In January, the bulk of my work here really took shape. I started working full time in the casa de espera but would continue my work to promote vertical birth in the community and among the personnel in the Centro de Salud. I also made myself available 24/7 to attend any patient desiring vertical birth in the Centro de Salud. During this month it was just me and two nursing techs working in the casa de espera. We planned, organized, and carried out four educational sessions, two in the neighborhoods of Atalaya and two on the radio. We also participated in one educational session in the Centro de Salud specific to the health promoters (including at least one lay midwife) from the native communities closest to Atalaya. In our educational sessions, we talked about the casa de espera and the importance of institutional birth, and I presented on vertical birth and my work in the Centro de Salud to implement this practice. Things went pretty well for my first time doing this kind of promotional work.
I also made some progress in my promotion of vertical birth. At the end of December I had worked with Ana, a great midwife from the Red de Salud (health network), to officially request several items needed to create a space for vertical birth in the Centro de Salud. Several weeks later the first items arrived, including a special bed and a birthing stool. Shortly after that, a patient of ours from the casa de espera was the first to try them out. She was pregnant with her third baby but had only one living child as the other had died during delivery and her pregnancy was complicated by a syphilis infection. She really seemed to like the birthing stool during her labor and did not want to get off it. However, at the very end of her labor her water broke with thick meconium and the baby’s heartbeat was dropping too low, so the doctor decided she needed to lie down to deliver her baby. Even though it was not a vertical birth, I felt that I made progress in moving a little closer to that goal. The most important thing about the entire situation was that because of the casa de espera, she was able to stay close to the Centro de Salud so that she and the baby both were able to receive the care and treatment they needed during and after delivery. A little more than a week later, both mom and baby returned to their community healthy and strong.
Toward the end of January I finally did attend my first vertical birth in Atalaya, though it was not in the Centro de Salud. Due to my promotional efforts, another midwife in Atalaya, Virginia, and one of her patients heard about my work here and invited me to come attend the birth which was to take place in another healthcare center in Atalaya. The patient was pregnant with her second baby and the baby was measuring quite large, so both she and the midwife were concerned that she might end up needing a cesarean section. However, as Virginia also had some experience with vertical birth, she understood that this type of delivery would likely be easier and improve the patient’s chances for a vaginal birth. With the help of her husband and both of us midwives, the patient had a beautiful standing delivery with no complications. Her baby boy was big, too, weighing 4200 grams, which is over nine pounds.
The photo at left also appears in a newspaper article about my work: