping Babies Breathe
Helping Babies Breathe (HBB) is an initiative of the American Academy of Paediatrics and the World Health Organisation. It is a programme that has been implemented to ensure that every birth attendant is skilled in the basics of neonatal resuscitation as part of one of the five 2015 Millennium Goals (to reduce infant mortality). Apparently, in Countries where this programme has been implemented, governments have found a decrease of up to 25% in neonatal deaths. Helping Babies Breathe is a neonatal resuscitation curriculum for resource-limited circumstances. It was developed on the premise that assessment at birth and simple newborn care are things that every baby deserves. The initial steps taught in HBB can save lives and give a much better start to many babies who struggle to breathe at birth. The focus is to meet the needs of every baby born. Helping Babies Breathe emphasises skilled attendants at birth, assessment of every baby, skin to skin contact with mother, delayed cord clamping, temperature support, stimulation to breathe, and assisted ventilation as needed, all within “The Golden Minute” after birth. Midwife Marianne Littlejohn and myself are trained as teachers and trainers of HBB and volunteer for Operation Smile and have thus far taught midwives, doctors, NICU staff, nurses, doulas, birth attendants, mothers, fathers, and interested people these basic but life saving skills. We have been privileged to teach all over South Africa, as well as in Malawi and Kenya. Plans are also afoot for us to teach in the DRC and Lesotho, as well as continuing to teach in South Africa. This last week I taught the skills to a group of peers, WOMBS doulas and CPM Mandi Busson at friend and colleague Lana Petersen‘s home. I must admit to feeling slightly intimidated, teaching friends and colleagues but this fell away very quickly as stories were shared and we acted out various scenarios from precipitous unplanned home births to water births. What I love about the HBB programme is its emphasis on normal birth – that it reiterates that approximately 90% of all births are straightforward and that it teaches as its introduction how to facilitate that: Skin to skin, delayed cord clamping, breastfeeding, etc and that even when a baby needs help to breathe, that every step is take to ensure that that mother and baby bond and cycle is not broken. Here are some pictures from this week’s course. We had so much fun acting out the various scenarios that plans are afoot for some fun birth theatre sports, possibly to be presented at this year’s Cape Town Midwifery and Birth Conference. If you would like to host or attend a Helping Babies Breathe course, please contact...
Read MoreMeeting a Traditional Midwife in Malawi
Marianne Littlejohn and I volunteer for Operation Smile by teaching the Helping Babies Breathe (HBB) programme. In June of 2014 we were flown to Malawi to teach at the Kamuzu Central Hospital in Lilongwe . Over five days we taught approximately 40 people each. Malawi is an amazing country. It is incredibly poor but we were really pleasantly surprised by the hospitality and kindness and receptiveness of everyone we met. What I love about the HBB programme is its focus on normal birth, its simplicity and its adaptability to whatever environment it is presented in. We have so far taught in high tech hospitals, to home birth midwives, low resourced settings, to doulas and mothers. Each course is different because it works with the experiences and environments the people being taught bring to the workshops. Kamuzu Central Hospital is a reasonably well equipped hospital with sensitive and compassionate midwives. Some of the people we taught were very experienced midwives, doctors and paediatric nurses with many years of experience with very compromised babies. There was interesting discussion and sharing of stories and knowledge – we definitely learned a lot from the people who attended these workshops. One of the women we taught, Violet, a highly experienced midwife, told us about the work she used to do providing training and education and equipment to Traditional Birth Attendants (TBAs) in her region. TBA is the term used to describe traditional or lay midwives who have no ‘officially’ recognised training. Usually they have learned their skills from other traditional midwives. It is a controversial title as it takes away the centuries old title of ‘midwife’ from those women who have always attended pregnant and labouring women and who often carry skills and knowledge passed down through generations. Violet told us about a TBA living in a village not far from Lilongwe and offered to take us to meet her if we could organise the transport. The following day we organised a car and a driver and were driven about 45 minutes outside of Lilongwe over dusty and bumpy clay coloured roads, past simple handmade clay brick homes and thorn trees and goats and women wearing colourful cloth skirts. Along the way, Violet told us that TBAs had been the backbone of maternal care for a very long time in Malawi. She told us that the Malawian government had trained many TBAs in basic midwifery skills to provide care for pregnant and labouring women. The government had also provided updates and further education every month to the TBAs to ensure their skills were kept up to date. The government had also provided the TBAs with equipment and medications. It had been Violet’s job to provide these updates and education to ensure that the TBAs were following best practice when caring for pregnant and labouring women. Violet’s duties had also been to ensure that the TBAs were stocked with the medicines and equipment they needed. She had enjoyed this work. She had enjoyed the travelling and admired the TBAs she was responsible for. Two years previously, in a drive to encourage women to seek care from hospitals, the Malawian government had banned TBAs. This had not really changed the birth statistics in the hospitals, Violet said, all it had done was driven the TBAs underground and yet most rural women still sought care from the TBAs they knew and had grown up with, and who had probably attended their mothers when they themselves were born. Lack of transport to the hospitals made it difficult for mothers to get to the hospitals even if they wanted to. The government...
Read More