Moving, Snorkeling, Jack's Ridge, and Fourth Catch!

Juni and I before our run.

One of my roommates came back from house sitting and we went for some runs. We also have been going to the pool on occasion for a cool off. One night, Juniper and I went for a run while Kelsey and another missionary were at the pool. We returned to the pool and after some splashing and laughs I was in the water for revenge! 

On Friday the 29th we moved from our temporary birth room two houses down back to the clinic. It was being painted and having some tiles repaired. The temporary site was a bit cramped at times and so it was pretty nice to be back in our original space. At the end of shift we all pitched in and moved everything down the street. There was 20+ people and it took little time. Thankfully there was only one labor and one postpartum during the move so we were able to move quickly. I helped and then left for home. 

Tilly and I had McDonald's for dinner. I conquered the Coke Float by asking the cashier for the ice in a separate cup rather than with my coke and ice cream!!  I packed my bags for the Saturday boat trip. Due to the schedule, I thought I was going to be unable to go on the boat trip but one of my roommates (Juniper) was an angel from above and suggested working for me until we returned (I was scheduled 2-10pm and we were to return around 5pm). Since she has been here for a year, the supervisor was okay with the substitution. I am so very grateful to her!

the spread of food {yum!} and cabana we rented

All of us midwives who have caught babies at the beach

heading out for the day

Saturday the 30th we went on a boat trip to the ocean to snorkel and enjoy some sun! I left early in the morning to go to the docks and pick up Lisa, another summer missionary, and for the other girls to rent snorkel gear. Juniper had gear that she let me borrow so Tilly and I didn't have to rent (it would have been 150pesos, or $3.50USD). We all loaded onto the boat and headed out for the day, all 40 of us. The boat was packed! It was about an hour's cruise to our first snorkel site. We went to three sites total including our lunch stop. The last site had a beautiful drop off/wall that offered a great view of the deep blue waters and a cliff of coral. The total cost for the day was 200pesos, or $4.67USD! That my friend is what you call a steal! 

The pontoon we took out for the day

Lisa, Me, Kelsey

check out our ride... look ma! no hands!

It was my first time snorkeling and I thoroughly LOVED it! It was so incredible to see a whole new world under the water! At our second stop we had a pot luck lunch. It was a fantastic picnic with fried chicken, watermelon, and potato salad! It was so fun to get to know the other midwives outside of the clinic setting and let loose. A bunch of us got the opportunity to ride on the pontoon runners from site to site, what an experience as well!

He was trying to push us off. We jumped shift first!

I returned from the snorkel trip to shower and relieve Juniper from my shift at the clinic. I arrived at the clinic around 5:30pm to a slow shift so I got to bond with Eva, another missionary until an active labor came it. The woman delivered fast and with a healthy baby! Praise God!

Eva's catch, I assisted

Sunday was an extremely LAZY day in our house! I woke up while Tilly and Kelsey slept after night shift. Juniper, Jacqueline and I had a feast for breakfast/brunch: bacon, scrambled eggs, and homemade hashbrowns! Later in the day, Kelsey and Tilly went to the pool while I stayed home and worked on journaling. We got ready fast and went to Jack's Ridge and for massages around 4:40pm. 

Jack's Ridge is a park in Davao, that "once formed part of the headquarter of the retreating Japanese forces towards the end of the World War II. The Americans had landed in Davao on May 1, 1945, forcing the Japanese to beat a path to Matina Hills where they had a commanding view of the Davao Gulf where the American ships were anchored. Fierce fighting soon erupted between the two forces, and as history shown us, the Japanese lost. Today, more than half a century later, Jack's Ridge is filled with reminders of its historic past. Caves dug by the Japanese pockmark the area, and once in a while people still find bullets and other war materials in the rocky soil.

There is also talk that hidden somewhere in the caved are gold bullions and other treasure that the Japanese had taken from other countries and brought to Davao.

Whatever the truth is about the treasure, Jack's Ridge maintains the feature that made it an important outpost for the retreating Japanese forces, a commanding view of Davao City and the Gulf, the same view within the premises is also refreshing, since the owner has made its mission to preserve the natural beauty of the place." 

It is on top of a mountain and offered a beautiful view of the entire city. We took a taxi up. We grabbed dinner while there and headed back to a spa for massages. 

It was Kelsey and Laurie(another summer missionary originally from Iowa)'s first time to have massages and I think they both had memorable experiences! It was an open room with curtains and so all five of us were in the same spot with separate therapists. It was great to relax and bond through this as well! 

I hurried home for night shift in a bit of a rain storm, showered, and went to meet Kara (a new summer missionary) to head to the clinic. We arrived to a dead clinic so I showed her around and answered some of her questions. I was second up for catching a baby based on my last catch and hoped for some action.

 My patient arrived at 10:38pm but was not in very active labor at all. Her contractions were spaced out and she was still smiling and laughing throughout my questions and examination. Prior to checking her dilation, she asked if she could go home! My supervisor decided to check her before sending her home since she was  G2 P1 (Gravida 2 aka second pregnancy Para 1 aka had delivered one baby, a two year old cutie!). Generally G2's progress through labor much faster than G1's so we wanted to be on the safe side. We checked her and she was only two centimeters dilated and so we instructed her when to come back. She thanked us and headed home. 

Marrian Mae #4 7-2-12 1:52AM 2900grams

I was able to get about an hour's rest by the time things settled down and at 1:45AM I heard Kuya  Felix (guard) saying "Labor. She's back." I hopped up and headed to the cubicle. My patient's water broke on the way to the bed and I readied myself at the bed. She pushed well and baby girl was out at 1:52AM! I followed all of the advise from past labors and supported the perineum as the baby's head crowned and wiped the face after it was delivered. I think that my skills are improving in terms of catching! I feel less lost and know what to watch for and where to put my hands!

 It was Kara's first observe and first birth ever, praise God that it was a normal birth! There was no cord wrapping or low heart tones. Baby came out with an APGAR of 7 (-2 for color, -1 for tone) and improved to 9 within 5 minutes of birth! The placenta came out well and complete which is very good for mama and helps the uterus to return to a smaller size quickly. I have become more confident in explaining the placenta to the charter as time has gone on.

Kara, Me & Marrian Mae, "Che-Che" (mama)

footprints for mama Marrian Mae

I got to do all of my patient's postpartum checks, baby's Hep B & vitamin K, newborn exam, birth certificate form, and transfer mama to the postpartum recovery area. At one point Sylvette, a Filippina Midwife, asked me if I had told the bana to wash the linens and I of course said no. It turns out that while I was busy with transfering his wife, he had taken the plastics AND the linens from birth to handwash. We require the banas to wash the plastics on the beds (to reduce our exposure to blood) but have the linens washed for sanitary reasons by the helpers at the clinic(bleach, etc.). It is not uncommon for hospitals here to require that they wash any used linens before they leave so that is why he started that task. I would have to say he is one dedicated man! They named the baby girl Marrian Mae! This was my fourth handle!

I endorsed my patient to day shift and headed home for some much needed rest! I slept from 8am-4pm when Tilly and I headed to Crocodile Park to make a down payment on the white water rafting trip we will take later this week! The park is pretty tourist driven and included a zoo with a huge crocodile, parrots, and lizards. With our package for rafting, we get tickets to the park, a zipline place, lunch, water bottle, and tickets to a butterfly house.

After our trip to the park, we headed to the other house for dinner where both Tilly and I became sleepy and took short naps. I called home and then headed home for a good night’s rest before day shift on the 3^rd. 

Day one Baby Check for Marrian Mae

Day shift on the third was pretty slow as well. Since I caught a baby on the 2nd, I was last up and Brenda (one of my roomies) had just returned from her month long break and was first up. We had one birth, at 8:08AM and her postpartum cares. Most of shift I talked with the other midwives, journaled, or snoozed a bit. I did get to see my baby from the previous day for her one day baby check. I love getting to know the patients more with each subsequent check-up, as a woman is so very different when she is not in the throws of childbirth. Baby Marrian Mae appeared healthy, and I just reminded her mama to breastfeed every two hours for 20minutes on each side, even if it means waking the baby at night. This is a hard concept to teach around here, as the parents like to let the baby sleep through the night but the baby remains lethargic (tired) if they don't eat. It is a viscous cycle, additionally the baby doesn't gain weight as well either. On shift I also did a prenatal check up without the assistance of my cheat sheet!!!!!!! I would say this is an accomplishment because the Vesyan is what hangs me up during assessments. 

hanging out at the end of my shift, start of theirs

 

Special surprise for Landon! 

When I returned home, I learned that the chicken that has taken up residence in our yard had her chicks today! Seven total! I ran out to look and they were running around the yard with their mama! Our neighbors had asked for her back earlier in the week, and came over tonight to collect her and the chicks. I will miss Roxanne dearly (PS- I asked her owner and it turns out her name is Jasmine, I thought maybe I should tell him he should reconsider ;) ). We joke around the house that Roxanne (Jasmine) knew that she could hatch her chicks safely here due to all of us being midwifes. 

 While I was talking to him, his wife peeked her head over the fence and said that her daughter was born at the clinic we are working at! So many people recognize us in the city and can tell us someone in their family who delivered their babies at our clinic. 

Our neighbor, Roxanne, chicks, and his daughter who was born at our clinic

It is ending July 3rd here now, and I am reminded of all of the festivities that occur back home on the 3rd (as in FIREWORKS!!!!), especially since it is dark here. In honor of the occasion, enjoy some fireworks! If you catch this sometime between the 3rd and 4th- grab a burger, hotdog, brat, sparkler, or something else entirely celebratory for me! Love you all! 

 The last video is a personal homage to the song selection of good ol' KDST!

Love you all! Happy Independance Day!

July 3rd 10:35pm

Happy Birthday Grandpa Gravel!

83 Never looked so good! Happy Birthday Grandpa Gravel! I love you! Thank you for teaching me so much (like how to properly butter an ear of sweet corn or that cashews reign supreme or that the Cubs are the best team!) and for being such a great role model! Wish I could be there to share the Happy Joe's Pizza, we will have to plan a night when I get home! Love you!

The Gravel grandkids (most of us anyway) circa 2009, Grandpa's 80th birthday bash. The next day was Chitown for a Cub's game!

Some little tidibts

Swing shift was pretty uneventful but we did get a TON of gauze folded and ready to be put in the autoclave to be sterilized. As I was leaving, there was a labor patient ready to push but other than that, we sat around and chica-chica'd (chatted) for most of the shift. I worked on some NCLEX questions on my iPod, turns out I'm getting rusty (yikes!!!).

Tonight after shift, as the guard was getting ready to take me and my supervisor home, we loaded some extra bunk beds into the ambulance. We dropped them off at one of the homes of a helper (cleaner/laundry lady) at the clinic. As I rode with two midwives and a guard in the front of the ambulance I had a huge smile on my face. How blessed I am that these people have accepted me into their lives and into their families! They remind me of so many of my surrogate families back home who have adopted me as daughters some point. They share information about their families, teach me new things, pray with me, give me hugs, and share about their culture! While we were piled into the cab of the ambulance, one of them had her hand on my knee as we chatted about my time here and I told her I would be sad when it was time to leave. She assured me I was welcome back at any time and to continue to pray to God about where my life would lead. I haven't stopped smiling since they dropped me off, they are such blessings to my time here!



PS- Some of you have asked questions about things I haven't been posting about so here are just a few things that I wrote down the other day that I have come to appriciate about here and home:

• Toilet paper. We have it at our house but it isn't uncommon for stores or malls to not have it. When we go out, we have to carry tissue with us just in case. Also, the sewer system doesn't quite enjoy toilet paper so we just toss it in the wastebasket. 
• Garlic press. How have I never used one before?! I am in LOVE with this simple tool! 
• Lines in stores. This takes me back to my Fareway days when we made sure to keep the lines moving very quickly. Depending on the time of day, you may wait in a short line here is for 15-20minutes. Tilly and I abandoned ship just the other day because there was a malfunction with the cash register and they couldn't seem to fix it and none of the other lines looked to be moving.
• I enjoy public transportation! Yes, back home I enjoy the freedom of hopping in my car to drive to Target or home but it is kind of nice to not have to find a parking space or fill up the tank. I enjoy interacting with the people here on the jeepney rides and tricey drivers. Many of the drivers depend on customers for their livelihood and to support their family. Also, since I have the main routes I need to take down, it is way less of a headache now. It is super convenient to walk a couple of blocks and hop on a jeepney and be dropped off at the mall.  I shall miss this, and can't wait to explore the buses in Cedar Rapids! 
• Weather forecasts. Now I know that sometimes at home it is hard to tell what the weather will do but here it can be sunny one minute and just a few minutes later it will rain. The forecast always calls for rain based on the humidity but it could be sunny all day. It is so nice after it rains because the temperature generally drops a few degrees and the humidity is cut.

Love you all!
Casey 

Harden Junior and Ivan

Saturday 23rd/Sudnay 24th

a little love from home :)

 I am continually reminded of God's love here! Saturday, the 23rd I worked night shift. I had awoken from my nap before shift a little late and rushed out the door. I was lucky enough to catch a ride to the clinic quickly but was dreading a busy night. I hoped as I walked from the jeepney to the clinic that it would be pretty chill during shift. Little did I know that it would be the busiest shift I have had yet! I arrived to find two letters from home on the table, which I had been waiting on for about 3 weeks. It was a great way to start the night with some encouragement and love from home.

What a busy shift! L Ate Elsa, me. L Ruth, Ate Sus

Since I was first up for the shift, I was given the active labor in bed 1 at endorsements. I talked with my supervisor before I went into the cubicle, telling her that I had only had one catch so far and that I would need a bit of help during delivery. Ate Susan (Sus) smiled and said she was more than willing to give me pointers and help. I hopped into the curtain to check my patient. She was still breathing through contractions but I could tell she was ready to push. I called Ate Sus in and the two other midwives on shift came in as well. It was time to have a baby for mama Airen and papa Harden! This would be their third baby. I sat at the bed, readying myself for the baby to come. This time around, I felt more comfortable with hand placement and a lot more calm. Ate Sus gave me some pointers and praise the Lord, baby boy came out healthy with rockstar APGAR scores at 10:36pm. After the birth I was able to ask Ate Sus some questions about what I can do to improve for my next birth, and I got some very good information.

L- Harben Junior R-Ivan. With Ate Sus (supervisor)

Since she delivered so soon in the shift, it meant that I got to care for her through immediate postpartum and continued postpartum. It also meant I got to do his newborn exam and prepare the birth certificate. They named him Harben Junior, and he was absolutely perfect!
Another two active labors came in and they were fully dilated. Ruth and Ate Elsa (two other midwives) caught these babies nearly back to back. It was such a busy time, that I helped out by hopping from curtain to curtain cleaning supplies getting ready for births later on. Shortly after one of these births, another labor patient arrived. Since everyone else was busy with their patients I checked her in. She had elevated blood pressure which puts both her and the baby at risk during delivery. I followed protocol and had her drink some water to hopefully lower her blood pressure and reported off to my supervisor. Since her contractions were not very regular, we decided to monitor her for a while. Once Ate Elsa was finished with her patient, she took this new admit so I could finish my paperwork.
Another fully dilated patient came in around 3:40am, and it was my turn to be up again! I checked her in quickly and Ate Sus stayed close as I monitored her and the baby. At one point, the baby's heart tones went sky high and then super low. Ate Sus hopped in and had me chart, just so that she could manage the in a more active way which was a-okay with me. Once the head started to come, she had me hop in and helped me to deliver another baby boy at 4:36am. This baby came out a little harder than my first and required a bit more persuasion but had healthy APGARs. The parents named this miracle Ivan.
Before the end of my shift, I made sure that both babies and mamas were doing well and worked on paper work for them.

Hyacent Mae (catch #1)

I headed home, ate some lunch, did my laundry and took a brief nap before heading back to the clinic for a three day baby check on Miss Hyacent  (the first baby I caught). It was so great to get to see her and her mom doing well. They also brought her baby brother again- Vincent, 3 years old and is adorable! I love getting to know my patients even more during their follow up appointments! It is so fun to see the babies growing and changing and to learn more about the family's life.

Directly from Hyacent's baby check, I took a motor (like a motorcycle but closer to a crotch rocket) to church. It is the same church I went to earlier in the month and had said that it was going to be an English Mass but not so. I realized it was in Vesyan after it started but it was good to worship again and I am begining to understand the language better. It was PACKED to the max for the 4:30pm Mass! The priest encouraged people to squish and line the aisles. I looked back and there were people three deep standing in the back and along the outside screens/doors. It was St. John the Baptist's feast day and the one sentance that the preist said in English was, "John, just as Jesus was in the form of a baby was a gift from God." From volunteering at the clinic I can truly attest to this testimony. It is completely incredible to see these babies born healthy and the families so very happy and eager to welcome them into their lives despite some of their life situations.
I got caught in a bit of a rainstorm coming home from church and picked up another water bottle (now I can bring water and my smoothies to work with me) and umbrella at a small store near church. I got home and grabbed scrubs off the line for the next day, hoping that they would dry out from the rain in the house by 5:30am for my day shift on Monday.

Monday the 25th 
Monday I worked 6-2, and it was a pretty restful shift, praise God! I was able to rest and catch up with another summer missionary and share our experiences. At about 8:00, Ate Elsa said "Casey, we have to transport someone. Let's go." I jumped into action and changed my shoes from birthroom shoes to street shoes. As we headed out the door she said, "Wait. Have you had the chicken pox?" I told her I had and she said it was okay for me to go with her. A patient had arrived who had an active case of chicken pox and we had to transport her to the hospital because it is too dangerous for us to have at our clinic because we do not have isolation capabilities and with so many babies in and out it is risky. Ate Elsa drove the ambulance while I sat in the back with the patient and her bana. Side note- Ate Elsa, just like everyone else here is a very defensive driver! She rocks!

Hannah's catch, I charted/assisted

When we got to the hospital, Ate Elsa had me go into the hospital and check in the patient on my own. Thankfully the OB/GYN area was not busy as I got them right in with a nurse. The doctor even came up to me and asked me questions about the patient, which is pretty rare I hear. Ate Elsa parked the ambulance and helped the bana fill out paperwork and we were off for the clinic. There was one birth during our shift and she came in fully dilated and pushy. I checked her in and almost caught but the first up midwife, Hannah hopped in after her baby check and caught the baby just in time. It was the patient's third baby and she was a pro! Hannah was so very proud of the mama and baby at how well the baby breastfed and how well the patient's helpers were on top of everything.

1 day old Harden Junior and family

After shift, I waited around the clinic for my one day baby checks of Harden Junior (#2 catch) and Ivan (#3 catch). They were a bit late but I read my book and talked with two 16 year olds who are visiting Salem (another midwife and her family) for a few weeks doing mission work here. They have never seen a birth and are eager to witness at least one. Since we were slow, I let them watch as I did a baby check and let them listen to the baby's heart. The smile on their faces  reminded me of why I am here and how amazing of a gift these babies are!

Baby Ivan and family- His brother's name is Ralph- he's so cute!

I walked home from clinic to the other house for Ate Maricel's dinner (remember she cooks for us Monday, Wednesday, and Friday). Since all of the second year midwives were out for dinner, it was the summer midwives and first year midwives that remained. We had some great conversation and many laughs! It is so great to hear everyone's stories and how they came to find the clinic here. It is also nice to relate cultural experiences with each other. Tilly and I headed to the mall to get a book light for me and paper plates for another girl. The line at the store for plates was not moving for over  20 minutes so we abandoned that cause and headed home.
Once home, Juniper (a roommate) asked if I wanted to go on a run with her. I agreed and we went for a tour of our neighborhood.  I don't remember the last time that I ran for that long, but it felt SO very good! I headed to bed and read my book for a while before calling it a night.

Love,
Casey

Baby Harden Junior- they brought him to his one day check in an outfit I gave them!

Baby Ivan (catch #3)

This three year old was giving out kisses to all the babies at the clinic

Thank you God this opportunity to serve you and these women! Thank for you for two healthy baby boys- Harden and Ivan! I pray that  you keep them in your heart and in your hands as they grow. Amen.

Yogurt, magic bags, and solo market trip

Saturday the 23rd

After the guard dropped me off from swing, I started some homemade yogurt. We joke around here about being able to enter a contest as a house against Laura Ingles and win! Yogurt takes 8-12 hours so I made it before I went to bed. I woke up at 9:30am and peeked at my concoction on the counter. It worked! It was so very simple and I totally prefer it to yogurt from the store. These are the types of things that I never dreamed of learning while here but they are certainly added bonuses! I did a very happy and excited dance in the kitchen while one of my roomies congratulated me and laughed. It is quite an accomplishment in my book.

Successful batch of yogurt!

Later, another roomie made homemade cinnamon rolls which were delectable! Soooo good fresh from the oven. We joked about the regulation of the oven again and hung out.

so tasty!

Kelsey and I ventured out to an indoor market/touristy place with a Filippina midwife we have gotten to know at the clinic. She is new to the clinic and so we all had a fun time finding it by taking a jeepney and asking the locals where to go. It  was a lot of fun and I wanted to buy EVERYTHING! There were so many pearls, bags, dresses, etc and it was all fairly reasonable, in addition to asking for the ‘best price’ and then they would lower it by 20 pesos. I got a malong, a tote, and a ‘magic bag.’ A malong is like a sheet sleeping bag type thing. It can be used as a sheet, blanket for the beach, dress, hammock, etc. The tote and the magic bag are matching and are quilted fabric, similar to a Vera Bradley bag back home and super cute! Kelsey and I got tipped off on these treasures from our fellow missionaries, and will be using the magic bags as they do- to store our stethoscopes, thermometers, pens, etc in for ease of transportation. I can’t wait to go back and paroose a bit more!  

The highlight of this trip was a man who sang “Pretty Woman” to us as we were leaving his store, I had a good laugh at that of course!

When we got home, I grabbed the wallet of house money to expend the weekend budget on market foods. Kelsey and I tackled this task without the assistance of our roommates (other than some good tips before we left). We got two huge bags FULL of produce for just under 800pesos (or $18USD)! We got mangos, pineapple, asparagus, pomello, cucumbers, carrots, onions, tomatoes, oranges, and turnips. We returned home and unpacked and Kelsey made a DELICIOUS dinner of pasta and asparagus.

Missing you all! I’m off to take a nap before I head to night shift!

Love,

Casey 

6-23-12 7:43pm

oh, and just in case you needed a little lift in your day, enjoy! Now picture a man serenading you as you leave a store. Good, eh? 

Postpartums, rain showers, and catching babies!

Hello everyone!!

This is funny because they all just cram in! (jeepney)

So it has been pretty busy around here lately, I think that our crazy schedules are finally catching up with me! When I am home, I have been talking with my roommates or reading. Outings to the mall are always fun and I even got my turn at buying food for the house for the week from the grocery store and the market using our budget.

I got home one day to find a chicken in our bushes! She is our neighbor's chicken who flew over the fence and set up shop with some eggs. We named her Roxanne  to go with her rooster cohorts Rickie and Ronnie.

Roxanne!

We are not quite sure when we will tell our neighbors she is over here but she makes for some good laughs!

I made some banana muffins with some over ripe bananas. Even if we buy green bananas at the market, they are yellow by the next day and brown just a few days later. It's okay by me because I love banana bread. I was a bit nervous because our oven doesn't have temperature regulation. It is a gas oven and it involves regular checking on your food to ensure not burning it. My first batch got a little bit dry but were still pretty tasty. I made another batch the next day.

Baby out at 5:59AM Wednesday

On Wednesday morning, I helped with another birth assisting and postpartum care. This birth was another good one,  praise the Lord! This woman leaned on her bana (husband) a lot while on the birth ball. Baby was out at 4:59am and she arrived around 12:30AM and her bana kept falling asleep between contractions!!! Even when she grabbed onto him, he was in and out of sleep!

Wednesday night Tilly, Kelsey and I went on another adventure for dinner. We found a nice Italian restaurant at one of the malls and had a DELICIOUS meal! The owner lived in Chicago for 15 years and came and talked to us several times. He must have liked us because he sent complimentary appetizers over to our table and kept complimenting Kelsey's blonde hair and blue eyes! He assured us that if we returned, we would receive a discount. The food was FANTASTIC! Each of us paid about $8USD and that included our beverages too! It is pretty crazy to think that some people here cannot afford that and we thought it was such a cheap meal.

After dinner, Tilly headed out to get ready for night shift and Kelsey and I tried to get a pedicure. Unfortunately it was close to closing time so we just bought some nail polish to use at home. We both had grand plans to get home and hop in bed early but mother nature had other plans for us! While on our jeepney ride home, it started to DOWNPOUR! The Filippinos rolled down the plastic tarp on the windows but I had a bit of a struggle getting my part latched. One Filippina looked at me and smiled. She tried to show me how to do it but the plastic just wouldn't stretch in my favor! Kelsey and I busted a gut laughing! We hopped off of the jeepney at our stop but stayed at a roadside shop for ice cream waiting out the rain and eventually dashed to a nearby restaurant for refuge. We ran across the street after a while (in the downpour) to talk a tricey driver (a motorcycle with a cab attached) into taking us into our gated community. He was concerned because the rules say no triceys but our favorite guard was working and he let us in after looking both ways. Sometimes I think that we provide entertainment to these guards ;). I love our outings all together, they always offer so many laughs!

 This video displays the downpour!

Thursday the 21st: a day that will live in infamy!

Checking Tilly's baby

 I arrived on day shift in time to watch Tilly catch her second baby! I charted the birth and did the postpartum cares for her patient as she left. This was the last item on my list before I could catch a baby! My supervisor for the day was awesome as were the girls that I was working with. It was a busy day and I was helping with baby checks, postpartum cares, and other things while everyone else was busy with patients and other things as well.

Hyacent Mae! First catch!

The guard came in announcing a labor. (10:20am) Our supervisor looked around asking who was up. After she said it was her, she turned to me saying, "No. It's you!" with a huge smile on her face. I hardly had time to think about it as I gathered a BP cuff, thermometer, tape measure, doppler, and reviewed my patient's chart. I had admitted patients before but always handed them off when delivery was eminent. This was different, this patient was mine. I said a few quick prayers as my patient was in the bathroom asking for God's help as I began this journey and for a healthy and safe labor and baby. Since everyone else was with other patients, they talked to me through the curtains asking if I had questions. I monitored my patient's contractions and made sure she stayed hydrated. When my supervisor checked her, she was 6cm dilated. Since it was her second baby, we knew that she would deliver soon.
I stayed with my patient and monitored the baby and encouraged her to breath. Her mom was her bontay and was awesome at supporting her daughter during contractions. Kelly, another missionary popped in periodically to see how we were doing. I had her check my patient once or twice and baby wasn't coming just yet. The next thing I know, I looked and then looked back and 4cm of head was visible! Kelly kept saying, "Support the head. Support the head." I supported the head as it crowned and head was out! My supervisor was there by then and helped me check for cord around the baby's neck. There was a nuchal cord (as in wrapped around the neck but it was very loose). Mama pushed and baby was out! (11:49am) I held the baby and did a summersault with it to unwrap the cord. Baby's APGARs were good, 9 and 10! Baby girl!

I continued to do postpartum checks on my patient for the rest of shift, and did the newborn exam on Tilly's patient (all by 2:00pm). I also did a newborn exam on my baby and gave it Vitamin K, eye meds, and Hep B. I stayed until 3:00pm to finish up charting. Tilly and I visited Kelsey at the clinic and took some of our donated supplies and Kelsey a Milo Mix in shake from Jollibee.

Hyacent Mae! 6-21-12 11:49AM

Checking out Hyacent Mae

A happy Mama, Mai Mai and Hyacent Mae

We both caught our first babies in the same day!

Friday the 22nd
I had double shift at prenatal clinic, one day baby check on Hyacent Mae, and then swing shift 2-10pm. We had staff devotion which were very good. Sylvette shared a testimony about an event in her life and shared James: 4:13-15

Come now, you who say, "Today or tomorrow we will go to such and such a town and spend a year there, doing business and making money" Yet you do not even know what tomorrow ill bring. What is your life? For you are a mist that appears for a little while and then vanishes. Instead you ought to say, "If the Lord wishes, we will live and to this or that."

It was such a great reminder as I have been thinking about what this next academic year will bring and beyond. I am so thankful for the things that these women have been sharing with me! 

Prenatals went well, I shadowed Ruth (another missionary) for two or three patients and then was given my own bed. I am  still working on my Vesyan (the language) so it was a little slow going but I was able to see 4 patients in about an hour. I am getting much better at palpating (feeling) the baby's position and only used a fetescope to find heart tones on Friday. This is good because you have to be more accurate about baby's position when using the fetescope than the Doppler because the Doppler can pick up the baby's heart tones through the placenta. All in all the fetescope is more accurate if you can find the heart tones. The youngest patient I had was 15 and the oldest was 36. The 36 year old's baby was breech but it was okay still because she was only 33 weeks and the baby had time to turn. I learned so much doing prenatals and even worked on my skills reporting patients at the end of the shift.

This is part of our morning worship with the patients.

One day old, Hyacent Mae, mama, and her brother!

I headed to the birth room around 1:15pm, to do my one day baby check on Hyacent Mae. They had not yet arrived and so I had some lunch, shared by a fellow midwife and received a text from my patient saying they would be late. I was not worried nor bothered by this because I had to be at the clinic until 10pm anyways and it is socially acceptable to be late to appointments. I had to have my supervisor translate the text though because it was in Vesyan. (".hi c micha diay ni i inform lng nq maAm cAseyn malate me but oN da way ne me dha..."- it says: I am just texting you to inform you that we will be late but we are on the way ma'am Casey). I did the baby check and told mama that her baby was the first one that I had ever caught. She replied, "So this baby is so very special to you?" Her face lit up and was so happy. I told her that I would print pictures and bring them to subsequent baby checks. She even brought her 3 year old son to the check, he was very olu-olu (shy).

Hyacent Mae, too cute  (Tim knows that I love a baby's crying face, it's just too perfect!)

Swing shift was pretty eventful. Three babies were born (two of which were born within 10minutes of mama arriving), a patient was sent home because she wasn't very far in labor, another went to join her baby at the hospital and another was transported to the hospital. This woman had simply come in to see if she was dilated but her vitals had gotten out of whack since prenatals in the morning. Her pulse was VERY high and baby's was very variable (high then super low). While the other midwives prepared her for transport, I sat with her mom and prayed and held her hand. The power of prayer and presence are truly remarkable! I could tell that the patient's mom was scared and so I sat with her until her daughter walked to the ambulance. I am uncertain the rest of that patient's story since I stayed at the clinic during her transport.

We restocked some things in the birth room and then the two fully dilated patients came in and delivered so quickly! We all pitched in assisting, charting, and restocking birth carts afterwards. It was a very memorable shift!

What a fun group of inspiring women!

Love,
Casey
Saturday the 23rd at 7:35pm here