It'll be a miracle if I can string two words together into anything resembling a coherent thought over the next few weeks. My trip to Peru is next week. I know plenty of women flow smoothly from role to role; traveling effortlessly all over the darn place while looking gorgeous in whatever hat they're currently wearing (whether that's their Mom hat or their Career-Gal hat). That's not me. I'm not currently feeling smooth or effortless and I've never looked good in hats. Ah well, go with the flow, right? Currently, the flow is clunky, not smooth. That's cool.
I'll be traveling with CARE to Ayacucho, in the mountains outside of Lima, where I'll get to experience prenatal and obstetric care Peruvian-style. As I mentioned in earlier blogs; this trip is inspired by Christy Turlington Burns' (one of CARE's celebrity ambassadors) visit to Peru last fall. Thanks Christy, for the inspiration. You, by the way, seem to look really good in hats. Lucky.
Here are some of the things I'm looking forward to seeing: deliveries in the regional hospital in Ayacucho; vertical birthing chairs; the radio room where villages and towns outside of Ayacucho communicate with the hospitals to coordinate transferring patients for emergency care; nurses, midwives and doctors doing their jobs; and most of all—Mothers. I can't wait to talk to Mothers.
Mothers are mothers everywhere, especially when they're in labor. There's no experience I can think of outside of pregnancy, labor, birth and motherhood that's a more common denominator. The process is basically the same for all of us. Sure, there are as many variations on that theme as there are women but when you get right down to it; we all "get right down to it" the same way. We do the job we're built to do with the best tools we have available.
This week's filled with details from planning flights and finding my suitcase to arranging how my young kids at home will get to ballet lessons and get their homework done while I'm gone. Thousands of women all over the world are doing exactly the same thing; figuring out how best to combine motherhood with work, travel, and life outside their own personal Mom-arena. Whether it's a trip to a neighboring village for groceries or a to another continent, the intricate details and negotiations required to make it work are part of the universal job called "Mom." Wish me luck. I've got that worried feeling that I'm going to forget something crucial and the delusion that only I can make it work. It's not true, I have a completely competent husband and grown daughters who will fill my job description and keep track of my "little ones," beautifully. But you know how it is or if you're expecting your first, you soon will. I'm a Mom. That's the deal.
This week's reader-question is a great one and a wonderful opportunity for me to explain a really common delivery technique. My reader 's sister recently had a baby. Her doctor broke her water bag before delivery and my reader wants to know how they do that. "How do they break the water?" She didn't want to ask her sister or friends because she didn't want to appear "dumb." Oh honey, I'm so glad you asked this question. I've had hundreds of patients ask the same thing. Many women think they're "dumb" if they don't know some specific thing about birth. Not true. You just haven't been presented the opportunity to know this information before. No one's ever taken the time (or maybe didn't have a reason) to explain the process to you before.
"Breaking the water" means the doctor or midwife makes a hole in the amniotic membrane that surrounds the baby. It's inside the uterus and the doctor/midwife reaches through the vagina and cervix to get to it. Here's the technique: We ask our patient to double up her knees and let them flop apart. Then, of course, we tell her to "relax." Funny, right? With a sterile glove on one hand, we put some lubricant on our index and middle fingers. We reach into the vagina until we find the inside edges of the cervix. If the cervix is opened enough that we can get a couple fingers through it, there's a good chance we can feel the amniotic membrane. It feels kind of like a wet, slippery balloon filled with water. We also feel carefully to make sure baby's head is down and well applied to the cervix to minimize the risk of the umbilical cord slipping through. That causes a whole lot of trouble.
If everything feels "right" the doctor/midwife then uses their other hand to slide an amnio-hook into the cervix. It looks just like a long, flat crochet hook. It's not sharp and won't hurt you or the baby. Once the hook is in there, it's just a matter of snagging a hole. Then—gush—out flows the water; sometimes a lot and sometimes very little. We make sure there are lots of towels and waterproof pads under Mom's butt to catch the flood. We check the color of the fluid to make sure it's clear of meconium (baby poop) or blood and that's it. The water's broken. It's generally a quick procedure and no more uncomfortable than a regular vaginal exam —no great treat but usually, no great trauma either.
Thanks for that question. That's what I'm here for; so you can get answers without feeling "dumb." How else are you going to know? If you keep those questions coming, ladies; I'll keep juggling hats and supply the answers. I can't promise to be smooth though this week. It's not looking good for next week either. Does clunky work for you?
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