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Comfort Measures!!!

Tammy and I have just had the most fun with rebozos since we introduced comfort measures to the women in the DRC. The Kenyan doulas breathed a collective sigh of amazement when they saw the first rebozo technique performed. I have to agree. Rebozos are amazing.  A simple and versatile tool to help meet many needs in labor.

We were not sure how much experience they would have with comfort measures. Most of the women are midwives by training, and we were concerned most of what we taught would be repeat information for them. But in reality it is not repeat information. They know how the information determines their role as midwives, but the role of the doula is different.  We did not need to teach them about birth, but we did need to teach them what a doula does at birth.

You can see the photos of our day here. The photos were not posed; we really were having that much fun. If you didn’t get a chance to see the women learning during day one, check those photos out here.

Tammy’s big surprise for the day was the induction process and cascade of effects on labor. It was almost identical to the induction process in the United States. But unlike the American women, Kenyan women do need to undergo induction unless they are post-dates, which is defined as 10 days beyond the estimated due date. The women were shocked that Americans will induce a woman at 39 weeks, and even more shocked the doctors needed to be told to stop inducing at 37 and 38. Honestly, from what we have seen and heard about the hospitals, there is no room to bring a woman in for a potentially two long induction.

A disturbing similarity we are experiencing is a collective warning to stay out of the public hospitals. The ministry of health tries to encourage women to give birth in hospitals, but the poor women know how they will be treated in labor at a public hospital and choose to avoid that treatment. This was exactly what we were told by the women in DRC. We find this very similar to the current movement in the USA to give birth at home to avoid unwanted interventions – though on a much smaller scale in America.

We spent the afternoon working through some scenarios to represent problems a doula may face. We were so encouraged by how quickly the women adjusted to the doula role, and we were greatly entertained by how wonderful many of them were at pretending to be in labor. In return we entertained them with our Swahili.

The writer from the parent magazine arrived today and watched part of the training. He was very impressed and shared his belief that this type of work would be very beneficial for the women of Nairobi, but he also challenged us and recommended the training would be helpful for rural women as well. We don’t disagree, we just know how difficult that was to arrange in the DRC.  But we have such an amazing group here in Nairobi, we could eventually expand.

We have already begun making plans for returning next year. I know the trip will be in the middle of my final semester, but I also know I cannot miss it. How wonderful that my global health teachers will encourage me to miss class for the trip, and my nurse-midwifery teachers will be equally excited for the opportunity.

 

 

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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