What now?

Why is it that unpacking my Chacos with African dirt on them always makes me want to cry? Today I feel so far from the place where I spent three months of my life, but something about my sandals is such a tangible reminder that yes, I was actually there. And then suddenly all these memories of my time there comes back to me. And it’s hard to feel so far from the people and places of those memories.

I’ve been pretty distracted from what my life was like in Nigeria as I’ve been traveling around for the past two weeks visiting family and friends. I spent a total of 2 days in the car and my car has an added 3,000 miles after the trip! But I made it to Michigan, Minnesota, Mississippi, and back to DC and got to see lots of lovely people along the way! It was so nice to be able to talk to people face to face about my time in Benin City and to hear about what I missed during my 3 months away. And I got to spend Christmas with all my family, which hasn’t happened for several years – I am so grateful.

Everyone’s been asking if I’m having culture shock since being back. I don’t feel too “shocked” yet – but I think the worst of it will come once I’m back at work and in school, once real life starts to hit me. So far, I don’t think I’ve ever whined so much about being cold! The Minnesota winter cold was pretty brutal! And it’s also been weird as it’s been a little hard for me to adjust back to American food, which I never would have expected.

For right now, I feel thankful that the Lord gave me this opportunity to go to Benin City for 3 months of my life. I can’t wait to see how he’ll use my experiences there in the future. I definitely think I’ll be back in Africa – the where/when/how of that I have no idea about right now. But God has given me some measure of peace that He’ll help me figure that out when the time is right. For now, my first day back at work is tomorrow and I start school next week. I know there will be so much I’m grateful for at work and I hope that I’ll be even more enthusiastic about school now that I’ve seen how important it will be to remember everything I’m learning.

I’m praying that the Lord will continue to give me peace about where I’m at now and give His direction for each step I take in the future. Thanks so much for following this journey – can’t wait to see where else God will take me!

Almost…

(Written 12-2-09 but because of technical difficulties, published today!)

This time next week I’ll be on a plane headed to DC. What – CRAZY!? Seems strange to know I’ll suddenly be on the other side of the world next week.

My plans at the hospital have all gone better than I expected which is such a blessing and an answer to prayer. I did surveys at the Newborn/Immunization Clinics and ended up with 50 completed surveys. I gave each woman a banana bread muffin after filling out the survey. (I think I’ve forgotten to mention that I make banana bread ALL THE TIME here. Nigerians don’t eat many sweet things so there’s nothing like banana bread around here. I am even selling it now to staff at the hospital and sometimes to the university cafeteria. Michael Higdon – Miss Butterscotch lives on in Nigeria!) The surveys asked about how the mothers felt about their prenatal care, prenatal teaching, care on the labor ward, understanding of care provided, and care of their baby. It also asked them how well they felt they handled their labor and delivery and gave them opportunities to say what they thought should be different about their care. I think the whole thing was really a new concept for the patients and the staff. But I think it really helped me make suggestions that took into account the culture and needs of the patients (as opposed to how I would change things from an American perspective). I also hope that it brought more validity to my suggestions in the eyes of the staff. It was so precious to be able to go to the clinics again and see all the mommas and babies! My heart felt so full at those clinics – so much of what brings me joy and drives me to do what I’m doing is right there. May I just say that the women and the babies here are beautiful!

I met with the Chief Matron and Labor Ward Matron (head nurses) last Wednesday concerning my suggestions for changes to practices on the labor ward. The three changes included: allowing women to move about as they like during first stage labor, delaying the clamping of the cord to allow for increased blood flow to the infant (and calm the now-hurried birth process), and give only light suctioning instead of deep suctioning to every infant after birth (again, to calm the now-hurried birth process). They were, for the most part, accepting of my suggestions although I don’t think they saw much benefit in delaying the clamping of the cord. But they were both really sweet and encouraging as they said they enjoyed my time here, felt like I blended well with the staff, and stayed busy while I was here. They also said they really hoped I would come back and that I should marry a Nigerian (everyone here is rooting for that one)!

Then I was given the opportunity to present my thoughts at a meeting for all the nurses at the hospital on Friday. I presented the results of my survey first. The results of the survey were actually pretty positive. Most patients knew that staff cared for them and felt they were “trying” (working hard) for them. Most of the suggestions for change were based on the fact that antenatal clinic should be shorter (right now it takes about 4 hours). The high point was on antenatal teaching – the women really love this part of clinic so I tried to use that to encourage staff to use every opportunity for education. The low point was on understanding what was happening on the labor ward so I again tried to encourage the staff to educate on the labor process in clinic and on the ward. Other things the women said included that staff should not be shouting at them and that husbands should be allowed back in the labor ward. I then presented my research on the three practices I suggested they change. I was able to find recent research articles online through my school library that helped me support my suggestions.
I felt like the presentation was well received by the staff. We had some time for discussion at the end and a few nurses had some concerns about husbands being allowed in the labor room and delaying the clamping of the cord and suctioning of the baby. But I felt like we were able to have a good discussion and come to good conclusions. Thankfully, I also felt like I was able to communicate clearly during my presentation. The last thing I wanted was for staff to struggle to understand me the entire time!

So, I feel like my experience at the hospital has been a really positive one. I know I have learned a lot and I am grateful to have been a part of the Faith Mediplex family and the lives of the patients. I’m not sure how I am going to say goodbye.

It’s going, going, going…

Again, sorry it’s been so long since I updated. At some point life here just starts to feel like normal life and it’s harder to know what to write home about! Convention week has come and go.

Convention is a gathering of CGM (Church of God Ministries) leaders and members. Mama Margaret Idahosa (Feb’s mother) is the head of the ministry so convention is here in Benin City and she hosts a lot of people on the compound. So there were a ton of visitors here and every day was extremely long. I had work in the mornings and then convention in the evenings. I figured I was in church for about 15 hours over 5 days which I think is a new record for me!

Mama Idahosa was consecrated as an archbishop and Feb was consecrated as a bishop. ALL of the pastors, deacons, and deaconesses were anointed and prayed for – and there were A LOT of them! In some ways it was interesting to see history take place for CGM as Mama and Feb were consecrated. In other ways, the convention was exhausting; there was an overwhelming amount of protocol and ceremony. And then back at the compound there were bishops everywhere! So the protocol continued at home.

I am enjoying feeling more proficient at the hospital and able to actually help with practical tasks. Last week at Antenatal Clinic I was able to be the third nurse to see patients. We were done earlier than we usually are and I had to ask the nurses only a few questions. It feels good to start to get the hang of things and to care for patients on my own terms!

Friday last week was crazy busy on the labor ward. We were full already and women were walking in left and right saying they thought they were in labor. I really enjoy being busy, though! Because it means I get to do more and see more.

I helped catch my fifth baby today. It was frustrating, though, because I still would have done things differently if I was on my own. The woman wasn’t allowed to stand at the end of her labor even though she kept asking. She was given an episiotomy automatically (since it was her first baby) before she had even pushed twice. Here they don’t like for the women to push for very long. Most of the women, with encouragement, are able to push out their baby in 5 minutes or less after starting to push. So, it can be really stressful because the women are pressured into pushing as hard as they can and are scolded if they don’t push well.

I feel like I have small victories on the labor ward that are quickly followed by feelings of defeat. Last week I encouraged a woman to keep pushing after staff had given up hope and were planning for a c-section delivery. Half and hour later when she delivered on the labor ward, I was so relieved and grateful. YES! This is what midwifery is about! Then five minutes later I watched her being yelled at by the midwife (for a totally inappropriate reason). And my heart just sunk. Some days I don’t have a problem accepting the reality of what happens at the hospital. Other days it just breaks my heart all over again.

I talked with the Medical Director at the hospital on Monday and he was completely supportive of all of my ideas for change. He gave me the thumbs up for doing patient satisfaction surveys in the Newborn/Immunization Clinics for mothers who have been through Antenatal Clinic and the labor ward. I started today and got somewhat confusing results. I don’t know if the women are afraid to be honest with me, don’t understand my survey, or really do feel satisfied with the care they receive and wouldn’t change anything. I hope to do two more days of surveys so we’ll see how the final results turn out. I also got the green light from the Director to bring up some suggestions I have for change. I’ve picked three specific practices on the labor ward and found research to support a change for each of them. The Chief Matron (head nurse) and I plan to meet later this week with the labor ward Matron to talk about them. Then, the Director asked me to bring them up in a meeting with all the staff nurses at the end of this month. I was REALLY encouraged to have his support so now I just have to DO what I’ve planned! Please pray for the staff at the hospital and for me to communicate well.

I have about 3 weeks left here. Some days I can’t wait to go back to DC and other days I can’t imagine leaving here. I know I will really miss everyone. I’m trying not to get anxious about leaving but just enjoy each day and the experiences that come with it.

Getting into a routine…

Sorry it has been a bit since I posted. It feels like life is moving right along here and I hardly feel like I’ve been here for almost 7 weeks!

I am starting to feel less like an outside observer on the labor ward and more like I have a place and a job. I caught another baby this past Thursday and I felt a lot more trust from the labor ward staff. I think they were actually really excited and proud to see me catch another baby!

I have been trying to be more proactive in helping the midwives on the labor ward because, unless they are really stressed, they will do everything themselves without asking me for help. So now that I am understanding the process of care on the labor ward, it’s easier to step in and ask if I can help with specific things. Thursday looked like a busy day from the start as we had three laboring patients, one of whom was probably going for a c-section, and another patient already scheduled for a c-section. On morning shift, the labor ward matron is always on duty and then there is one other nurse who is doing most of the work. With c-sections, the nurse has to attend the delivery to see to take care of the baby afterwards, so with one (possibly two) c-sections that morning, I knew we were going to be plenty busy and that the nurse was going to need help watching the patients on the ward.

So I asked if I could do all the monitoring and charting for two of the labor ward patients and the nurse showed me what to check and how to chart it. I was excited to be busy! I checked the fetal heart rates, contractions, and blood pressures hourly and got more practice than I’ve ever had before at checking cervical dilation. It was such a great feeling to feel like I could do everything for the women that they needed. And it was nice to have more confidence and trust from the labor ward staff. I also empathized with the staff as I understood more of how when you’re caring for more than one patient it’s difficult to always be therapeutic. I wasn’t able to stay with every woman when I wanted and I had to check things even when the woman just wanted to be still and not be bothered. But I tried to explain as much of what I was doing as I could and wait until a woman was in between contractions before asking her to change position or let me check something.

I tried to stay mostly with a woman named Victoria who was having her third baby and was the patient farthest along in her labor. It’s funny to me how even when women have been through labor before, it’s sometimes no less overwhelming or unbearable for them. By the time Victoria was almost fully dilated and ready to push she was saying how she didn’t think she could bear her labor anymore and was ready to give up (not that she really could). I kept trying to encourage her, remind her that she had already done this twice before, and that she was almost done. She delivered a beautiful baby boy who cried right away and I got to catch him! I was able to do more than I ever have to take care of a woman and her baby and I really enjoyed it!

I definitely have an everyday routine here in Benin. I wake up early to have tea (I traded it for my usual 2 or 3 cups of coffee) and some quiet time with the Lord in the mornings. Then I eat something delicious for breakfast made by Auntie Tracy or Auntie Augustina (the two nanny/cook/housekeepers in the house) with Matthew, Laurie, and/or Feb who are usually headed to the university. Then I meet the driver, Umokaro, and police, Uncle Bassey or Isaac, and drive to the hospital. I love seeing all these familiar faces in the morning – I will definitely miss them when I leave.

I have been going in for the morning shift from 8 AM to 2 PM everyday. There are devotions in the main hall at the hospital for all the morning staff. Although I don’t usually know the worship songs, I enjoy watching everyone dance and listening to the voices. The worship is always acappella and everyone, staff and clinic patients, seems to really enjoy it. Then there’s a short message, which I can sometimes mostly understand and other times not really follow at all. Some accents are really hard for me to understand, especially when the speaker is really passionate and shouting the whole time. At the end of devotions, I usually greet the Chief Matron and then walk to the labor ward.

I like walking around the hospital because so many people greet me and ask how I am enjoying my time here. Since I’m obviously from out of town, a lot of people at the hospital have stopped to meet me so I feel like I know a lot of people there. Here people are usually very warm when greeting others, and people often squeeze my hand or my shoulders when saying hello.

After my shift is over then the driver and police pick me up again and take me back to the compound. Lunch is on the table when I get back and during lunch someone else is usually coming back to the house after school or work. There’s usually one, two, or ten visitors to the house during the evenings! So after work, I read, go online, meet the visitors, or just hang out with my “family” here (what I do the majority of the time). Feb and Laurie have an extensive movie collection so I’ve also watched a lot of movies since being here. There’s also a ¼ mile sidewalk around the compound so I try to make use of that and get some exercise.

That’s about it for my day-to-day happenings!

I still have not talked to the medical director (who’s currently out of town) about using a patient satisfaction survey at the hospital. Church of God Ministries is having a convention here in Benin City so the compound will be full of visitors this week and I expect things to be really busy!

Thank you…

I want to say thank you to everyone who’s been praying for me and everyone who helped get me here. I sometimes still cannot believe I’m here and wonder how it all happened! It is such a comfort to know there are people thinking and praying for me. Knowing that not only encourages me but helps me feel a little less lonely. I am starting to REALLY miss everyone and wish I could share lunch or a cup of coffee with one of you!

I went to Abuja last week, a pretty developed city here in Nigeria, and visited DIFF Hospital. DIFF specializes in IVF (in-vitro fertilization) therapies and thus has lots of multiple pregnancies and preterm deliveries. So they also have a NICU with more equipment than the one here in Benin City. I went to see the hospital to have something to compare Faith Mediplex to and kind of as a way of seeing what’s possible in healthcare in Africa. I was impressed with what they had in the NICU at DIFF but also with what they were able to do without. They had incubators and bilirubin lights but no ventilators or monitors. They also had one nurse to 5-9 patients!

It was nice to see a new place and get a different perspective. I had a little bit of culture shock driving into Abuja, though, because there are large paved roads and highways with traffic lights and clear traffic lanes. I felt a little bit like I was back in the US and I was a little overwhelmed, to be honest.

I was glad to get back to Benin City on Saturday; back to some familiar people and places. Although I have been pretty discouraged this week at the hospital. There is so much about the way we care for patients there that I wish was different. I also wish I knew more about the normal labor process so that I could talk more with the midwives about how care could be different and the rationale behind potential changes. I’m still learning some basic skills specific to labor and delivery and still proving to the midwives the skills I feel confident in – like checking fetal heart tones and starting IV lines. I get really frustrated at the way I see the women treated and wish I could do more to change it.

One idea I have is to do a patient satisfaction survey for the women in antenatal and intrapartum care at Faith Mediplex. That way, it would be the voices of the women who could point out the strengths and weaknesses of the system instead of me or someone else coming in and pointing a finger. Please pray for me on this as I try to form a survey and figure out a way to introduce it to the hospital administration and staff.

Thanks again to everyone who is praying for me – I am so grateful!

A Second Birth

It’s hard to believe it’s already been a month since I stepped on a plane to Nigeria. But I would say time is going by at just the right pace!

Yesterday I caught a baby for the second time and it was a much more positive experience than the first. When I came in the morning to the obstetrics ward, there was a first-time mother, 27 years old, who was 3 cm dilated. She shares my Benin name, Itohan, which means “mercies of God” and which some hospital staff here gave me. She seemed really nervous, kind of frightened of the contractions, and unsure of what was happening. I knew she needed someone to explain what was happening and to feel like she had help available when she needed it. I tried to encourage her to eat and move around as she felt comfortable because once she was back in the labor ward she wouldn’t really be able to do either.

I was excited to see someone go through labor from the beginning stages since women rarely come in before they are 4-5 cm. I was also excited to be able to be there for her from the beginning.
Now that I am more familiar with how they do things on the labor ward, I felt this time around I was better able to do things to care for Itohan and also to help her understand what was going on. I stayed with her almost the entire time and tried to help her keep a rhythm with her breathing while she had contractions, rubbing her back with every contraction. She was even falling asleep between contractions in the later stages! (Which means she felt pretty safe and relaxed – and pretty tired!)

It’s really exciting to see all the things that I am reading about what women need in labor ring true in my experiences. What I have seen so far is that women want to know that what they’re experiencing is normal and that they are doing well in coping with their labor. They want someone close by, close enough to hold their hand, and to feel they are not alone. I’ve found that once I come close to a woman in labor, especially late labor, she does not want to let go of me! A lot of them ask to be held and some of them even rub my shoulders or back while I rub theirs!

When it came time for me to leave yesterday before Itohan’s baby had been delivered, I just couldn’t leave her. And the midwives were all telling me I should catch her baby since I had been “trying” for her so long. (Trying here means you are working really hard and it’s how most of the mothers I help thank me here – “You tried for me, you really tried for me.”) So I was able to stay and catch her baby, with lots of direction from the midwife, and take care of the sweet baby girl after she was born! I told Itohan several times that she had done so well and celebrated her baby with her. It was such a blessing to get to be there for so much of the process and help a first-time mother go through it and, hopefully, help her feel confident in herself and excited for the birth of her baby.

Women are amazing! And the God who sees them through the amazing miracle of birth is so unbelievably amazing!

A full rundown of Week 3 :)

10-3-09

This past week has been interesting. The labor ward has been slow recently so Monday I went to help out at the well-baby clinic. My job ended up being weighing all the babies, who all looked at me smiled (no joke, I really mean every one) – I think it probably had to do with me being white and smiling silly at them. They were so precious! Tuesday was slow as well so I took pictures on the labor ward (look for them soon on Facebook) and read a Labor & Delivery textbook.

Wednesday I lectured on first aid with another American during the BIU (Benson Idahosa University) student leader’s orientation. That was pretty intimidating, but I think it went well and it was kind of nostalgic to be among college kids again getting ready to start a new year. Matthew is the other American; he’s here starting his freshman year at BIU. He had never been out of the US and never been on a plane before coming here – whoa – but he plans on going to BIU for all 4 years of college and then going on to medical school. He worked as an ER tech and an EMT in the US so that’s why he joined me for the lecture.

Thursday was Nigerian Independence Day and I went to help out at a local church, Church Plus, outreach. It was a medical outreach that saw about 400 people in Benin City. It was cool because they had an ophthalmologist and a dentist on-site and they are even helping people get some small surgeries after the event. I took a lot of blood pressures and helped figure out what complaints each person had and who they needed to see. I learned some new “Pigeon” phrases and definitely had some practice at understanding the local accents. Pigeon is the language that everyone speaks here although I don’t know if you could officially call it a language. It’s kind of like pig-latin English. Instead of saying “How are you today?” you say “How you day?” and then the response is “I day fine” instead of “I’m doing fine today.” That’s pretty much the only phrase I’ve got down, but I’m getting better at understanding other people’s conversations.

Friday I was back at the hospital where the only patient in the labor ward was a woman with preeclampsia (really high blood pressure) who was admitted for management of her blood pressure. We then later discovered she was 5cm dilated and had been having contractions all day (she was only 34 weeks along). There was talk of taking her for a c-section but then no one could find a fetal heartbeat. The baby ended up being stillborn after I left for the day. While I was there, the whole situation was pretty stressful and I struggled to follow what was going on.

The communication on the labor ward between the nurses themselves and to the patients is often hard for me to understand. Maybe that’s because there isn’t much of it and sometimes there’s only one nurse working the ward. I’m learning that I have to ask questions – even about simple, important stuff like how many cm dilated a woman is because the nurse will examine a woman and just walk away without saying anything. I struggle to know the balance between not being irritating to the nurses with constant questions but also doing what is best for the patients and taking advantage of learning opportunities for myself.

Saturday I went to a birthday party for a one-year-old and was forced to dance in a dance competition. I lost – but I almost won because the kids cheered for me because I’m “Ohebo” (I’m white). By the way, the kids here can get their groove on! Most of the 5 year-olds there could break it down way better than I can – shaking their hips and everything!

Sunday I visited Church Plus. I REALLY enjoyed it because I met lots of new people and the church service was refreshing because it was practical and there was lots of humor mixed in. I also ate a meal outside of the compound and got to just sit and relax and talk with some new people! Let me just use this day as an example to explain how crazy I’m treated here sometimes. Everyday I am escorted by a driver and a police in a SUV (washed every day) to the hospital and then I’m escorted back to the compound in the afternoon. (Yesterday, though, I drove with the pastor and his wife to Church in a regular car with no police to a new part of town– I really enjoyed it!) Everywhere I go I sit in the front row (church, BIU, even the birthday party). Some people, especially little kids, curtsy/bow when they see me because that’s what you do here to people of honor or respectable elders (it’s crazy to be curtsied at). They don’t see very many white people here in Benin City, so when people see me I think they assume I am someone important. A lot of it also has to with my hosts, Feb and Laurie, since they are well known and well respected here. At Church Plus, the pastor asked me to say a word to the congregation, pray for those at an altar call, and say a word to the church leaders after service. It was pretty overwhelming, but I tried to just take a deep breath and say “Okay, Lord, whatever you want me to do…” It was an honor, though, to be involved in a body of believers I had just met. But anyway, as a person who usually likes to lay low and work behind the scenes, this part of my time here definitely challenges me.

Week 2

From Sunday through Tuesday this past week, I joined the Idahosas for a family vacation of sorts while the kids were off from school for a holiday. We went to Lagos by road and traveled for 7 hours each way. There were frequent checkpoints along the way where police were checking for unregistered cars and bombs, according to our police who traveled with us. I am sure Bassey, our police, saved us a lot of time and frustration as we were able to just pass through each checkpoint. In Lagos, we went to the mall, to a movie, and swimming (my favorite part) and I enjoyed spending time with the kids even though it was chaotic at times. We took a quick look at Bar Beach, but didn’t go very far as it was PACKED with people on break for the holiday.

The rest of my week at the hospital was a bit more stressful than last week. Even though most everyone I’ve met here in Nigeria speaks English, they speak a British English with a thick Nigerian accent and I still have a hard time understanding others and others have a hard time understanding me. This, of course, makes communication with patients and hospital staff slow and frustrating at times. Sometimes, it’s funny though – like when a very pregnant patient thought I was asking her to lie on her stomach during antenatal clinic. She tried, but was really confused, and another nurse stopped her before she got too far into her attempt. We all laughed about it, thankfully.

Yesterday was particularly stressful on the labor ward as we had a woman with a cervical laceration after delivery of her baby that took almost two hours to repair. The doctors were really worried about bleeding from the laceration and were anxious to get it repaired quickly. However, it was extremely painful for the woman and she did not cope very well with the repair. So everyone was on edge until the laceration was finally repaired. All I wanted to do afterward was just comfort the mother as during the procedure the doctors and midwives had been scolding her for not cooperating. They also kept reminding her that she probably tore because she was pushing before she was fully dilated – basically telling her it was her fault for the tear and she needed to just be quiet and let them fix it. I know there has to be a better way to do that procedure, even emergently, so as to cause less trauma to the mother. At the end of the day, mother and baby were alive – thank the Lord. But I know that the mother must feel a good deal of shame and is probably terrified to have another child.

Oh, how could I forget – I caught my first baby on Wednesday! I had lots of help and direction and the whole thing was rather rushed, but I have officially caught my first baby! It was kind of disappointing because the birth process is so untherapeutic on the labor ward. I guess since midwives work on the ward, I expected it to be different, but the midwives here function like most Labor & Delivery nurses in the US (midwife means a whole different thing in the US). After birth, the baby is placed on the mother’s stomach and then taken away for suctioning and bathing. There are no congratulations to the mother, no telling of the baby’s gender, no time for mother and baby to bond. I’m sure that the labor & delivery system in the US is frustrating to midwives in lots of the same ways as baby is usually whisked away right after birth. But midwifery really stresses letting mother and baby bond and not doing any interventions unnecessarily. So I let the baby I caught stay on mom’s stomach as she was breathing just fine (and most babies don’t need suctioning) but everyone on the ward flipped out and rushed the baby away for suctioning. Then, here the midwives deliver the placenta by pulling on the cord gently until it comes out. I would have rather just let it come on it’s own time, but I did what the midwife told me as here they think letting the placenta come naturally increases risk for bleeding. This makes no sense to me – actually it seems backward – and is one thing I need to research. (All my midwifery friends, feel free to let me know if you find anything!)

So, all in all, feeling a bit more awkward this week because of struggles with communication and as I learn the routines and procedures here. But, it’s only Week 2 of 12!

Week 1

So, I have now officially spent my first week at the hospital. I spent Wednesday and Thursday morning at the antenatal clinic (prenatal clinic) at the hospital and let me just tell you – Benin City has A LOT of pregnant women! Between the two clinic days I’m sure we saw well over 100 women, maybe even 150. The clinic works kind of like an assembly line, since there are so many women, and it was kind of a shock to me since it seems very impersonal. The women get there early before morning devotions (which the hospital does every morning) and get a number, then they are called by their number for the rest of the day. First, their number is called for blood pressures (I’m really good at taking blood pressures manually now as I took almost every woman’s blood pressure). Then their number is called for their height and weight. And then their number is called for the nurses to check the baby’s size, position, and heart tones. After that they are sent for ultrasound or lab tests. All of this is done without ever calling them by name or giving them time to ask questions. In between blood pressures and checkups, one of the nurses gives a talk to the group at large about an educational topic and gives the women a chance to ask questions during this time.
I am wondering if the women coming to the clinic mind this kind of system since no one seems to be complaining or trying to ask lots of questions during the checkups. I don’t know whether they have just gotten used to the system or if they are scared to do something out of the ordinary. But there are so many opportunities for education in the prenatal setting and I think women are especially interested in their health while they are pregnant.
I will probably be at the clinic at least once a week so I’m hoping to understand more about what changes the women would appreciate. For now, I am just trying to not be afraid to do things differently myself, even if it is just greeting the women before I take their blood pressure.
All of that aside, it is exciting to be able to actually do prenatal assessments. I am getting better at figuring out the baby’s position. I have felt and seen a hand and a foot through a belly – so crazy! I have heard fetal heart tones with an old-fashioned fetoscope (basically a metal cone). And for all you medical people out there, I have felt a lot of funduses and am getting better at measuring fundal heights!
It’s exciting to remember that this is only my first week and that there are many more to come!

I’m here!

In Nigeria, I am not Miss Everly. I am Auntie Everly. And I think I like that title better since it has a way of making me feel like family to people I have just met. The Idahosas, my host family, has been so welcoming and generous!
It is wonderful to come to Nigeria for the second time around because I recognize places and faces even when I am far from home. It is less overwhelming than the first time since I know more of what to expect and how things go here. I have already gotten reacquainted with friends from my first visit – it was so nice to see them by surprise!
Since coming to Nigeria last Thursday, I have already had some interesting experiences. Before leaving the airport in Lagos, I already had two phone numbers – one from the customs guy who said he wanted to be “in the running” if I was going to get married in Nigeria and one from the porter for our bags who said he would be expecting my call. I was a backup singer for Osasu, an 11-year-old rapper wannabe, in a talent show at church (it went terrible, but you have to love us for trying). And I also attended a Nigerian comedy/award show with Feb and Laurie Idahosa where some “Nollywood” (the Nigerian Hollywood – not kidding) stars and rappers made an appearance. I’m sure Nigeria will hold more unexpected experiences like these…
Today was my second day at the hospital here, Faith Mediplex. It was my first day on the delivery ward and I saw two births! I spent most of my time with a 23-year-old who was having her first baby. I tried to just be there for her and comfort her. Midwifery practice teaches that women need someone to be present with them during labor – someone they know is not going to leave them and who will keep them from being alone. I was glad to see that idea ring true today as I could tell she needed someone to be there when she had bad contractions. When it was time for the baby to be born, the midwife asked me if I wanted to catch the baby. I was shy and said “No, it would be my first” and I wanted to make sure someone was attending to the mother during the delivery. She said catching a baby was like a piece of “heaven on earth” and that I would have to do it someday. The matron (who is the chief nurse over the hospital) told me yesterday I would catch many babies during my time here. I can’t wait – even though I will be terrified, I think, when it actually happens!