Contrast...

After a long night on call with several women in labor and a lovely birth, my head has had time to fill with the contrasts between how we practice obstetrics here versus what I'll see in Haiti. Nothing like being up all night thinking...literally.

Part of me is really excited that I'll be able to really get to the roots of midwifery; the essence of birth without all of the hub-bub of intervention and convenience. BUT with that also comes a lot more sadness and tragedy. We live in a culture where birth is supposed to be "perfect" and fit into a certain high expectation. We are not supposed to acknowledge that death happens with birth and that they are not mutually exclusive in most of the world. And of course, when something devastating happens, it MUST be someone's fault. As a contrast, I'm going to a place where women understand that childbirth is a dangerous proposition. 60+% of women don't have prenatal care and many don't have a trained provider there to attend the birth. With birth comes the chance of death, and it is understood that the "perfect" birth cannot be assumed. With an infant mortality rate of about 6%, it is just part of the risk of having a baby.

I had a great chat with my backup physician overnight about the experiences I might have in Haiti or on my upcoming Doctors Without Borders adventure in the fall. I have to say, I've been exposed to a ton of complications over the past couple years which I can only assume were put in my way to prepare me. Cord prolapses, vaginal breeches, eclamptic seizures, sepsis, etc... The "see one, do one" mentality very much applies considering where I'll be. Most of my fears come from the fact that I'll likely not have a physician available to take over if the shit really hits the fan. Just me. (Hence my mantra at the moment "I can do it I can do it I can do it") :-).

Alright, enough for now. Forgive my ramblings....lack of sleep will do that to a peson.

More later,
M