***Warning*** some of this information may be a bit graphic for men or children.
I recently attended a “birth-life-saving-skills (BLISS)” training for Afghan women. I had been considering this as a project for some refugees that have fled the fighting in the mountains. I am no longer just considering, I have decided. It is a great course. I attended the training with another foreign doctor, some Afghan doctors, some educated Afghan women, and some Afghan women who are completely illiterate. I think that many of the illiterate women had seen more births than any of us “educated” people had. The course teaches very simple things that one can do to prevent death during the birth process. For example, cutting the cord after it has been tied off in two places, and cutting between the tied areas. Also, cutting with a knife or scissors that are not full of dirt and mud or blood from previous births (i.e. clean), rubbing the baby vigorously after birth so that it will start to breathe. Often, if the baby doesn’t breathe, they just give up, when something as simple is a rubbing it, flicking its feet, or cleaning out its mouth and nose are enough.
The course also tells the danger signs that indicate the woman or baby needs to be transported to the hospital, and what first aid to render in the mean time. For example, if a woman is hemorrhaging, she should drink a lot of salty water (there are no ambulances here to provide IV fluids on the way to the hospital).
Anyway, this blog is meant to be about the stories we heard the women telling. Sometimes, there are things that are so horrific, that you wonder how people survive having seen it.
Story 1:
There was a woman in a rural village who was hemorrhaging. The description sounded like placenta previa, when the placenta is blocking the birth canal. A baby cannot be born vaginally with placenta previa. She must be born by c-section. The lady who was attending her birth (whether it was a local midwife, or an old woman from the village who is trusted to deliver babies by the sheer number of which she has seen, is not clear), decided to give her pitocin to make the baby come more quickly. (Pitocin, or oxytocin is the hormone our body creates that sends women into labor. Sometimes it is given under controlled conditions in the states to speed up a slow labor, or stop a hemorrhage AFTER birth… in any case it should never ever be given to a woman in a remote village. One of the risks is that her uterus will rupture) When it was clear that her hemorrhage was not going to stop (using pitocin in this case I think ensured that it would get worse). The poor woman travelled 2 hours by car when she couldn’t go further because of the lack of roads. She then got on a horse to carry her the rest of the way (1/2 hour). She and the baby both died on arriving to the hospital.
Story 2:
One woman was having trouble due to a prolonged labor. She was very tired and in a lot of pain. So, the people of the village put her on a blanket and shook her to make the baby come quicker. Then, a dog was brought in to bark and make noise to chase away the Jinn (evil spirits). She eventually hemorrhaged and died.
Story 3:
One woman had three children who were blind. (this often happens here because of inbreeding after generations of women marrying their first cousins) Her husband told her it was because God was punishing her, so he made her fast during Ramadan. (Ramadan is 30 days where Muslims fast in order to gain favor with God. Pregnant women, sick people, travelers, and children are exempt from fasting and women with there monthly cycles are not allowed to fast) The woman became very weak. I cannot remember if she lived or not.
Story 4:
This story is more personal, as the woman was my employee, Nan. She has 6 children, 3 of whom are deaf. She is a very educated woman, who knows this is due to marrying her first cousin. However, when her 7th was born, her mother-in-law told her it was because her breast milk was bad and that she shouldn’t breast feed anymore. The baby was very sickly, and eventually died. She is convinced it is because he didn’t have the immunity that her breast milk normally gives a child. So, she lives in guilt and shame over her 3 deaf children, and over her dead child, because she was trying to prevent his deafness. No matter how much I hugged her after she told me her story, she refused to be comforted. She cannot be convinced that the death was not her fault!
Story 5:
Warning This story is very graphic!
There was a woman who had a very prolonged labor, and for some reason the baby got stuck (it is not clear if the head was too big, or if there was shoulder dystocia). After days of labor, it was clear that the baby could not get out, so someone stuck something sharp into her and cut the baby to small pieces and pulled it out piece by piece.
I don’t write these things for their shock value. I write them to get them out of my head. This is why I am here, so no more women have to go through these things.
