First teaching session
Monday 27th August. The day had finally arrived. The time had come which we had been planning for 9 months. Amazing! We were going to meet the women and start our sessions. The night before Lyn and I had spoken with Mike about how to begin. Early on in my preparations to come to PNG I had realised not to plan too much. Be flexible and see what they want from me. I had also come up with the 4 L’s – Listen, Learn, Look and Love see blog http://wp.me/p2xIUF-1b.
Mike encouraged us to share our own stories about birth, bring in the personal to forge links and relationship with the women. Me, we. By sharing our story we were opening ourselves up to them, being vulnerable before them. Very soon I realised that these women were no different to me. Their hopes, dreams, desires were the same. Except that they were suffering from the terrible loss of so many mothers and babies.
We were expecting about 30-40 women to attend. As we walked into the church there was no one. Then a couple of women came along. I was beginning to feel that perhaps I’d read the whole situation wrong and there’d just be a handful of women. I handed the brown baby doll with placenta around to them to look at and handle – they loved that. Then the floodgates opened! All of a sudden there were women everywhere! Babies too. Older children were chased out by the women!! They peered over the low screen that surrounded the church. It was incredible. Now the room was full of expectant faces – all looking at us. I remember looking across at Lyn and we just gave each other a knowing look: Wow! Ok, let’s do it.
Heidi had been assigned to interpret for us. She was a very shy young woman who was not very confident, but she did a great job. I knew I had to speak slowly and clearly using simple terms. Waiting for her to interpret for me allowed time to think more clearly about what to say next. I welcomed everyone and told them how pleased we were to be there. I then explained to them what we planned to do for the morning session. I then introduced myself – that I was a midwife, that I was married to Richard, that I had 2 sons aged 11 and 9. I then went on to describe my birth experiences. I used the doll and the pelvis to explain how Ryan had got stuck after a very long labour and so I needed a caesarean section. They understood the whole concept of long labour, baby getting stuck, but their experience of that kind of labour is usually the mother and baby dying. I went on relaying my Vaginal Birth after Caesarean VBAC of Matthew – again another long and difficult labour. They got it. We were on the same plane.
Lyn then introduced herself and while telling the stories of her births, I used the doll and pelvis again to illustrate what had happened for her. The women were mesmerised and seemed to hang off every word and watch intently.
Then it was time to hear from them. I tell them that we have heard that many women die in Papua New Guinea when giving birth – big visible nods around the room. The women are actually very shy and do not speak of their own experience, but when we ask them why they think women and babies are dying, they begin to share their experiences. Immediately the floodgates are opened. From all over the room stories were told. In my diary I’ve jotted down the reasons for women dying: Mostly from bleeding, placenta stuck, mum exhausted and unable to push baby out (both die), baby dies inside the womb and then the mum dies as well, Malaria and other infections. The reasons for babies dying: umbilical cord not tied off properly, infection and baby too small and weak.
The women tell us that a woman in labour lies flat on her back throughout labour and does not move. Then another person pushes on the pregnant belly to help push the baby out. I want to cry… I can see it now: a woman in agony, unable to move from her back, others pushing on her belly and probably traumatising the uterus causing it to rupture or else not clamp up after the placenta (belum) is delivered, hence the woman exsanguinates to death. They also tell me that women pull on the umbilical cord to get the placenta out and many times the uterus (haus belong bel) comes out as well. Oh dear!
Before I left Australia I remember reading a book called “A Book for Midwives” published by the Hesparian Society. They publish books and resources to assist health carers in the third world. All the material has been donated free of charge by experts in their field. The textbook for midwives was excellent and so practical. A comment that stood out for me at the time and which flashed through my mind was that many village birth attendants have not had any formal training, have taken on this role because they have watched many births and heard stories, but what can happen is that wrong practises get passed on through the generations just because that’s how things have always been done, rather than there being any education about the practise. So, even though what I heard made me want to cry because some of the practises were probably contributing to the deaths of the mothers and babies, I had to show great respect and restraint and very gently educate them about how the body works to labour and give birth. I certainly didn’t want to be pointing fingers, rather encouraging them to be the advocates of change through better knowledge.
After listening to the stories of women dying – we were told over and over again it was ‘many’- it was obvious that they were traumatised, feeling hopeless and desperate about all these deaths, I had some divine inspiration. I thanked them for sharing their pain with us. I then encouraged them that each woman sitting there that morning was either a chicken or a pig (read previous blog http://wp.me/p2xIUF-3j) because they were there wanting to learn and make a difference for the women in their villages (by this early stage I only thought there were about 5 villages represented, later on I learned there were 19!). I congratulated them on their willingness to serve the women in their communities and told them that they could make a difference and help save lives, by sharing what they learn through the week and then telling others. I reminded them that if everyone does a little bit, small steps, big changes can happen. They were nodding their heads vigorously. I then suggested that we pray for all the souls of women and babies that have died in the past and ask God to help us be women of change, to learn many things this week that will make a difference to the lives of women and babies in their villages.
Now remember, when they pray it all happens together, so there was this beautiful moment where all the prayers of the women rose up to heaven. It was a truly memorable experience and I just knew that God was there with us and that He heard our prayers.