December 8, 2010

The Namesake

I watched a live birth and now feel like a parent.

You may remember my friend Fanta’s sister, Kumba. I spoke about her in one of my previous blogs, the 15-year-old girl that had been married off and was fighting tooth and nail to get out of it. Yeah, she got pregnant. At first it was really upsetting for me to see her pregnant. But then she moved from her husband's village back to my village, and the more I saw her and the longer I was here in Gambia, the more I got used to the idea that having kids or being pregnant here does not equal maturity or adultness. It's just something that happens.

On Saturday, I had to go to the bank in a town a few hours away. On the way to the road, I stopped at Kumba and Fanta’s compound to greet and see about the drumming program that night (Fanta and her friends all chipped in to hire drummers to come so everyone could dance. The drummers came Friday night and were coming again that night). Their mom stopped me and told me Kumba’s stomach hurt. I didn’t hear her at first, and thought she said Mba’s stomach hurts (which is a male name here). So I said, What’s wrong, diarrhea? Because 9 times out of 10 that’s what it is. But she explained again and then I realized she was saying Kumba and meant the baby. So I freaked out and ran over.

Kumba was laying on her bed with the TBA (Traditional Birth Attendant, the woman in my village that delivers all the babies). The TBA informed me that Kumba’s water broke (I had no idea she was even at 9 months yet. She made it seem like it was only 7, but people here never know how long they’ve been pregnant. No ultrasounds or anything). My first thought was to get her to the hospital, but it was clear that was not a priority for anyone there. So I did my best to convey in Mandinka how the first births are always the most dangerous (which I’m sure the TBA knows herself) and that Kumba needed to get to the hospital now before she would become unable to be transported. The TBA was definitely offended that I was implying that she couldn’t cut it. But I didn’t care. I called someone in the next town to go to the car garage and send a cab here. I couldn’t wait for the taxi to come as the car to the bank town had stopped to pick me up, so I gave her mom money for the cab and told them I’d meet them at the hospital when I returned.

On the way to the bank, I was feeling really guilty because during the drumming the night before, I had forced Kumba to get up and dance with me. Honestly, I had no idea she was 9 months pregnant. I kept thinking over and over again, what if I caused her to go into early labor? What if the baby dies because of me? But then, I thought about how I would watch our 9-month pregnant cook in my training village chopping wood with a super heavy ax. AND THEN, I remembered seeing Kumba all last week pounding with a huge, heavy pestle (or mortar? I can never remember which is which) and realized that there’s no way the dancing was harmful. And I felt much better.

I got back around 4pm, fully intending to go straight to the hospital, thinking that the drumming had been cancelled. But Fanta (my friend/Kumba’s sister), who had just visited Kumba at the hospital, said she was going to attend the drumming program (which would start after 10pm) and then return to the hospital after, around midnight, because it didn’t look like Kumba was going to deliver anytime soon. Fanta’s plan sounded perfect, but what if she was wrong, and Kumba suddenly delievered?

While I definitely wanted to go to the hospital to support Kumba--if Fanta had not assured me that their mother’s co-wife, Lindo, would be with Kumba until her discharge, I would have gone right then--the biggest reason for wanting to go was purely selfish: I thought it would be really cool to see a birth and maybe my only chance to do so. Even though I really, really wanted to go to the drumming/dancing program (it would be my last drumming session ever), I DID NOT want to miss the birth. I have seen many drumming sessions, but would probably never have the chance to see a birth ever again.

I was considering just skipping the program and going to the hospital right then, but I didn’t want to show up at the hospital at 5pm only to have Kumba not give birth until 9am the next morning and have missed the drumming for nothing. So I called one of the guards I know at the hospital to get the number of one of the maternity ward nurses so I could check in and see how far along Kumba was. He wasn’t working, but gave me the number of another guard who was. I called him, and he went to the ward and gave the cell phone to one of the nurses so I could talk to her. She told me that Kumba was probably not going to deliver anytime soon because she was refusing to walk around. Typical.

Still, I was not completely convinced that I could get away with going to the drumming and still see the birth. So I got the nurse's number and decided that I would keep calling and checking in and if at any point she told me Kumba was about to deliver, I would drop whatever I was doing and go. Luckily, Kumba’s mom came home from the hospital right then and said Kumba will deliver before morning, but not before the drumming. She’s had maybe 6 kids, so her saying that was like my ticket to go to the drumming without worrying about missing the birth.

After the drumming, Fanta (my friend/Kumba’s sister), Fern (my friend in PC that lives nearby) and I walked the 2 miles to the hospital, arriving around 1am. Luckily, their mom was right, Kumba had not given birth yet; her contractions were several minutes apart. The nurse was asleep when we arrived: very comforting. And the mom’s co-wife was nowhere to be found. When I reached Kumba she was asking me to help her because the contractions really hurt. I was stunned when the nurse told me they don’t give the patients any medicine until after the birth. I asked the nurse how often they check in on her and he said every 3 hours. I checked her chart and the last check-up was 3 hours earlier. I was like, Yo guy, I think it’s time to check. So he grudgingly did. These night shift nurses are so lazy, you have no idea.

After he checked her, Fern and I went back to Kumba. I held her hand, rubbed her back, just tried to comfort her however I could, but I could never tell if she wanted me to be there or not. Meanwhile Fanta and mom’s co-wife, Lindo, are just sitting on the far side of the room. Fanta, who is around 7 years older than Kumba, has been pregnant twice and lost both babies. She looked really red-eyed and possibly teary. I figured she must be feeling a lot of concern for her younger sister and also sadness over her previous birth experiences. So, I understood her wanting to sit away for a bit. Lindo, however, I felt really should have been with Kumba.

After awhile of Fern and I being next to Kumba without Lindo nor Fanta coming over, feeling more and more unsure if I was breaking some Gambian protocol and worrying if Kumba even wanted us around, I decided to ask Fanta what the hell was going on. Fanta informed me that “It’s not good to be over there before Kumba gives birth.” She wouldn’t explain why, so I just figured it was some cultural thing—no matter how long I stay here there are so many practices I’ll never understand—but, if you ask me, it sounds like the most counter-intuitive thing in the world. Kumba is only 16 and this is her first baby. While 16 is by no means outrageously young to be giving birth here, it is considered young, nonetheless. I asked Fanta if it made her upset that Fern and I were there and she said, No, but I’m not going. So I returned to Kumba, where I stayed until the end of the birth. And I left Fanta sitting, where she stayed until the end of the birth.

When we first arrived, during Kumba’s first contraction, I immediately felt like coming to the hospital had been a big mistake. Earlier, I had been determined to stay for the entire birth and spend the night until she had been discharged, but seeing her wince and whine and then watching the nurses (a second one came, in plain clothes) examine her vagina, I didn’t know if I could take it. I also couldn’t tell if Kumba was embarrassed that we were watching the nurses’ examination or if she just didn’t want us there or what. So at first, it was pretty awkward and scary. But once her contractions sped up and the nurses were ordering her to push, Fern and I began to have more of a defined job. When the contractions would come, we would help her keep her legs bent while she pushed.

At one point she called the nurse over and said she had to use the toilet. I started helping her off the bed but then he said she couldn’t go anywhere and to wait for him to bring a bed pan over. At that, Kumba said she was ok. I asked her in Mandinka, are you really OK or do you just not want to go in the bed pan? And she said she didn’t want to go in the bed pan. And I said, what if I send everyone else away? But she said no. After a few more contractions and pushing, it became clear that Kumba had had a bowel movement. In other words, it smelled like shit. I asked Fern if she smelled it and she agreed (Kumba doesn’t speak any English, so we could talk without her knowing what we were saying). Kumba seemed coherent enough that I was worried she might get embarrassed if I tried to clean it up and I wasn’t sure if she had noticed yet, so I left it alone. But then it became clear she had realized what happened and was trying to fix it. So Fern got out some toilet paper and I cleaned up the bed and her. With every contraction and accompanying push, more came out, so I was literally wiping her ass. Although it was pretty gross, I was surprisingly not that bothered by the task. I think I was just happy to be needed and helpful.

Then the contractions got much faster and bigger and Kumba would sort of thrash around and scream and shake. And then she started saying, Mahana, I’m going to die. I’m going to die. (Mahana is my Gambian name.) And I kept saying, No you’re not, I promise. You’re not going to die, I won’t let you die. But I could tell she was really scared. She was crying and yelling for Lindo, her mom’s co-wife, to come. So Lindo came and checked in momentarily and then went back. Kumba grabbed her shirt to stop her from walking away and was crying out, Mom! Mom! But Lindo just shook Kumba’s hand off and went back to her spot. (I later asked Kumba about them not coming over during the delivery and she said it was because if they stood there they would cry and crying is not good. So don't think they are really cold for not being there for Kumba when she was delivering. Gambians are really weird about crying, it doesn’t mean that they didn’t want to be there for her and support her.)

Eventually the nurses decided it was time to actually do something. So they came over and gloved up and got ready to deliver. And then, get this, the power went out. It’s not like it just randomly shorted. It happens every single day. There is only power from 7pm-2am and 9am-3pm. It was after 2am and the power shut off and it was dark. They got some flash lights and came back. Fern was holding one flashlight and they set up another one on the end of the table. It was seriously like being in a movie about Africa. I couldn’t believe it.

At first I thought I wouldn’t be able to watch the actual delivery, like the baby coming out of her vagina, but then I realized I could do it, and not only grudgingly, I actually was much less grossed out than I thought I’d be. After a lot of pushing, I could finally see just the top of the baby’s head and the hair. And I yelled to Kumba in Mandinka, I can see its head. It’s coming, PUSH! And so she pushed and pushed and I was holding her hand and yelling and she was sort of screaming and the baby’s head was coming out and then she gave a big push and its head came out. It was sideways, eyes shut. It looked dead and I was terrified that it was. Immediately after the head came, the rest of the baby’s body just slipped out, umbilical cord and all.

I was really surprised that the rest of the body came out so quickly. I was still terrified that it was dead, but a couple seconds after that, it started to move and a wave of relief and amazement washed over me. I couldn’t believe that just seconds ago, there had only been 5 of us, and now there were 6. It was the craziest, most amazing thing in the world. I looked up at Kumba and said, The baby’s here! And she said, What? She hadn't even realized the baby was out. So I said, Look! And she leaned forward, saw the baby, smiled faintly with relief and lay back down.

They cut the umbilical cord and carried the baby over to a little basket-like thing. Normally they put the babies on this table which has a ton of lights to keep it warm, but seeing as though there was no electricity, they couldn’t do that. I totally forgot to ask about the sex of the baby, so I did and they told me it was a girl. I went back to Kumba and told her it was a girl, and she looked at me and said, I’m going to name her Mahana. I started tearing up a bit, but managed to keep it together.

Then the nurses came back and started to take out the after birth and all that shit. It was disgusting. At one point I made a face like I was going to vomit while watching (not on purpose, of course), and then I looked up and Kumba was watching me and just laughed nervously. I felt bad, she was clearly embarrassed by all of us looking at her vagina and my being grossed out didn’t help.

I can’t remember if there was a lot of bleeding right after the birth or not until the after-birth, but at some point, she started losing a lot of blood. It was spilling out onto the bed and then onto the floor. Some of it was making it into the basin under the bed, but a lot was not. It was really gross, like a horror movie. And more than that, it was really troubling. I don’t know much, well, anything, about births, but it seemed like she was losing wayyyy too much blood. I started freaking out. It didn’t help that there was a big poster in the room about a study that was done on the causes of mother morbidity (not sure if that’s the right word, aka mothers that die giving birth) and the main cause had to do with blood. Either that there was no blood available for a transfusion or the loss of blood wasn’t diagnosed early enough, etc.; obviously I had read that poster several times throughout the night so I was really scared. But the nurses assured me it was ok, that there were just some small tears. They found them and sutured them up.

At this point, it was after 3am and we were all exhausted. So all of us, Fern, Fanta, Lindo and I, found some empty beds and went to sleep for a couple hours. I should add that as soon as the baby was born, Fanta and Lindo came over and Fanta silently cried. When I woke up around 6am, I went back to Kumba and found her sleeping with fresh blood on the floor and on her bed—confirming my worst fears that she was going to die (clearly I have no concept of the fact that women bleed a lot after birth).

I freaked out and immediately went to get the nurse who, surprise surprise, had not checked on her. So he came back, checked out the situation, rolled up a ball of gauze and shoved it inside her (they were fairly rough throughout the entire birthing process). He said he would monitor how much blood was being loss by how bloody the gauze was. She cried a lot and kept begging him to stop. I said, Uh, don’t you think you should probably figure out why she’s bleeding. But he didn’t seem too concerned. Then I said, Don’t you think she should breastfeed now? Maybe that will help stop the bleeding (for those of you that don’t know, breastfeeding somehow alerts the mother’s body to stop bleeding). He said sure.

So I brought over baby Mahana, as I like to call her. Kumba said Mahana wasn’t going to know how to breastfeed and I said, yes she will. Just try. (Lindo and Fanta were still sleeping at this point). Without even a second of hesitation, Kumba brought the baby up to her breast and expertly used her hand to manually extract some milk onto the baby’s lips (something I’ve always heard was not naturally easy for women to do and in fact took some time to learn). Once it sensed the milk, with its eyes shut, the baby began to open and close its little mouth. It was the most amazing thing in the world. I cannot even explain it. The way in which Kumba, this little 16 year old girl, knew what to do and the baby automatically knew to start sucking. It was so beautiful. I was very impressed by the whole thing. Then the two of them fell asleep together on the bed. I took a picture. But her breasts are showing, which ain’t no thang to me, but is slightly pornographic to people living outside the continent of Africa, so probably I will not post it here. But believe me, it’s a beautiful picture.

Kumba was discharged around 10am. Her bleeding tapered off significantly and completely stopped the next day. (Despite cleaning staff coming at 7am, I don’t think the blood was actually cleaned up until around 9am. It was just sitting there on the floor under the bed.) I spent the rest of the afternoon with another baby Mahana, she's about 5 months old (I now have three namesakes, or tomas as they’re called here--babies that are named Mahana after me), and the whole time I felt a physical ache being apart from Kumba and her baby. I felt like it was my baby, too, almost like I was the father or something. I know that sounds weird. I can’t really explain it, but they were all I could think about. All I wanted to do was be close to them. The experience definitely bonded the two, well, three, of us in a way I can’t begin to describe. It was just unbelievable and I feel really lucky I was able to experience it and that they are both healthy.

Ok, that’s all (hahah, a 6-page blog post). I left my village for the last time today. It was pretty rough, Kumba sobbed last night and this morning. Maybe I will write about that later this week. But for those of you that are wondering, I will be home by December 20th.

Non-pornographic pictures coming soon.


Marta Thompson said...

Marnie this is truly amazing. Thank you for sharing. You are a wonderful friend to have around and I am sure you will be sorely missed. I am also happy that you are living every second of your life there to the fullest, and not shying away for adversity or the unknown. I'm so proud of you and even though its hard to leave, at least you're leaving behind three little namesakes!

nadia.ayloush said...

I can't believe this entire blog post. First of all, you have just won your spot as one of my leg holders whenever I decide to have a baby. I might even pick you over whoever my husband may be at the time. Secondly, I am completely amazed that you handled that whole experience like a champ. I think I would have fainted and maybe thrown up a little bit. Sounds like a truly amazing experience and I'm so proud of you! You will never forget an experience like that and I'm glad Kumba had you there with her to provide the support and comfort she needed! On another note, I am very excited to see you so soon and I can't wait to hear some more of your stories. Love you!

The Ferris Wheel said...

Wow, Marnie. What an amazing finish to it all. Best of luck on your return stateside!!!

Adina said...

Marnie, this is the most amazing post! What an incredible experience. You've clearly left such a permanent impression on people's lives there! I love you and miss you and am so proud!!