(To preface, I wrote this on October 15th and couldn’t upload due to tech/wifi difficulties)
I am writing you from my kitchen, eating a bowl of yogurt with fresh strawberries, something that just came into season at the verdulerías (a taste of summer, how divine!) I am feeling very content this morning as I reflect on helping in my first ever home birth yesterday. Here is an excerpt from my journal, written from the couch during a bit of downtime:
“I want to remember this tranquility forever. This home, the natural light pouring in through floor to ceiling windows, a perfect spring breeze swaying blades of grass in one swift backyard dance. Everything is alive. The fireplace, the smell of white pine settling on our shoulders, the cat curled up in a chair facing me, the whispers of the midwives cooking lunch in the kitchen and Agostina breathing through contractions in the room over. Folk music plays in the background, the deep rich red rug holds my gaze—each part of this house playing a role in the welcome. Concrete floors hold us upright as we wait patiently. I am not even aware that this is happening in Spanish anymore, there is an unspoken language passing between each of us. We are collectively being held in anticipation, in warmth.”
I woke up at 9am yesterday to several texts from Agostina (the mother-to-be) in our birth team group message. Her due date isn’t for another week but she woke up with mild, rhythmic contractions separated by 5 minutes each (early latent labor). I quickly cancelled my Spanish lesson for the morning and a moment later Ana entered my room saying, “en diez minutos, vamos.” When you work as a private doula, there is a lot of preparation. This (among several things, I am learning) differentiates the job between a private and volunteer doula. In the hospital, we show up for our shift and whoever is there in the 8 hours we round is who we interact with. We don’t form relationships with any of the patients beforehand, often we aren’t even meeting them until they’re in postpartum and, while we divide up the week to ensure doulas are present each of the 7 days, the relationships to these mothers lasts the duration of the shift (with the exception of some families in the NICU that we get to know over several weeks). With Agostina, we have had monthly meetings, visits to her house, talked in depth about her hopes and desires for the birth, made a Plan B option to the hospital should it be necessary, and formed relationships with her husband and their 2-year-old. Ana has worked with this team of midwives for many years—everything is thorough and thoughtful. There is an emphasis on minimal intervention, on natural pain relief, on relaxation, on the role of the partner, on movement, on prioritizing the needs of the woman, on nutrition, on breastfeeding, on privacy (!!!), on ambiance. When we arrived at their home (pictures below because it is beautiful), Agos was sitting in bed with her husband, smiling and eating breakfast. The rest of the day unfolded naturally, and never once did it feel anything short of calm.
Agostina had the privilege of preparing for this day extensively, and by the time it arrived she was incredibly well-equipped to progress smoothly through her labor. She bounced between walking around the house, sitting on a birthing ball, laying in her bed, and sitting in the bath, all while breathing through progressively stronger contractions. The midwives checked the fetal heartbeat once every two hours and did one check for dilation at the end, but mostly were there in the event that something stopped going according to plan. Ana and I accompanied Agos emotionally throughout the day—bringing her water/food, sitting with her through contractions, mirroring her movements/breathing, setting up the room for the birth, cleaning their house. At lunch we all ate around the dining room table close to the fire, sharing stories and laughing, it almost started to remind me of Christmas. She labored for about 7 hours, the final 2 in the bathtub. When finally she got out to move to the bed, we stopped in the middle of the room where Agos had squatted down, and in one long scream, both her water broke and the baby was born—just like that! It was unreal, like nothing I have ever seen. We helped her move to the bed and put the baby on her chest and let the family have a moment alone in the room until the placenta was birthed.
As someone with a healthcare background, I understand both perspectives of birth. It is something women have been doing for all of time, but it has only been institutionalized in the last 100 years (like most things). In some ways, that has been a very good thing—more chance of both mother and infant survival with the option of quick emergency care, safe surgical intervention, NICU development. However, there is also a lot of agenda in the institution. The patient becomes more like a product and less involved in decision-making (speaking from the perspective of what I have seen in Argentina). They have less autonomy, and overall, the process is extremely rushed. In the hospital, there is more of an emphasis on mitigating pain. In home birth, pain is viewed as a helping agent, a natural part of birth. At home there is no rush and no induction, no numbing or poking or prodding. No interruptions by people you’ve never met, no medication, no unnecessary C-sections or episiotomies. I don’t want to say that home birth/private birth work outside of the hospital is without agenda either. A lot of the more “natural” birth advocates have an agenda regarding how birth should progress. However, if the institution is more about intervention and “doing,” private/natural birth work prioritizes the least intervention. There were many moments yesterday that I felt like I should be doing more, being more productive, intervening to feel a part of the purpose of it. But by and large, it was the most peaceful birth I’ve ever witnessed, and it occurred to me that maybe my job was to not intervene, but rather to provide support when it felt appropriate.
So I have one final week here! So much has happened since I arrived in June (including my phone being stolen for the second time immediately after uploading my last blog post :/ ). My goals for the week are enjoying my final shifts at the hospital, completing my final two Spanish classes, saying goodbye to friends and my host family, buying Christmas presents for my near & dear ones back home, going to a vegan street market in the city tomorrow, and managing to fit all of the chipa I possibly can into my suitcase 🙂
Talk to you once I am settled back in State-side! Since my phone was stolen immediately after the last post and I have been using a friend’s old 2014 android, I don’t have any new photos to upload, so instead I’ll show you some pictures from over the course of my time here that I never posted, enjoy!