Please enjoy my reflections on a night at Margo Maternity Clinic:
After being haggled by bold men and looking death in the eye several times on the way to work, the clinic feels like a refuge. I welcome the familiar buzz of nurses chattering while they prepare their dinner and the tug on my scrubs of small girls wanting a ride on my back. The night shift always begins sitting on the benches beneath the “Benefits of Breastfeeding” mural, listening to conversations in Twi, trying to pick out the words and phrases that sound familiar. Ma Dorcas, the older midwife, lies on the bench, sleeping soundly despite the crackling cell phone blasting P-Square and Akon’s latest hiplife hit. Two fans shudder and shake, transforming the bare light bulb into a strobe light. The telltale honk of a taxi at the gate barely interrupts the conversation; only one nurse rises to let a car in.
After the woman in labor has her blood pressure checked by the archaic but bombproof meter, the first question is a demanding, “where is the rubber?” This is my cue; I rise and search through the various carry-on sized suitcases or metal buckets of personal items for a drab plastic sheet and vibrant two-yard (traditional all-in-one cloth) that will lie beneath the mother for the remainder of her labor. Introductions take place between contractions as I lead her into the delivery room and spread her plastic and cloth on the table for the first exam.
The laboring mother paces the labor and delivery rooms, pausing and arching her back during the contractions. Some look for me during these intense moments, wanting a shoulder to lean on or a hand to squeeze. Others shy away, leaning in the corner of the room, reaching back with the palms of their hands flat against the wall. The image is always striking; somehow despite the pain and exhaustion, these women are always beautiful. Perhaps I am witnessing their daily fortitude transferred seamlessly into a different setting.
Three steps separate the labor and recovery ward from the delivery room. I stand on the middle one, holding the heavy mustard colored curtain out of the way of the pacing mothers. This means I am also there if a contraction catches a mama mid-stairway; my arms seem to react before my mind, flying to support a muscular back or to grab arms searching for balance.
Once we move into the delivery room for good, my position is never comfortable. I squeeze against the wall, leaning over the fan, or squat by the stool, simultaneously supporting a body that is at the whim of nature and anticipating the unpredictable rupture of membranes. Once they rupture, it is time to move to the delivery table. The smell of lime-scented antiseptic wafts from the tub of water at the foot of the bed, and someone is sent for an IV infusion kit. At this point my gloves are on for the remainder of the delivery, the sweat pooling in my palm and adhering the latex to my hand. I continuously wipe the beaded sweat from the mama’s brow with a washcloth that transitions from pure white to tan as it picks up particles of the red dust of Ghana.
The pushing rarely lasts longer than fifteen minutes, and often there is no tear. Once the tense moment passes between birth and first cry, I relax and turn back to the mother. Her exhaustion is apparent, but her face always brightens when I tell her she has given birth to a “small, small girl” or “small, small boy.” While the midwives massage her uterus, stimulating contractions equally or more intense than labor, I rave about how strong she is and how her new baby is “so, so beautiful.” Soon these contractions force her to reenter her own labor world; she tunes out my comments and reaches for my loose-fitting scrubs. The baby is doused in baby oil, measured, and swaddled while our new mama is cleaned and her soiled cloths are packed into a metal bucket to be taken home when she is discharged mere hours after the delivery. I support her once more up the three steps to the adjoining labor and recovery room, and spread her plastic and a fresh two-yard on the well worn bed. Mothers, aunts, sisters, female friends, and other new mamas are there, all intermingled and babbling. Weary smiles, congratulations, and hugs pass between me and whoever is present, though often I am not completely sure whose family members belong to which sweet baby; it doesn’t really matter though, as the entire room shares the same indescribable emotion that follows the birth of a healthy child.
Once everyone is settled in for the night, I move onto my next duty: cleaning the scissors and bulb syringe in bleach and then hand soap. I’m pretty sure they were clean after the bleach, but the inexplicable elements of these sort of procedures always seem to be the most important to the nurses. Once the instruments are safely in the autoclave, my responsibilities are lifted for the time being. I struggle to carry a disintegrating foam mattress into the dual-natured ultrasound and on-call room, the screen door slamming shut behind me. Lying in the pressing heat, the smell of birth still rising from my scrubs, my mind races until it settles into a fitful half sleep. Soon a honk or knock at the door wakes me, signaling the arrival of yet another woman and her entourage here to welcome a new child into their community.
Photos by J. Marcus
In the beginning of February 2013, I will be departing for the red, dusty country of Ghana in West Africa to work as a labor doula. I have been placed at the Margo Maternity Clinic, about an hour from the capital city, Accra.
The Margo Maternity Clinic is one of the largest in the district, serving about 70 patients a day. Most patients are women and children who are there for a general or prenatal checkup or for labor and delivery. A general checkup would include malaria and malnutrition screening, a blood pressure check, and looking at any other emergent issues. Prenatal checkups include many of the same things, though focus more on the pregnancy itself.
Like many health centers in Ghana, the Margo clinic is sparsely furnished in terms of modern equipment. The lack of funds is also an issue. In Ghana, families must pay on the spot for any expenses that arise, from the IV medications and sutures to the motorcycle taxi ride to the clinic. This will be quite an intense trip for me, I am sure-- I am most familiar with the reassurance that there is a well equipped operating theater down the road and adequate trash disposal facilities at the hospital. Working in such a different climate-- during their dry season!-- will also be quite a contrast to Vermont's chilly winters. Despite the adjustments I will undoubtedly have to make in my expectations and actions, I feel so fortunate to have this opportunity to engage in Ghanaian culture in a way that is so closely connected to my passion: being involved in healthcare.
Thank you to the fantastic organization, Days for Girls International, both for their support of my trip to Ghana and women worldwide! DFG volunteers create the makings for menstrual and postpartum kits for women across the world. Kits include supplies to either help young women stay in school through their menstrual cycles or to support new mothers in their postpartum life.
Days for Girls has been generous enough to donate 60 kits for my upcoming trip to Ghana. I will distribute them to new mamas in the hospital and at the clinic. Throughout my trip, I will keep everyone updated on the distribution through this blog-- so stay tuned!
This distribution project does cost money on both my part and Days for Girls' part, so if you are interested in supporting the distribution of these postpartum kits, please contact me and I can include you. Thank you!