Yah. That happened. My last doula client delivered her daughter in the bed of our truck. (A pick-up truck is a bakkie here. Pronounced with a looong a, or something like that.)
I met this mom one Thursday a few months back. Showing up for my teach-and-serve-at-our-local-clinic/health-care-facility, a nurse sent her to see me for Prenatal Counseling. There we sat, me sounding like a goof teaching about the Stages of Labor and the difference between Early Labor and Real Contractions, in siSwati, cuz you know I’m a disaster like that.
After our lessons, I gave Mom a briefing on what my role as a doula looks like. She emphatically said, “I want you to help me like that.” So we made some plans to meet again in a few weeks at her house.
We met. We planned. And might I add, we practiced OVER and OVER how to time contractions, why timing contractions was important, when she was to call me, why I needed her to call me when the contractions started, and what might happen if she didn’t communicate with me (aka I wouldn’t be able to do my job).
Well three weeks ago, I got a 4 am phone call. She told me contractions were several minutes apart. I figured, “This is it.” Long story short, I didn’t exactly clarify what she meant by “several minutes”. Turns out she meant about, oh, 20, with *ahem* Braxton Hicks contractions. She nestled up in the Waiting House (there by the hospital) to sleep and chill until those real doozies started.
After waiting there for TWO weeks. She went home. She didn’t tell me. So when she called on Monday morning at 1:30am. I said, “Okay, well go over to the Labor Ward and have them check everything out. Could be labor…… oh wait. You’re AT HOME?! WHEN did you go home? WHY didn’t you call me?”
Not too keen on another false alarm (and knowing how chic panicked last time), I calmly asked her to time contractions for 30 minutes (what we had agreed she would have already DONE at this point!). Lo and behold, she had not timed then in several hours, so she didn’t have any information to guide me into where her labor was.
I called back in 30 minutes, and she proceeded to read off her contraction times (see! I DID teach her something!). And I got an icky feeling in my stomach.
“Hey sister. Are you telling me your contractions are coming 2 and 1 minutes apart right now?” My doula brain translated that: Unless her patterns are completely abnormal. And unless she goofed her counting. She’s very well CLOSE to pushing. She’s got less than 45 minutes. And she aint got no car. And she aint got no public transport. And she aint gonna walk very far with those contractions coming like that. Best shot she has is her boyfriend to throw her in a wheelbarrow and rush her to the main road, where they try to meet….
An ambulance. “Hey sister. You need to call the ambulance. You could be very close to delivering. You know I’m not a nurse or doctor, so I can’t take you myself. I will meet you there. But call the ambulance.”
When I rock up to her front door. I see no ambulance, but several women trying to help this failing-to-stand-up-woman on her feet. When a lady in labor starts throwing herself on the ground and hitting her hands and knees, I usually figure that baby is coming any ole time. Fact: Most women don’t give birth standing up. When they’re lying, kneeling, squatting, and grunting. Oh buuudddy the baby aint stopping now.
“Did you call the ambulance?” I asked the father.
“No we didn’t. She wanted to wait for you to take her,” he replied.
“I’m sorry. I cannot take her. Do you see her? She is very close to delivering. We wouldn’t even make it there, I’m guessing,” I responded, still keeping my I’m-so-level-headed-so-you-all-wont-freak-out,-even-though-I’d-like-to-shout-a-little-bit-right-now-voice.
“Give me your phone. I’m calling the ambulance,” came my demand.
Between 10 minutes of direction giving, information divulging, and emphatically assuring the dispatcher that I didn’t think she’d last 20 minutes before delivering, I directed the two women helping Mom to get her into the truck of our bakkie. (You know where this is going, cuz I already gave it away in the title! 🙂 At one point in the phone conversation with the dispatcher, I noticed Mom ask her aunt to lay out a blanket between her shins, behind her as she knelt on all fours. A bit distracted with the call, I thought, “Oh good, she’s going to sit down on a blanket.”
Mr. Dispatcher and I agreed that I would drive her to the main road (to save time), and then wait for the ambulance by a bus stop along the highway. Fine. Good. Fair. Then came the frightening debacle where he told me, “Okay. Well, unfortunately we don’t have an ambulance, so you’ll just have to wait,” I kept my cool. I asked him, “Are you a medical professional? Are you an EMT?”
“Yes ma’am. I am an EMT.”
“As a medical professional, what would you advise me to do? Should I wait here? Or should I drive her to the hospital because we could be waiting for a while?” I asked.
He responded with, “Do you have gloves?”
Gloves, gloves? Gloves. In my bag.
“Yes I have gloves,” my mouth said, as my mind said, “Please don’t tell me to catch this baby?!”
My mouth kept going, “What do I need gloves for?” (Fearing the response that would come.)
“Well, ma’am, there can be a lot of blood after the baby is delivered. Sometimes they don’t stop bleeding.”
“Oh you mean hemorrhaging,” I casually gave him the English word. Just in case he didn’t know it, you know.
Oh my stars, she could hemorrhage to death. What am I going to do?
“Ma’am I can see you need an ambulance. Please let me check with my supervisor. I’ll call you back.” He told me to go the junction at the highway and wait for his call.
Not really having a choice, I agreed to wait for the call. Turning to communicate this with the women and Mom, I asked Mom, “Can you hold on for just a few minutes? I want you to breath through contractions…”
In siSwati she wailed, “I’m already delivering.” Translating it in my head, I peeked around her shoulder (I was standing at her face).
“Oh. Why yes. Yes you have. Okay.” There lay a baby on that neatly placed blanket between Mom’s shins.
My brain jumped to what should happen next. – Is the baby okay? Is he/she breathing? It’s cold let’s keep baby warm. And let’s check mom for bleeding and how she feels.
Thankfully, baby interuppted my thinking with a wail. My phone-turned-flashlight showed two arms and legs and a head, so all looked good there. Mom. Mom wasn’t bleeding at ALL, praise Jesus. And she seemed okay, minus the fact she just birthed in my truck bed on a blanket.
My phone rang. The ambulance was on it’s way. It’d take 15 minutes. “How’s the mom?” he asked.
“Oh she’s okay, I think. She delivered. It’s a girl!” I calmly responded. [Note: I’ve learned I’m actually quite calm in these type of situations. Nobody needs to know this isn’t normal for me. Aint nobody got to figure it’s a crisis. At least not how I’m reacting all cool and calm-like, folks.]
I coaxed mom to sit down and demanded she do some skin-to-skin with the baby to her chest. She and the ladies looked at me like I was crazy (Have you ever SEEN a new-born. They’re kinda icky at the on-set!). She said something about, “But usually the hospital cleans her first. And I need to deliver the placenta.”
I looked back at her like she was crazy. “Yes. But we’re not IN the hospital. And I need that baby to start breast-feeding so it stimulates your hormones to release oxytocin, so your uterus starting shrinking and you don’t bleed to death. Okay?” (Okay, maybe I substituted “bleed to death” with “bleed too much.” Her aunties found a cloth quickly and wrapped the baby, then mom held her to her chest. I told them to watch her so she didn’t pass out or fall over. “And someone put a blanket over her shoulders and around that baby.”
Then I got in my car. Realized my keys were missing, and went running around the car 7 times (maybe I didn’t look so calm then), asking, “Have you seen the keys? The keys! I need the keys!? Lord Jesus. Help me find the keys. This can’t happen now!”) One auntie stood up, and found them on the roof of the car. She shoved them towards me. I snatched them, jumped in, and bumped us 5 minutes down the dirt road to the highway.
Parked. Hopped out. Asked mom how she was. She’s fine. No placenta. But baby looked warm and was still breathing.
And then we saw the flashing lights. And it was all okay. Within moments of the EMTs arriving, they had clamped the cord, and Mom pushed out the placenta. It was the cleanest, least-bloody (in fact, there was NONE!) delivery I have seen.
– Well, I’ve yet to meet with mom for her post-partum visit. But I believe we’ll be having a nice chat about her breach of our contract and how she seriously endangered her child. Because I did gather that her contractions started at 7 pm. Yet she only phoned me at 1:30am. Alas, I may never know WHY.
– My car has been washed. But you know, it didn’t even need it. Those aunties folded up that blanket and walked it home, while I followed the ambulance to the hospital. Like I said – clean. You’d never know a baby was born back there.
– When a woman is allowed to move and groove, breath, and push in whatever position she prefers (this time it was on her hands and knees), it can turn out completely fine. In fact, she might have been better off. At the hospital she would have likely had an episiotomy, stitches, and prolonged late labor from only being allowed to lie on her side in bed. Not that I’ll be recommending unattended-by-medical-professionals-bush-or-bakkie-births, buuuut it’s interesting to note.
– Thank the LORD everyone is okay.
– I’m off call and we’re leaving town this weekend to finally go climbing. And celebrate another experience of birth and new life.