A divine appointment. The desire of my (Ally) heart, delivered, literally. A beautiful answer to many prayers leading up to leaving for the year. For those reading that don’t know, I have been a neonatal intensive care nurse for nearly 6 years now, as well as a midwifery assistant for home births for 2 years. My long-term goal is to return to school for a second masters as a Certified Nurse Midwife. Back to the story. Yesterday, October 30th, I delivered a baby at a rural health center in the bush of Zambia, alongside 3 other teammates who hope to be midwives one day as well, one a new-grad nurse. The experience was beautiful, inspiring, and vision casting for us all. I hope this live birth is the first of many on the race I assist with. The Lord was so sweet to orchestrate perfectly all pieces of this night/day. I have also been working on a maternal/infant health survey in each country we have been doing ministry in so far as an extension of my nursing education master’s degree capstone thesis project. This experience gave me so much detailed information about maternal care here in Zambia and learning from the amazing staff there was such a blessing. My project for my masters was the development of a skilled birth-attendant training program for communities in rural Africa. I read study after study, but nothing compares to first-hand experience and learning from those who work on the front lines of community health in the rural areas.
Brandi, Breanne, Allison (also a nurse), and I. *Monster to share in case we were up all night*
I was able to work with the amazing hosts us girls are here with in Zambia (more to come about our regular ministry soon) (and yes, Austin and I have been apart all month) to coordinate a trip further into the bush than we go for regular ministry to a very busy, under-served, under-resourced health center in Nyawa, Kuzungula district. Our host is working to dig a well in a neighboring village that currently has no water. They walk 8-10 miles for water at the moment, so the trip out there coordinated with their most recent drilling attempt. I invited the other girls on our team who are interested in nursing/midwifery to come along because my desire was to see their hearts lit on fire for the care of women and feed their dreams to care for mothers and babies in a holistic way as midwives as well. Our day and a half there was so awesome for everyone and turned into a beautiful ministry opportunity to many mamas who had delivered the past few days and many there waiting to give birth. This clinic serves 21,000 people that live in the rural villages of the surrounding region and has around 10-15 births a week. The health center is very primitive, dated, small, and has very little resources, but man, they work so hard to protect moms and babies. Zambia has a goal of no maternal deaths and their tiny birth room walls were covered in algorithms for the management of many complications, when to transfer, as well as a simple area for neonatal resuscitation, complete with the NRP guidelines on the wall. Definitely made me miss my job as a NICU nurse and midwifery assistant a lot. All births there are natural, as pain meds are not an option. Only when they have local lidocaine stocked do women receive any for stitching tears after delivery. For my nurse friends, they also do not use Pitocin at all because they cannot monitor baby or mom well enough.
*The delivery area at Nyawa Health Center*
We made the 2.5hr drive out there at night, arriving at 9pm and we camped out front of the clinic in our tents. The mama we delivered was in labor when we arrived so we got a tour of the small facility by the “In-Charge” public health official named Martin and met her and the other fresh postpartum mamas, 3 babies had been born that day. We slept for a bit and then Allison (the other nurse) and I were up with the staff and mama in labor from about 2-4am as she was struggling to progress and it gave me a chance to chat with the one nurse on duty that night about a few of my survey topics. He has been a nurse for only 6 months. No doctor. No official midwife. Just him. Crazy. I am so inspired by their ability to work well in such limited-resource conditions. Wow. They are so creative and innovative.
*Where we stayed for the night*
After the mama went back to rest and take advantage of her stalled labor, we slept for another hour and then we all woke and packed up our tents at 5am and started the day before patients began arriving. Again, the Lord’s divine timing, the day we were there was also the antenatal/prenatal appointment day, so as early as 6:30 mamas started lining up for their appointments. The clinic sees around 50 mamas each week on their prenatal day. In the later morning we were all able to help with the prenatal appointments and learn from the nurse doing them that day. She was really sweet and after observing a few she looked at me and was like, okay, your turn. So I did a few of the appointment assessments and then we then got all the girls to do head to toe assessments, measure fundal heights, and listen to fetal heart tones with very outdated fetoscopes. I loved teaching a bit and seeing the girls step outside of their comfort zones, hunger to learn, and also love on all the mamas so well. They will all be great midwives some day!
The mothers shelter *See below*
The day before we left for the health center, I asked our host how I could bless the mamas that are there waiting to have their babies. See, many women live SO far away they all come at about 34-36 weeks and live at the Maternity House until they deliver so they can be at the health center rather than home alone without assistance. However, they are responsible for providing all of their own food, bedding, water, ect while they are there. This is very difficult for many, rural families are very poor, especially this time of year at the end of dry season when families are running out of food waiting for the rains to come so they can plant again. So, she said bring them food. Most of those mamas need better nutrition as a whole. So the other nurse, Allison, and I went in together and bought salt, sugar, beans, dried fish, tea, maize meal, and cooking oil for all the moms. In addition, we got laundry soap, body soap, baby lotion, baby soap, and postpartum peri-pads. Gifting these items to them was such a blessing. We spent time at the maternity house early in the morning, sat and talked with the mamas, prayed the Lord’s protection and Hand over each of them and their babies and approaching labors. It was so awesome. My heart beats for mothers. The rural African mothers are, in my opinion, the strongest women in the world. I have so much admiration for them, their sheer grit, hard work, and endurance against conditions that many of us could not even fathom is incredible. I literally love them so deeply. That maternity house is basically 3 empty concrete rooms. They sleep on the floor at 9 months pregnant, patiently waiting for labor to start. And yet, such joy. One of my favorite moments was teaching them to use peri-pads. Most, if not all, have never used a pad in their lives. For period and postpartum they use strips of fabric or nothing. Access to sanitary items is a HUGE need in the rural areas. We all laughed together as I stood up and showed them where it goes, how to open the pad flaps and reiterated many times they are not washable, as Africans save and reuse everything, which is awesome, but not with those. What we really needed was the reusable pads!
*Passing out our care packages*
Teaching about peri-pad use.
*All the mamas waiting to deliver*
The mama we delivered was 18 years old and her husband was not there, as she lives very far from the clinic. I am so thankful we were there to support her, pray with her in the middle of the night when her labor was stalled and bring with us the comforting presence of the Holy Spirit. She finally made it to 8 cm by 10:30am and was fully dilated by 11:30. She only pushed for about 15 minutes. Allison was with her at the head of the bead, beautifully encouraging and loving her. I was with the nurse, supporting her perineum to avoid tearing as she pushed (sorry TMI). When we finally got the head out, we could tell the baby was really big, no wonder it took so long! We were having trouble birthing the shoulders until I found the nuchal cord around her neck and once I freed that the rest of the body delivered well. The baby was a bit “stunned”, floppy, and blue. Made my NICU mind a bit nervous for a minute knowing we had nothing beyond a bag/mask for resuscitation, but with some good stimulation on mama’s chest, suctioning of the nose, mouth, and yes, an old school turn upside down by the nurse we got her crying and clearing those lungs. All 4 of us cried, well 5 counting her mom when we told her it was a girl finally. For Brandi and Breanne, who hope to become nurses and midwives, this was their first true, involved birth experience. How cool?! Birth is so powerful and showcases amazingly the perfect design of our heavenly Father, Creator. I am left speechless, every time. Her mama named her Precious. And that she was. She mama was so stoic and strong. Literally not a peep the whole labor. Not until we were repairing her grade 2 tear with no meds did she show signs of pain. This is just what you have to do out there. Like I said, these African bush mamas are the strongest women in the world. In two days, she’ll walk many miles home to her village with her new baby.
*Baby Precious and her sweet mama*
I could stay there. Officially moving to Nyawa Health Center. On a real note. I am just so thankful. As we were driving back to our home base, the Lord spoke to me and said, Daughter, I gave you the desire of your heart. I see you, I hear you. I gave you this passion and vision for a reason. I just cried as we drove. Overwhelmed by His faithfulness. My heart beats for them. Every mother deserves a safe, caring, compassionate delivery. I will use my life to advocate and fight for them. Pray with me for the health of Precious and her mom these fragile first few weeks. Most neonatal deaths occur in the first month after delivery. May she be covered, provided for, and protected by the hand of the Lord so evidently.
Thank you for letting me share a piece of my heart with you. Hoping and praying for more births this year. At least one on each continent for my global maternal and infant health survey. And please keep praying for rain. This land is dry and hurting. Can’t wait to share more about our month of rich ministry here in Zambia and also hear from Austin. I haven’t talked to him all month as the boys are in the bush of northern Zambia and we really wanted to be intentional this month with the girls and guys we are on teams with. I get to see him in 6 days! By the time you read this we’ll probably be back together. Praise the Lord!
Love to you all,
Ally
