We received a text from one of our Project Life leaders the night before asking for prayer for her sister (for privacy sake we'll call the sister Esther). The text was unclear if Esther was in labor, or already had the baby, or even where she was. As the story unfolded we discovered that the baby girl had died hours before. It turns out that the laboring woman was attended by a poorly trained "hilot", a local traditional birth attendant. When faced with a shoulder dystocia, she didn't know what to do. The head of the baby was born at 2 a.m., the rest of the body followed an hour later. Let that sink in. A simple technique or two would have easily saved this baby's life.
The story doesn't end there. Yesterday, Sonny and I were able to take this grieving mother to our friends at a local Christian Charity Birth Center for a postpartum check. The hilot had disappeared and had done no follow up. We discovered that Esther had postpartum hypertension, a life threatening condition that can lead to problems with the heart or stroke. It was recommended that Esther go to the hospital to be seen by a doctor but she refused. Then she had the option to stay at the center for observation and care, but she still wanted to go home. She was grieving, tired, and wanted to be surrounded by family.The staff at the center prayed with her, gave her hugs, shared her grief and provided her with necessary things to go home with like Tylenol, pads, and even a BP cuff that the family could use to monitor the blood pressure. I took Esther and her sister home, stopping on the way to buy them healthy protein rich foods and clean water. We were in touch with them all last night and this a.m. Her family has been caring for her and they are reporting the BP to the clinic midwife every few hours. It has gone down, but still not fully resolved. Later today, after I teach at the jail, I will be joined by my midwife friend and I will take her to Matain to do a follow up visit in the fishing village.
Why, you might ask, didn't Esther go to the hospital or a birth center? Why couldn't she find a qualified midwife to attend to her birth at home? Why didn't she receive adequate prenatal care? Many of these questions are summed up in the "Three Delays", based on research in the third world. We know that here in the Philippines 32 out of 1,000 infants and 162 out of 100,000 women die during pregnancy and childbirth.
For more on the Three Delays, go to our Buntis/Pregnancy Project Page) Most of these deaths can be prevented by prenatal care, education and access to well trained midwives and doctors.
Many women here are hesitant to go because they can't afford it (even the so-called "public" hospital charges) and/or they are mistreated and treated disrespectfully. Recently I was visiting someone in the local postpartum ward and the woman sharing the bed (yes, they were crowded that day so it was two to a single bed) began to cry and say "They treat us like pigs, ma'am, they treat us like pigs" She had been waiting for 14 hours to see her baby who was in the nursery. It seems there weren't enough staff to process the newborn and get the baby to the mother. Another time we helped a mother who couldn't afford the hospital bill so she escaped, leaving her deceased baby in the hospital. We later helped her negotiate the bill and retrieve the body for burial. I have many more stories like this, too many to share them all here.
I'll blog an update soon about Esther and baby. Please remember her and the family in your prayers.
Update- Esther's blood pressure still high. She is grieving the traumatic birth and death of her baby and doesn't care about taking care of herself. We were able to share the seriousness of the situation with the husband and family members, and trying to encourage them to take care of Esther. They are all dealing with grief and overwhelmed.
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