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Dr. Coral learning about the realities of giving birth in Guatemala

3/3/2012

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CATALINA
 
At the age of 17, Catalina had never seen a birth firsthand, but knew that she had some interest in being a comedrona (nursemidwife).  She had a dream one night that she was in a room with a woman who was having awful pain and bleeding a lot, and she was able to help deliver the baby and everything turned out okay.  Just a few months later, she was called to the home of a laboring woman to see if she could help her, and she found that the circumstance was exactly what she had encountered in her dream.  She feels that God prepared her for that situation with the dream.  From that time forward, women began to come to her and ask for her help with their births.  Now, at nearly 60 years of age, she serves her community by attending births, helping counsel women about their pregnancies, examing them to be sure the baby is growing well and in correct position, and even helps them when the baby is young with feeding advice and recommendations for sick infants.  
 
Carrie, Lauren, and I arrived at Catalina's house to find a line of "embarazadas" (pregnant women) waiting for her return. She had gone to run an errand, and returned shortly after our arrival.  Her bright smile and friendly manner welcomes anyone who steps foot onto her front porch.  She invited us in to her room, where she has a bed where she and her husband sleep each night, and where women come from far away to deliver.  The women, one by one, come and lie on her bed as she examines them.  She uses a "cream" (something like a cocoa butter) to massage their bellies and reaches around to their lumbar spine for a little massage.  She then performs Leopold manuevers and tells exactly where is the baby's had and back and bottom. For most, she also give her opinion about the gender of the child, it seems mostly based on how the baby is lying or how big the baby is ("she is small and low") or how the baby is behaving ("he is a boy because he is very active and kicking a lot.  The women smile and are satisfied that all is well.
 
After the 1st patient, I ask if she would like to try to use the doppler that I brought.  It is an old doppler that was used during my residency years, but is very outdated, but she is very excited to be able to demonstrate the "corazon' for each mom.  She tells me that when the women get close to delivery, she puts her ear to their bellies to hear the baby's heart, so this is very exciting for her to use.  
 
After she sees the women who are waiting for the morning (approximately 8 in all), we sit to chat.  She loves to share her experiences, and talks about how she uses certain plants to help with labor:  she brings a "guarumo" plant, which is growing just behind her house.  She uses the leaves of the plant to make a tea that can help with a retained placenta.   She showed a plant that they use to "bathe" with when a child has a cough.  She also told us that the "eye" of the almond is good for cramps (menstrual and labor).  She told stories about women who have lost babies at a very young age (days to weeks to months), and women who have died in childbirth, and the effects on their families they left behind.
 
She often counsels women to go to the hospital to deliver if she feels it is not safe to deliver in the village, but many do not have the money to go to a clinic (a vaginal delivery costs the equivalent of $500 U.S.), and at the government hospital they are often either turned away or made to wait for hours to receive care.
 
We talked about her dreams for helping women in her area, and our dreams for providing safe pregnancies, births, and post-partum care for women.  She was surprised to hear that women in the U.S. see a doctor after they deliver.  In Guatemala, women almost never see a provider (doctor or comedrona) until they are pregnant again.  
 
Too many stories of stillbirths, deaths within the first few hours/ days/ months.  Death of mother in childbirth.  
 
But her passion for her community is amazing.  She really wants to learn and do whatever she can to help the women in her community.  This amazing woman who cannot read, yet has 6 "certificates" from courses she has taken over the years to learn more.  
 
She has also taken on the task of preparing the Kids Against Hunger food for about 90 kids in the community every Tuesday and Friday.  She has a HUGE "kettle" in which she cooks 13 bags of food.  The children come bringing their plates/ bowls/ containers...and leave with smiles.
 
Catalina's husband is very supportive of her; when a woman comes in labor, he is often asked to leave their bed in the middle of the night and go to sleep in the kitchen while the women delivers on their bed. Other times, he is asked to help care for the children of the woman, who have come with her since they cannot be left alone at home, while she is giving birth.  
 
We met with Carlos, the "presidente" of the "auxillary" of the village.  He seems to be the one who can make decisions about land and resources in the village.  He showed us two plots of land that belong to the village.  We discussed the possibility of building a "women's health center", which would incorporate a birthing center, where women could come to deliver, have prenatal and post-partum care, receive vitamins and education; a feeding center for pregnant women as well as children under 5, and maybe even a health center to address the needs of young children.  He thoughtfully showed us both areas, and talked about the benefits and drawbacks of each. He explained that the one area would be closer to the main road, where it would be more accessible for women who might come from other villages, and also would make it easier to have access to the hospital in San Benito (an hour away) in an emergency.
 
Over a pleasant dinner with Ismael, Orfe, and their beautiful children, we shared stories from the day.  Sister Pam had a great day exploring 3 schools in various areas and meeting with teachers and students.  She has big plans for tomorrow to further the microenterprise cause here.
 
A day of listening, learning, and enjoying the culture of the Peten.
 
I pray that this will be an important stepping stone in the path that God is paving for us here.
 
Several times today Catalina used the phrase "dar luz" (give light) to describe a birth.  I pray that we may help to "dar luz" to those here who may feel darkness, solitude, desparation or hopelessness.
 
Please keep us in your prayers in the coming days.
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