Tuesday, December 20, 2016

Placentas, air pollution and four week old babies

Air pollution, placentas  and  four weeks of pregnancy

Air pollution from a wide variety of sources acts metal development causing a wide range of health problems including prematurity, low birth weight babies and developmental delays.  Each year, we spend billions of dollars to care for infants and children impacted by air pollution- while failing to prevent these complications by tending to a cleaner environment.
The fossil fuel industry, including fracking, transport and storage, cause significant damage to newborns.   This is most often in low income communities due to zoning laws that protect higher income babies from an increased level of air pollution.

Researchers have worked hard to determine exactly how and when air pollution impacts the health of babies.   They mostly depend on retrospective studies that look at air pollution on specific days and then look at prematurity, gestational hypertension and other birth defects of pregnant women impacted by the air pollution.  They look at women who live within a mile of fracking as well.

The studies have been completed in many of our fossil fuel extraction sites as well as sites around the world.  Brown University, John Hopkins and Colorado School of Public Health have all found a correlation.

They found a correlation between fossil fuel extraction and its ambient air pollution with prematurity, low birth weigh leading to future disabilities, congenital heart defect, and gestational hypertension.

No one knows exactly how prematurity happens but they suspect that the earliest weeks of pregnancy are some of the riskiest for the unborn baby.  One baby suggested that ambient pollution at just four weeks is the most dangerous.  Many women do not even know they are pregnant yet.

Researchers believe it has something to do with placental implantation being impacted by the chemicals in ambient air pollution.  It also can cause an inflammatory pathway that exists throughout the pregnancy.

This is consistent with researchers who now believe that eclampsia begins in the placenta.

The Environmental Protection Agency is charged with making sure that corporations do not hurt the health of humans and the natural resources that protect their health.   States, county and local governments also are charged with making sure the air and water is clean.  They believe that pollution is a necessary evil for jobs but few acknowledge that the health care an school budgets are greatly impacted by "looking the other way."

A pro-life community assures clean air for all people and most of all - the most vulnerable- the yet to be born and their placenta.

Big business continues to move ahead with pipe lines, fracking and a wide range of storage and transport  mechanism that shed pollutants into the air where an unsuspecting pregnant women is impacted for the rest of their life.

New Republic ( 2/15/2014)

Monday, December 19, 2016

What's a baby sacrifice zone?

I was writing and I thought well, if there are city and country sacrifice zones, then there are also Baby Sacrifice Zones.  There are cities, rural mining areas, whole countries that are sacrificed so that some people can  be wealthier.  The high pollution levels are accepted by the general public because of the jobs or income or products that sacrifice offers.

The problem is that most often the people living in "Baby Sacrifice Zones" may not know the danger to there children and most often don't benefit from the economics of the zone.

A Baby Sacrifice Zone is a place where women are exposed to large quantaties of polluting factors, over time, that impacts the health of their reproductive system, hormones, births and their children.


           You may be asking but how do Baby Sacrifice Zones get created?

That's a great question.  It's different in different parts of the world.  But it goes something like this.  A business enterprise needs raw materials or wants to process them and so he looks for a place to do this.  It may be extraction or processing or making a product.  They know they can not do this in a place where the wealthy live.

So they look for a place they HOPE no one will say anything until its too late.  They work with government to skirt laws and regulations and wham - we have fracking and mining in rural Pennsylvania and oil trains in Eastern Oregon and a pipe line in Standing Rock.

In cities, like mine, the government annexed low income communities of color and then used them for their Baby Sacrifice Zone.   They told them it would mean jobs or city services and then mostly gave them pollution and damaged health.

           Did they know this would cause premature births?

Most likely they did not....BUT THEY DO NOW.

            The research is clear but no one is willing to break up the heavy industrial zoning that causes
BABY SACRIFICE ZONES.   City Planners are holding tight to the idea that all heavy industrial must stay in one place- and that one place is a low income, historical community of immigrants and forced immigrants.

Voting Pro-Life

I originally wrote this before the election when I was hoping people could see that pro-life policies include creating a healthy life for the next generation; that climate justice, healthcare, and good education are all part of a pro-life political platform.  I post this again, on the day the electors meet, with a prayer, that they will vote for the next generation's well-being.

Voting “pro-life”

I listen to a friend say that her parents will vote for Donald Trump because of one issue only – abortion.   They don’t care what else as long as he is anti-abortion.

I have heard this over many election cycles but have wondered what it really means to be “pro-life.”   When Quakers say they are anti- war they talk about “Taking away the causes of war” They consider those attitudes and practices that lead to war.

And so it is with abortion.  What are the attitudes and laws and policies that lead to an always difficult and painful decision?   When you look a, you can see that progressive Democrats do more to take away the need for an abortion and to prevent problems with childbirth and pregnancy.

1.     Countries with socialized medicine have fewer abortions.  Yes, if you want fewer abortions health care for all will lower that rate.  Mothers will be able to proceed with a pregnancy knowing they and their child will have healthcare.
2.     High quality birth control prevents abortion.   A political party that funds birth control and makes it easy to access is a party committed to lowering abortion rates. 
3.     Many countries with lower abortion rates, give mothers longer and better maternity leaves so they can fully recover and care for their baby.  The US maternity leave law does little to encourage mothers to move forward with an unplanned pregnancy.   A pro-life stance includes high quality and supportive maternity leave.
4.     Free education.  Wow. My baby can have the opportunity to go to community college for free.  I may not have much money but I can be assured this baby will have this opportunity. 
5.     Free or low cost daycare.  If you want to lower abortion rates, a political party that supports high quality daycare is a must.   Few families can afford to have one parent stay home for their entire childhood.   Daycare is a pro-life policy. 
6.     In Finland and many other countries, all mothers receive a “Baby box” in which they get everything they need for their baby.   All mothers get this.  There are no baby registrations and showers.  All babies are cared for by a loving community.  
7.     Clean air, clean water, clean soil and clean food.   Climate change and the effect of industrial waste are causing massive birth related health problems.  If a party is pro-life they clean up the rivers, work to stop climate change, demand clean air.   They give a baby a chance at good health, no matter where they live.  
8.     Respect for women and their bodies.    Rape, sexual harassment and abuse all undermine a woman’s confidence and ability to move into mother hood secure that she and her daughters will be care for and supported.   Pro-life means pro respect for women in language and all we do. 
9.     Control of guns so that parents can be assured that there unborn baby will be safe.
10.   That their baby will not grow up to be teased or discriminated against for their religion, skin color or ethnic background or sexual orientation.

So when you vote pro-life I hope you will consider all the many ways that a candidate or a political platform supports a country and a society that makes sure that every baby is planned and cared for.  

Pro-life equals climate justice, universal healthcare, good education, clean water and air, a loving respectful attitude towards women, free birth control.   When looking for pro-life candidates, consider those people who paint a picture of a country or community that supports life in all its many ways.   

In this way we will greatly reduce the need for abortion.  As our level of love and support and respect for women rises, as a society, the need for abortions will decrease. 

Donald Trump, under this definition, is not pro-life.   He does nothing to assure reproductive security.  

Fracking causes premature birth which is one of the greatest causes of the US’s dismal infant mortality rate.  Therefore you cannot be pro-life and continue this practice.   If you frack, you are ultimately causing death and harm to the unborn. 

My plea is that you consider what it really means to be pro-life.   I hope you will join me in re-defining the term pro-life to mean policies that assure each chosen baby a healthy, clean, non-violent place to be born into and thrive. 

My pro-life candidate is Hilary Clinton and all the down stream candidates who support a healthy, equitable, peaceful world.    If we use the needs of the yet to be born as a measure of our vote, you cannot vote for Donald Trump and be pro-life. 

Saturday, December 17, 2016

Premature Birth Link to Air Pollution

Air pollution is often related to fossil fuels.
In my town, city council and city planners allow large double diesel trucks to drive through a small town rather than use the designated highways.  They also pick up all of  Oregon's gasoline and drive it to local gas stations.  This is  the same place as 16 superfund sites and a large tank farm.  Ah yes, there is no real system of maternal health in this small town either.  Its also miles form the nearest hospital and ah yes - the schools are not high performing.

And yes, if we raise the rents perhaps all of this will improve because the new wealthier homeowners won't put up with it.

Where is the 'baby sacrifice zone" in your community?
How will Donald Trump's choices for his cabinet protect babies in the next four years from prematurity related to air

Environmental Justice is Reproductive Justice

Environmental Justice is Reproductive Justice is Racial Justice

The next posts, in my blog, are dedicated to the long term impact of polluting factors on mothers, babies and the long term health of children and our communities.

Let's start with some statistics.....

One in ten babies in the United States are born preterm ( before 37 weeks)
It is the highest cause of death in children under the age of five.
The rate is increasing/ not decreasing.
36% of all infant deaths in the United States are caused by preterm births
African American women are 50% more likely to have a preterm baby than a white woman.
In Washington State, preterm births for Native Americans, are 49% higher than for any other ethnic group

The cost of a preterm birth is $26 billion dollars annually with some medical bills being over 2 million dollars for one baby.  This does not include the long term educational needs related to disabilities.

Babies born preterm may experience difficulty breathing, staying warm, feeding and just staying alive.  Later in life, they may experience many other health and developmental challenges.  It is not the way anyone wants a baby to begin life on earth.

The risk factors for preterm birth include many factors and one of them is simply being poor and not white.  Smoking, poor nutrition and lack of access to prenatal care make it worst but even if you do everything "right" being raised with less or being a woman of color puts your baby at a higher risk. For years researchers have looked for why poor women and women of color have more preterm babies.

I am suggesting we look at where they lived.  I am suggesting we look at our cities and where our fossil fuels come from.  I am suggesting we look at our city's "sacrifice zoning plans" for our answer.
I am suggesting that we look where capitalism and the exploitation of colonization took the wealthy for our answers.

 For if you look at the research carefully, it is clear that environmental exposure to poor air quality, fracking, lead in the water and pollutants in soil and paint and food all increase the rates  of preterm birth and pre-eclampsia.

What we also know is that poor women and women of color are far more likely to live in high pollution area or parts of the city dedicated to pollution so that the wealthier people can breathe clean air and have parks and clean water.  These women, in pristine neighbourhoods,  also have fewer birth complications.

So why, if we know that pollution and fracking and pipe lines and superfund sites are causing over one million babies to die each year do we allow these practices to go on?

But it is not just in my city or my country.  The World Health Organisation estimates that 1 million children die from preterm births each year.  They estimate 15 million preterm births, world wide, each year.  The United State is amongst the ten countries with the highest preterm rate.  It sits between Indonesia and Bangladesh.  China and India with the highest rates, also have high levels of air pollution.

Babies are an indicator species.  They and their mother's reproductive system and her placenta are all sensitive to the pollutants in our air and water and soil and pipes and paint.  What we know now, is that the harm done to a woman's reproductive system is generational.  What we know is that the very air your mother breathes can effect the outcome of your birth and your baby.

Getting the tobacco industry to take responsibility for the harm they caused was near to impossible and the fossil fuel industry will be even harder.   First of all. most people like 'sacrifice zones' because it keeps pollution out of their neighbourhoods where they don't have to look at it.   Second everyone loves fossil fuel products and feels like it has to be somewhere.  They are happy their baby is not sick and give themselves credit for doing everything right.  The March of Dimes knows and the CDC knows but it is so huge and so hard to change.

I am a midwife but I believe it "takes a village" to deliver a healthy baby to a healthy mother.  Perhaps you always wanted to be a midwife; that you always wanted to help mothers and babies.  You can be a Climate Justice Midwife and ensure better outcomes for mothers and babies by working to protect our communities form air and water pollution and beginning the long journey to replace fossil fuels with renewable energy.

This is a long, long labor. Just like good midwives, we will have to try many, many things but we will not give up because a healthy baby is always our goal.  When we take midwifery into our hearts, we take in our commitment to love each and every baby as our own.  We stretch our hands across the universe and answer the call to protect and provide for the next generation.  With love in my heart, I ask you to consider this calling and join me as a Climate Justice Midwife.

I now suspect the significant number of women dying of eclampsia in Haiti is related to the environment.  There is good research to support it.  It is perhaps lead in the pipes or house paint or chemicals put in the soil.

Standing Rock
Fossil Fuel poison is a form of genocide.  One you pollute the water and air and soil, it is very difficult to overcome the problems created by it.  It is like small pox on blankets all over again.

Your city
Find out where your fuel and electricity is coming from?  What part of your community is sacrificed for oil exports or for your home energy use.  Where are the babies in your region most likely to be born premature due to exposure to lead or air or water pollution?

Saturday, May 21, 2016

Far away - a plea for help for this young mother and baby.

Far away

I get an email from Haiti.  The young woman who was found homeless and pregnant has had her baby by caesarean section and they need formula.  She was HIV positive.  Why a c-section?  Why formula?

I write back that HIV mothers are still suppose to breastfeed.  I feel a desperation that melts into depression.  There is nothing I can do.  I am here and they are far away.  I lie in the warm grass filled with wildflowers and try to let the earth hold me. I let myself sink into her arms but when I stand up, it is still there.

I send emails to anyone who might be able to place them in an orphanage.  She is a teenager with no family or home to go to.  I clean and clean; trying to wipe away the images of babies dying in Haiti.  We are preparing for a new baby in our family.   I hike up into the forest and find branches for the baby shower decorations.  I put roses in glass jars and put them all over the house.  My yard is overflowing with roses. When it rains, the paths and walkways are strewn with their blossoms.

But I am in Haiti.  I call for a ride to the hospital and walk towards the room where the mother and baby are resting.   The translator says to me, "But this is how they do it."   I sigh and say, "But the baby will die."  She says, "The baby had HIV anyway."  I argue.  "Just because the mother had HIV, does not mean the baby will."

But I am not there.  There is no moto ride,nor a conversation with the translator or staff or mother.  I am far away.

I live near the confluence of two great rivers.  It is a wondrous ecosystem that was exploited and wounded. it exists as a colony of Portland. There are 16 superfund sites at the bottom my hill. Like HIV, you cannot see it but it is there.  I tell myself that it is enough to care about this place.  I make a free clinic in a car shop.    I try to root myself but my spirit leaves my body and flies to Haiti.  I try to return to my body but I can not.  I try to say that this is the world I was born into.

I see that the children on the hillsides in Cabestore's hair has turned red from malnutrition.  I tell myself I will try to find funds for a feeding program for the "poor school" but I cannot get through to anyone.  I tell myself I will, at least,make sure the 90 year old grandparents have a solar pump so they can grow  food for their grandchildren who are living with them and often have no food.  I make lists.

I buy slippers to keep in basket by the door so that less dirt is brought from the garden into the house. I try to take my mind off the mother and baby and the children of Haiti.

I am a midwife and I can see that I am fighting for this baby's life thousands of miles away.  Every protective nerve ending in my body comes alive.   I am midwife, working thousands of miles away.

 I tell myself to stay calm and answer emails and trust that the orphanage and the mother and baby will find each other in time.  I am blessed to have met so many wonderful people who I can contact. People who answer my emails quickly and with the same urgency I feel.   I work on trust and wait.

Wednesday, April 13, 2016

The Last Time I Saw Haiti - James Audubon

The last time I saw Haiti
                        James John Audubon

Birthplace of John Audubon ,as it might have looked to him, as he sailed away as a child.

Each evening, I was rocked to sleep by the music of my country.  It was as familiar to me as the sound of the sea and the rooster and the bird that wished me good morning.   In the day, when I tried to pay attention to my lessons, there were the songs of work, both in the house and fields and the bird in the tree.  If the facts of my childhood have blurred with time and history, the sounds of its people and the songs of the birds have not.    I was born on the southern coast of Haiti; home to the Taino Indians who lived near us and taught us all how to survive in a place foreign to us all.   My father called the land Saint -Domingue but the people called it Haiti.  I lived on a sugar plantation near a small port the French named Les Cayes.     Boats from France brought us many things and then my father loaded the ships with coffee and sugar cane from our plantation.  

There was drumming at night.  My father loved the drumming.  We would sit by a fire outside and listen.  My brothers and sisters would dance and our mother would make us ginger tea with sugar.   If my father’s friends came over, he dressed up and only spoke French but when it was just we, we laughed and told stories and were barefoot.

 Some said my father had grown wild and uncivilized from life on our island.  They encouraged him to leave the plantation and return to France.   I heard a man say he did not know how to keep his distance from the Africans.  This was true because the woman who I called mother and her children and all our friends were the many shades of brown.  

The woman who raised me, as her own said if he ever whipped a slave she would cut his throat in the middle of the night. He laughed but he also didn’t whip slaves.  Some people said he let a woman run his life.   He had a weakness for loving women and it didn’t seem he cared what color they were.

The mother who gave birth to me, died when I was a baby and so my next mother took me to her breast and saved me.  The woman who nursed me said only this. “ Your mother was very beautiful. Her skin was the rich color of coffee with milk in it.”   She was Creole and your father brought her home from Louisiana.    She loved you and then she died of the fever and there is no more to tell. “

I asked what is Creole and what is Louisiana as these were all I knew about my birth Mamma. 

“Creole is the sun shining in the sea. It’s African and Spanish and Indian and a little French.  Its all the beautiful landed right inside of you.” 

And that’s all they would tell me ever about her.”

 My father was always happy when my new Mama was near by.   She had babies near every year and we all said each one was cuter and healthier than the last. 

We had lessons in French everyday, but mostly we played and went fishing and I filled my schoolbooks with drawings of things I discovered as we played. 

When my father landed in Les Cayes, and rode to our plantation, he found the overseer had died and the slaves were pretty much running it themselves.   They had their own villages and gardens and farms and doctors and even priests.  My father said they were not real Catholic priests but some sort of mix of Africa and Catholic.   They spoke a language my father never heard of; just like the religion a mix of Africa and Taino and French.    As long as they made enough profit to pay for expenses and send a little to France, he let the plantation be as it was when he arrived.  

 When we went to Les Cayes I saw them whip the new people who were arriving from Africa. I saw a man hanging dead in front of the church.   My father said he had run away and so they took his life.  When I got home, I drew a picture of the dead man and then next to it a picture of the man alive.   I said to my father, “Look I made him come alive again.”   He threw it in the fire and said a drawing can never make a dead thing alive again and sat for a long time with his head in his hands until I crept into his lap and hugged him to me.

 One night the drumming lasted all night long and when we woke up the plantation nearest to us was on fire.   Some of the slaves came to see my father and they talked a long time.  I could hear my mother crying.   We all sat outside the door and listened even thought we knew it would be trouble if the door opened and we were there. 

“Master, there is no choice.   You and James have to leave.   We’ll make sure you get out safe and the boy unharmed but you gotta go, sir.”

Go where?   This was my home.   I knew I had family in a place called France but I did not ever want to go there.  Never.

We heard our father say he would never leave our mother and his children. He’d stay and fight.   But it was no use.  Our mother cried and said she’d be fine.   Besides she told him, “ She was siding with freedom and it wasn’t going to be a safe place for any white people.”

“Even if it means we can’t be together and we loose our land and all we love.”

“God knows I love you and all the children you gave me but nothing is worth more than freedom. Nothing is stopping freedom in Haiti.  I love you but you have to go.  Go make freedom in France. None of us can’t live free while others are slaves. “

“You are free.” My father argued.  You never were a slave.’

“I know but I can’t live side by side with slavery. “

A voice interrupted them.  “We need to go tonight. There’s a ship headed to France.  We’ll row you out.”

“I’ll take everyone.  We’ll all go then.”

“Just you and the boy.”

I ran then to the barns and hid out there.   I heard them calling me.   Old Audubon, my favorite slave, called me with our special birdcall. Finally I came out and put my head in his lap and cried.  

“I’ll run away and be a maroon and live with the Taino in a cave.  I will.  I will.”

He laughed and said the maroons didn’t much need a boy to help fight a revolution.” 

“Do you want a revolution?” I asked him.

“I want to be free, like everyone.” 

“But what about me?”

“You are going to France and will get a fine education and sail in a big boat. That will be an adventure for you.”

“No, you are my teacher.  You taught me all the birds and their calls and where to find their nests. You are my best teacher. “

He took out a small mahogany bird and pressed it into my hands.   ‘There are birds everywhere.”

Then my father came and shook me and said we were leaving.   It was dark and the drumming had begun again.   He had a bag packed for us and we were taking a path down to the sea.  It was a trail we had taken often when we went to the beach but it was dark and there was no moon.    We hid by the firestones; the place where we cooked fish and lobster and swam all afternoon.   It was the most beautiful place in the world.

When we got to the sea, a mango canoe was waiting and the slaves who had walked with us, held me tight.   They had taken care of me all my life.   I was scared now and clung to them.    

“We can’t be found helping a white man escape.” they told my father.  

Just then my mother burst through the underbrush with my sister, Rose. 

“Take her too.  Take Rose.”  

She did not wait but made off from where she had come.  There was no time to wait and so we took Rose too.  She was my younger sister and I was glad to have at least one of my family coming with me.

The two, who came with us, rowed us out to the ship.  It was quiet; only the sounds of drumming and singing up in the mountains to bid us good-bye.  Not even my mother or my sisters and brothers.    They were already gone. 

“Can we come back?  Please. When everyone’s free can I come back?”   But no one said anything.  Only the oars in the sea and then arms lifting me into the ship and the canoe slipping back into the dark.  

My father made us a bed and we lay down and watched the clouds disappear and the night grow bright with stars.   We were woken by shouts and a great fire which was our plantation burning.   My father put his head on the ship’s rail and cried.   The ship slowly pulled away.

The ships deck held a cage of birds that were worth a lot of money in France.  

“They want to be free too.” I said in a whisper.  They want to stay in Haiti too.   I opened the cage and watched the birds rise and fly back to shore.  The sky was filled with fire and smoke.

I watched my homeland slip into the darkness; a silhouette of greens glowing wit fire.  I stood there for a long time; watching her slip away. 

Then my father put a hand on my shoulder and said sternly, “It is done.  You are French and you must never speak of your mother or your family.  They are dead to us.  We two will know they live; that they eat mangoes and coconuts and swim in the sea, but we will never speak of them again.  We are French.  No more Creole. No climbing tees to look at birds nests.  We will live in the city.   Never tell anyone about your life here.   We will say your mother was French and that you are white.  No one can ever know where you came from.  The world is not kind.”

“But my brothers and sisters?” 

“They are taken from us.”

We passed a small island off the coast   we passed fisherman who waved and called a hello.   We stayed there on the deck, until it was only the sea all around us.  My father kept us out of the sun so our skin would grow pale.   He worked for hours to straighten our hair and our change our speech. 

After a long voyage we arrived in Pairs.  I was punished if I ever spoke Creole. My father said I was his only son and that my mother had been the daughter of a French plantation owner who had died at my birth.   I was never allowed to speak of Haiti again.

When Haiti won the revolution I hoped we could return but my father had reunited with his French wife and she knew nothing of our life in Haiti.   The French sent another army to fight and try to win Haiti back but they lost again and my Haiti was free forever.   My father talked about all the money he lost but he never talked about the family we lost. My new mother ran her hands through Rose’s and my hair.   I think she knew but she was a loving woman and a good mother to us. 

In Haiti, they said, when we die we return to the place of our birth.  They want to go home to Africa but me I only want to return to. Haiti. In my dreams, I see Haiti as she slipped from view that last morning and I know when I die, I will return to Haiti and the sea and the birds and my brothers and sisters.  We will catch many fish and lobster and make a fire on the beach and listen to the drums as the stars come out – just as it was the last time I saw Haiti.

When I was in Haiti, I visited LesCayes and thought of the young James Audubon as he sailed away from everything he knew, to start a new life in France.   He later said that he was not allowed to speak of his origins in Haiti.  Biographers wondered if he feared people would see something of Haiti in his eyes or hair or skin; things that would hurt his family and career.  I think of the woman who gave birth to him, the woman who nursed him and the woman who adopted him.  I consider the fates of his brothers and sisters left behind during the revolution and how they survived those times.  .  I think of the many people who forced him to “pass” as white, then and now, the many people who refuse to say,  “Ah yes, Audubon – the famous naturalist and artist from Haiti.    



Sunday, April 10, 2016

Emptying the Catheter Bag - lessons of the heart.

Emptying the Catheter Bags

 Learning and writing about the many ways women in Haiti work together in an ancient network of survival and dignity within a community of friends and family.

I am slowly moving up and down the rows of beds in the hospital.  It is late afternoon and there are few midwives to manage the three busy antepartum, postpartum and post surgical rooms.   There are no machines or beeps or signals when things go terrible wrong.  Just three midwives for the three rooms as well as the labor and delivery area.   Earlier in the day, the rooms are over flowing with students, preceptors and midwives.   By five it is quiet and it is then that the families take over the care and management of the rooms.  

From my sketchbook - Women emptying catheter bags together 

They give advice and offer support.   An elderly man moves form bed to bed, offering words, if not medicine.   I take vitals and write them on a chart I make; circling things that are abnormal.   

The rooms are full of women with catheter bags hanging from women.  It could be a post c-section woman or a woman who is pre-eclamptic and was given magnesium sulphate.  The bags hang from the beds and are almost always full of urine.   The ability to urinate is a critical sign of well being as well as an indicator of advancing disease.   The bags are a measuring cup of urine with lines indicating the volume of urine.  It is suppose to be charted and noted.   But there are not enough midwives or not a clear enough understanding of why it is important to empty them and write down the findings.  I am not sure which or if the two blend together in a relaxed state of neglect.  The blood pressures soar.

I am doing this rhythmically in an attempt at order.  I breathe and tell myself to stay in the present moment.  It is one two hours.   Blood pressure, pule, temperature, amount blood loss, listen to babies, Listen to stories and record my findings.   

The mothers are often attended by their mothers; elderly women from the countryside who sit by their daughters' beds and care for them as if they were at home.   They feed, clean and offer sips of tampico.   They laugh and visit with one another.  

Selfie with a woman who comes to help her daughter at the hospital

And then I look over and done woman is examining a very full urine bag.   I am thinking of the film, The Gods Must Be Crazy.   Another women joins her.  How does it work?   They seem to understand that they are all full and that they need to be emptied.   Do they understand that the urine has no where to go after awhile and it will hurt or could cause infection, regardless of its original purpose?

One woman gets a bucket.  She has figured out the mechanism and empties one bag.  Then other women joiner and they slowly make their way to every bed and empty every catheter bag.   The bucket fills up and the bags collapse and hang empty from their owners.   

After they finish, they carry the bucket outside and return with it empty.   The bucket is turned over and becomes a seat.   Everyone settles back in and sits beside their loved ones beds.   

I am pretty sure they were never given an opportunity to get much of an education in a country in which the ruling class has determined that one can only value an education you pay for.   In the absence of a formal education, they grow wise and kind and funny. They are no nonsense practical and love without any expectation of reward.   The strange bags they are suppose to pee in simple must be emptied.  And so they are.

They help each other.  They are wearing their best clothes.  I smile from my dirt soaked toes to the top of my matted, dust woven head.   When I grow up ( I am nearly 68) I want to be them.   I want to be that smart, that kind and that willing to work with others - not because of any outcome - but just because it needed to be done.  

I strongly suspect that they , like me, think it is much easier and safer to simple pee into the bucket in the first place.  I always got women up to pee in labor.  It emptied the badder to allow more room for the birth and it got the woman sitting on the toilet.  It prevented bleeding.   It got the baby into a better position.  "Go pee and have a few contractions on the toilet, " I said to hundreds of women in labor, as  they wrapped their hands around my head and cried into my hair.   

We laugh and shrug.