One month

I've been here in the Philippines for one month.

It's crazy how fast this month has gone by. Sometimes it seems like each minute lasts an eternity, but other times, I blink and wonder where the day went.

Right now I'm studying blood. A woman's iron levels during pregnancy is incredibly important. Low iron means she's at a much higher risk of hemorrhaging after the baby's born. Around here, a lot of women are anemic (meaning her hemoglobin levels are below 11). A ton of foods out here are loaded in iron and they're very cheap, but a lot of poor people eat hot dogs because they're also cheap and easy to prepare. Jeri has a lot of fun explaining to everyone what's in a hot dog. Blech!

Another reason the women have very poor iron is because culture has taught them to diet while they're pregnant. They're taught that small babies are easy to birth but what they don't realize is that the baby does 60% of the work of labor. So if a woman is dieting, by the end of labor, both she and the baby are so exhausted that they're both exhausted. In extreme cases, the mom and baby die. There is a direct correlation between dieting and anemia, but the women don't stop. Sometimes, they can't stop. Neighbors, friends, family, and everyone else in the Philippines are telling her to diet. Sometimes they're even limiting the amount of food she can have so that she can have a small baby.

After getting a woman's blood results, the first thing we look at is her weight gain. Chances are, if she's anemic or border-line anemic, she hasn't gained much (if any) weight during the pregnancy.  Today I saw a woman who looked very unhealthy and hadn't gained anything since when she started coming to Shiphrah two months ago. Some of that wasn't her fault, but a woman needs to gain weight during pregnancy. Unless she's very heavy, gaining a healthy amount of weight is a MUST!

Ok, I'll get off my soap box and go back to my point about why I'm studying blood... :-D

Jeri normally takes care of all that blood stuff during prenatals but she's leaving for the US next week for a month. So she wants me to take care of that while she's gone. This will be interesting as it involves critical thinking, counseling the mom, and knowledge of the language, as best as possible. This week I've been at the blood table during prenatals learning as much as I can. I think I know most of the phrases I'll need, but it's still an intimidating task, especially since Jeri does it so well. So please be praying that God will give me the courage and wisdom and ability to fulfill this task. I know I can do it, I'm just a little intimidated by the immensity of it.

Also, I've started taking on COCs (continuity of care). If there's a woman who comes in who's between 28 and 32 weeks (those numbers will be changing as I get closer to leaving), I can take her as a COC. What that means is I'll be the main midwife at her prenatals (and I have to do at least 4 prenatals on her) and I'll also be the primary at her birth. If I decide to become a CPM (after arriving here, I've discovered that the plans I had for the future are no longer going to work, so I'm not sure if I'm going to become a CPM or CNM. Right now I'm leaning more towards becoming a CNM because they're more widely recognized and I'd have the training to help more than just pregnant women.), NARM (National Registry of Midwives - the organization who certifies CPMs) says I need at least 4-5 continuities. Now, a continuity doesn't sound too hard to fulfill, but getting 4 prenatals in on a mom is actually harder than it sounds... Currently, I've got 25 COCs. The earliest ones are due in August, but most are due within two weeks time in September (Sept's going to be one crazy month for me!). 


Anyway, last week, there was a pregnant girl (I'd guess between 16 and 18) who I saw and I instantly knew I wanted her as a COC. During the prenatal, every time we touched her belly (which is a lot), she'd start giggling because it tickled. And then when we started feeling for her baby's position, she absolutely lost it and had to stick a rag in her mouth to stop giggling. It was so funny! 


She was back again today. I smiled when I saw her. She smiled back. And lo and behold, the moment I touched her tummy, she started giggling again. 


I wonder what she will be like in labor... :-D


Ok, I've probably talked your ear off by now! Tootles! And ready for more pictures? Scroll down! :-D


Ooops! Blogger just told me that I've run out of free memory space for pictures...I'm not sure what I'm going to do in order to upload more pics...Gonna have to think about that one...Sorry about that and hopefully I'll get the problem fixed soon!