A First Birth, A Fuerte Impression

A First Birth, A Fuerte Impression

          The first birth I was present at in ACAM happened on my first shift, Monday September 12th. This was a first-time mother who had been in labor for three days and had not slept since Friday, and it was Monday. After hours and hours of laboring, it was finally time to push and a beautiful baby boy was born. But it was after he was born when things went south, so to speak. Before the placenta was born the woman started losing a ton of blood, cups and cups were flowing out of her. She had no contractions, meaning she was not going to be birthing the placenta any time soon, if it were up to her body. From days of labor and hours of pushing her body and uterus were just exhausted. More and more blood was flowing, and the midwives had to pull on the cord to try to loosen it but it wouldn’t budge. The woman was in danger at this point, losing a lot of blood. Finally the placenta came out. But, even so, the bleeding did not seem to lessen. So much so that, in a frantic try to stop the hemorrhage, Dena (my facilitator) had to stick her entire fist in the woman and begin to bimanually, forcefully, contracting the uterus with her fist, forcing the uterus to clamp down. Misoprostol and Pitocin were both injected in the mother, but neither seemed to be working. There was a desperate attitude in the room: there was blood EVERYWHERE, they were pouring sugary juices in the mom’s mouth, running out of the room to call another midwife’s mother to come for help, running out for more towels, cloths, anything! It was utter chaos. The sisters and aunts were outside crying, not knowing exactly what was going on but being able to sense the worry and even terror in the birthing room.  Everyone in the room was moving very fast. 

            I left to create more space in the suffocating room. As I paced the hallway listening intently, my eye caught a young man in a red cap sitting in the waiting room, watching something on his phone, not looking up at all, ignoring the chaos of the evening. The birthing room was in was in eye and ear-shot of the waiting room. It would be easy to see the frantic nature of the birth from the waiting room. When the hemorrhage was more under control I entered again to see what I could do to help. The energy was calmer, but the mother was lying there, completely spent, having lost so much blood, her body limp and unimaginably exhausted. As I began to do what I could in the room to lend a hand, the man in the red cap walked in. Without even a glance to the mom lying in the bed the abuelita whom was present the whole birth excitedly handed the baby to this man. I could not understand why this random man would be handed this perfectly swaddled babe, and then I heard the words, “un padre orgulloso,” referring to the man in the cap. The man in the cap’s shoes were nearly standing in the puddles of blood on the floor from the birth, the woman lay motionless in the bed, unable to move, and he stood there holding his beautiful baby boy. I was in total shock. This was the father? This man who had the demeanor of a bored adolescent in the waiting room? This man who walked in the room, being careful not to stumbled into the numerous puddles of blood and didn’t even look at the woman in the bed was the husband on that very woman and the father of the baby? I went upstairs and I wept. 

            I wept because this, what I witnessed in my first birth at ACAM, is the very problem that our world faces. Every second of everyday there is a lack of appreciation for women as a gender, women’s healthcare, and women’s livelihood. So when the question is posed, “What strategies do you feel will help implement maternal health care as a basic human right?” it feels to me like a question that does not have an easy or feasible answer. The answer would be to go back, all the way to the beginning, and change the “raices” of a patriarchal society.  This man, this husband, this now-father, did not feel the need to be a part of this process with his wife, or to even have anything to do with it. I understand that, culturally, perhaps it is not as common for the husband to take part in the birth process with the wife, but what I cannot excuse is the lack of respect for which he showed his wife when he walked in the room. This woman, his wife, could have easily died while she was bringing the baby that they created together into the world. He had no idea how much blood she lost, how scared everyone was, and how much of a crisis was in the birth room just minutes before he stepped in to receive the perfectly swaddled baby. 

               This problem of inequality in recognizing women’s healthcare as a basic human right is unfortunately something that can only be changed if the way that women are valued in this world changes. There are, however, ways that places—mostly in Africa and Asia (the continents with the highest maternal mortality rates)—are trying to implement to better women’s healthcare as a universal right. For example, according to the Health Ministry Advocates for Human Rights video they mention that medical authorities, experts, and professionals have the responsibilities to enforce women’s healthcare rights and policies. They also mention in this video the need to remove the husband from the equation when deciding how and when the woman will receive healthcare and if she will even be permitted to enter into a clinic and be seen by medical professionals. Another point that was mentioned was access to fixes for fistulas and other child birth health issues that can arise to be more accessible and affordable. This would spare the woman from discrimination and rejection from her community. The video Discrimination Kills mentions the importance of providing culturally sensitive and accessible healthcare for women, and the importance of including women in the family-planning decision making process. This includes the contraceptive usage, and the choice of how many or if they have children at all. 

            These ideas above are beautiful and if implemented then we would see some improvements in women’s healthcare as a human right. However, the problem is, the issue of women’s healthcare goes back much further than any society, healthcare system, or birth control method. The issue of not valuing women’s healthcare as a human right is due to not valuing women and their unique and natural processes in the world. We see that the issue has roots in the beginning of time with deeply rooted gender inequality. The problem is not the lack of ideas, lack of passion, or a lack of movements to work towards universal healthcare for women. The problem is, how can these ideas even be implemented in a society that simply does not value its women and their health with the same level that they value their men?

            The only answer that makes women’s healthcare seem like something feasible to be universal would be education. One of the midwives, Emelda, told me my first shift that she always likes it if the fathers witness the births. There is something very educational for them to see their partner’s body goes through this transformation, this pain, and this process. They need to bare witness to the blood, and the reality of childbirth. If they do this, as Emelda explained to me, they will learn about childbirth and what it really means and requires to bring a child into this world. If they do not see it, then they just walk into the room after everything is over and just get to hold the baby, like this first birth at ACAM that I had witnessed. Often times they will consider birth control methods, or at least respect the woman for the process that she and her body went through to bring life into this world. 

             If the men, in macho cultures (and other patriarchal cultures), were more encouraged to be a part of the birthing process this would help to increase the education about what childbirth really means and requires. It is a model of education and involvement that would and will help to increase the feasibility of universal women’s healthcare as important throughout cultures that condone violence against women on an institutional level. If the man in the cap, the father of the baby on my first shift, had been in the room with his wife, he would understand what is required of the woman in childbirth. There is no way he would not grow respect for his wife after experiencing this with her. However, it is not until a man respects a woman enough to be a part of the process of her healthcare, and become a bit more educated on the topic and the necessity of it, that we will see any changes in the universality women’s healthcare as a human right. However, again, this involvement, education, respect and care for women’s health and healthcare cannot and will not be achieved until we address the depths gender inequality that resides in the patriarchal roots of a culture, and its system of living.