The first one came at night, just like Doña Eulalia predicted. It was 1 AM when the soft rap came on my door, “Chonita,” sang Eulalia, “Nos vamos ahora.” (Sonia, it’s time to go). I called back that I would be right there, threw on my warm clothes, my hat, and my tennis shoes, grabbed my little “Birth Bag” as recommended by MFM, and we headed out the door. The mostly full moon outshone the street lamps as we hustled through the cold to the house about a 10 minute walk from ours. I was so happy just to be called in the middle of the night, I didn’t care what time it was… It felt so authentic! And I was still marveling at how Eulalia knew that it would come at night.
When we arrived at the corrugated house at about 1:20 AM, the Mom was sitting bolt upright on top of her bed, shrouded in a thick blanket and looking very uncomfortable. Two toddlers were snoozing a few feet away, and her husband was running errands around the room. Doña Eulalia bid her to lay down face up to check her dilation. 10 cm, amniotic sack still in-tact. We were golden. It’s worth noting here that in low-resource medicine (or at least from my experience here), gloves are used more for the practitioner’s protection than the patient’s. Eulalia donned one set of gloves and never changed them the whole night. Gripped by a contraction but a few moments later, her whole body went rigid and her face contorted accordingly. Her breathing sped and she looked momentarily murderous, but she did not utter a sound. Eulalia watched her, “With your next contraction, it’s time to start pushing.” The next contraction came and she still refused to push. Eulalia instructed her husband to get behind her and support her upper body while gripping her hands to help her bear down. Next contraction, still no pushing, but her water finally broke and the baby’s head had begun its descent. Eulalia reached for my freshly gloved hand and told me to feel around to see what was going on. Sure enough, about five inches in, was a tiny head. “It’s so close!” I told Mom. “Just a few pushes and you’re done.” She looked at me skeptically as we explained how near the baby was. “I feel like I need to use the bathroom,” she said. Eulalia, smooth as ever even if her patience was starting to crack, assured her, “That’s the baby, it’s really time you pushed.”
Finally, with Eulalia, her husband, and I encouraging her, she pushed through her next two contractions, and just like that, a perfect baby girl lay crying at her feet. Eulalia bulb suctioned the baby and then went to deliver the placenta, leaving the towel drying to me. I was grinning like an idiot as I toweled her off and looked the around the chilled room. A simple, somewhat cluttered space, corrugated metal on all sides but the floor which is concrete, the TV spewing fuzz and an old Meg Ryan movie, Eulalia’s little black birth bag sitting on a corrugated wood tabletop, a queen and a twin bed side by side. Two sleeping toddlers, a woman, her husband, a midwife, the grandma, and me. And now all of a sudden this (F*ing incredible) baby. Amazing. It’s not like I haven’t seen it before, but it still blows me away.
The baby was out at 01:59 AM, the placenta delivered completely intact about 5 minutes later. Eulalia had her instruments cleaned with alcohol before she clamped and cut the cord. As I dressed and swaddled the baby, Eulalia cleaned her instruments again with soap and water (including the bulb), and packed them away until next time. Several signs that point to rural Guatemala as a veritable baby factory – there was no overthinking skin-to-skin – we dressed the baby before we even handed it off, the whole family was present and very comfortable with the process, and we were in-and-out in less than 2 hours. We left the family with instructions to call if there was any kind of excessive bleeding, and otherwise we would be back the next day to check on them.
At 3 AM, we strolled back out into the cold, the moon had only slightly shifted its position in the sky. We agreed that it was a very smooth, healthy birth. I thanked Eulalia again for showing me how it’s done. She smiled and said we could now sleep soundly knowing we would not be woken. Oh, and she let me in on how she knew it would come that night: She had snuck out at 6pm to check on Mom, who was 2cm dilated then… So sneaky, Doña Eulalia! I smiled even bigger.
And sleep well, we did.
The 2nd birth I attended with Dona Eulalia was at night after 3 days of a stomach illness for, but with my intestines under control for 3 hours I decided to brave a birth in San Rafael, a neighboring me town about 15 minutes by car. It was raining like the Great Flood, so we called the Bomberos, again. God bless their helpful hearts, they drove us up the muddy mountainside to San Rafael and picked us up again when it was all over. Other than having no electricity, the birth was equally as smooth and uneventful as the first. She was 8 cm dilated when we arrived, so Dona Eulalia helped her cervix along with a little oil and stretching. She delivered a perfectly healthy baby boy at eight minutes after nine. Eulalia wanted me to help with clamping and cutting the cord, which I happily assisted in. What I did not realize was that she wanted to photograph me doing it, with her gloved and bloody hands. It was too late for me to intervene, so I simply watched in semi-horror as she placenta-ed my iPhone. And then I laughed and made a mental note to clean the hell out of it later.
In both births, nobody made a fuss of congratulating anyone, it was simply another day, another baby. It amazes me that in two hours we can arrive, deliver a baby and some education, clean up, and leave the home in exactly the same condition we found it, except with a new crying baby. We are the storks.