Advice for an EMT volunteering with clinic births in South America?

[upsidedownworld]

Hi yall!

Glad to have found this forum. There´s tons of good information that I will be digesting over the next few months, but I wanted to post this question and see what kind of replys I could get.

I am an Wilderness certified EMT in the United States, a pre-nursing drop-out (got through Anatomy and all my Bio and Chem) and a volunteer at a Level 1 Trauma Center ER. Now I live in Peru and am volunteering 3 shifts a week at the local clinic/hospital/emergency room. Two to three doctors per day, each seeing 50 patients. 5-7 nurses and 5 technicians.

I attended my first birth (other than that of my sister) a few days ago, and while it was a powerful experience I was also overwhelmed with anger and saddness at the poor treatment of the patient(s), and would love some advice on what I might be able to do to make the mother´s and child´s experience more pleasant.

I´ll hold off posting to many details of the birth until I´m able to attend more and get a more balanced sense of what standard practice is, but in general what reccomendations could you make for situations where IV´s and O2 are routine, EVERYONE births on their back in stirrups, and the coaching to first time mothers are minimal.

In this case I stayed with the mother durring the 1st stage, encouraged her to find the most comfortable position on the bed (for her sitting up with her husbands hand on her lower back), worked on calm breathing in through the nose and out the mouth, got a wet cloth to wipe her brow, kept reminding her husband to keep his hand on her back and not her stomach or shoulder, and as the contractions became stronger encouraged her to stay focused on my eyes durring the intense pain and breathed/channeled energy/supported her. I was the only member of our staff in the room this whole time.

Durring 2nd stage, I was trying to encourage the mother to bring her knees closer to her chest, as she was just resting her calfs in the stirrups and didn´t seem to be able to push down into her pelvis.

After delivery of the baby, I talked to the baby as it lay on the warming table a room away from the mother and tried to give it as much physical contact as I could. I also asked the nurses if it would be okay if I actually brought the baby to the mother´s chest, and they seemed a bit surprised but said okay. The baby was sucking on its hat so I told the mother that her daughter seemed hungry and she might want to try feeding it, but she declined and the nurses had nothing to say about it.

I´m reviewing the lamaze website as we speak (I only remember a bit from the classes I attended with my Mom durring her pregnancy with my sister 13 years ago), but please any other resources, books, etc would be much appreciated.

Thank you all for your time. I spend my off days gardening and drying herbs with what the locals call a witch, learning about a whole different modality of health.

May we all open to the Spirit and become an empty vessel for healing,

From the land of the Eagle and the Condor,

Oscar

[kalley]

I am an aspiring midwife and don't have a lot of resources to share with you. I just wanted to offer my encouragement. I think what you are doing is wonderful.

One option might be to do some doula training if you have the time or resources. Childbirth International has a completely online program. Even if you don't have the time or resources to take the class they have their reading list available to the public. Best of luck to you!

[cookderosa]

While I am no where near a CNM, I was certified as a doula and so I second that suggestion. Doulas provide non-medical support to the mom. Doula training is ALL about helping the mom and providing good support.

[MidwifeMom]

One thing you can do is to have the mother try pushing on her side or on all fours if the facility will allow it. This opens up the pelvis and allows for a larger space for the baby to pass through.

During labor encourage breathing and relaxation. Encourage the woman to empty her bladder frequently to give baby more room, and to change positions (walking, sitting, standing, leaning over the bed, etc). Changing positions will help the cervix dilate and baby move down.

As for breastfeeding, encourage moms to breastfeed in the first hour while the baby is most awake. Then encourage breastfeeding ever 2-4 hours after. Even if baby doesn't initially get the hang of it, it is good practice. Mom's milk probably won't come in for a few days, but baby is still getting high antibody colostrum from the mother's breast.

You can also try to encourage skin to skin with mom and baby immediately after delivery by placing the naked baby onto mom's bare chest or abdomen and then covering them with a warm blanket. Studies show that this helps the newborn regulate it's temperature.

I know it's difficult to make changes when a hospital has such a strict routine, but encourage staff to make changes by showing them current research and by saying let's try this, etc.

Good luck, volunteering is a wonderful thing.

[wannabmidwife]

In this case I stayed with the mother durring the 1st stage, encouraged her to find the most comfortable position on the bed (for her sitting up with her husbands hand on her lower back), worked on calm breathing in through the nose and out the mouth, got a wet cloth to wipe her brow, kept reminding her husband to keep his hand on her back and not her stomach or shoulder, and as the contractions became stronger encouraged her to stay focused on my eyes durring the intense pain and breathed/channeled energy/supported her. I was the only member of our staff in the room this whole time.

Oscar

Oscar,

This is exactly why we're here and becoming midwives so that the process of birthing becomes a more natural and personal experience. It's aweful the things that are done to women in labor and unfortunately has become normal. Good for you that this experience has allowed you to see what's done and given you the opportunity to try and change things. Good luck in you endeavors and we're proud of you.