Sunday, February 28, 2010

Midwives in Senegal

"I have shared my belief and faith that birth is a physical occurrence for a meta-physical change, and will be the best day of your life. Yes, I have sometimes doubted the process of birth but never the outcome, not even in the face of babies who were not ready to be or stay with us. I have studied everything I could get my hands on in my journey to midwifery but nothing has prepared me for what I have seen and felt here.
At Kafountine I have met women who trust birth and its outcomes without question. They trust birth because birth is. I have met and worked with the sage femmes and matrones, collectively the Sista-midwives here, who routinely manage birth complications that many U.S. home birth midwives have little experience with, except to transfer. Here, even with the grossly limited resources available and the near impossibility of transfer, these Sista-midwives do not recognize our Western distrust and “what if” of the birthing process, of birth or birth complications—they just do what they can do, always prepared for whatever outcome God and nature dictate."

The above is a quote from a midwife named Claudia, founder of Birthing Hands DC, who traveled with several midwives and midwifery students to Casamance, Senegal to work and learn in a birth clinic. I seem to have found the blog detailing her experiences just after they have returned to the States, but it is a fascinating read!

The Birth Clinic is located in Kafountine, a village in west Senegal. It has permanent residents who are Wolof, Jolla, Mandinka, Peuhl and the various regional sub-tribes of these major tribes. In addition, it has residents who have migrated, on a permanent or temporary basis, from the Gambia or Guinea Bissau.  Almost everyone understands Arabic and some French in addition to several local languages.

Here are a few quote that I pulled from the blog posts that I found particularly intriguing:

"There is a high incidence (over 20%) of fraternal twins in Senegal as elsewhere in western Africa.  The common belief that this high incidence is a result of the consumption of African yams and sweet potatoes."

Only female friends and family members support the laboring woman. No men are allowed to see or be near a birthing woman and her birth fluids.

"The women are more staunch in getting the laboring women to move and walk and work hard. Labor is hard work and the faster and harder, the sooner the baby will come. Laboring women do not make much noise; the shake their hands, tighten and beat their fists, compress their forehead, jaws and faces, hold heir lower backs; and first time mothers kneel to the ground; first time Peuhl mothers sometimes call out for their mothers."

"These Sista-midwives are not proponents of “mother the mother” and “warm fuzzies” in labor. Tough love is practiced here by the midwives and the female family members—the message is “birth is hard work!” Fundal pressure was used only once in our presence and discontinued when we remarked about it. Women birth lying flat on the delivery table with their hips resting on a large bed pan.  Also, no female family members or friends are allowed to attend the birth."

In the village of Kobar, they visited and chatted with the traditional midwives. Here are somethings they learned about their traditions and beliefs:

"Dig a hole in the ground to bury the placenta. Encircle the placenta with the umbilical cord.  Make sure the end of the umbilical cord extends above the ground, like a baby plant. Failure to do this, especially leaving the end of the cord above ground, may lead to infertility."

"It is customary not to discuss the fetus!! The fetus is not a physical being but a spirit space and only God can know what is happening there. Instead you can ask, “How is your belly?”"

How do you treat post partum hemorrhage?
  1. Many Jolla women wear bracelets made of iron which is used as a form of protection for them.
In birth there is a lot of water, meconium and blood. If there is too much blood the Jolla woman takes her bracelet and sucks on it.
  1. Also – will place a woman in a very high concentrated salt bath.
  2. Last resort – the hospital.

All photos above are from Birthing Hands DC's flickr account - check it out to see more photos of the midwives' trip!

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