Mother Health International has first set of twins!

 First set of twin, baby girls, born at the 

Mother Health International birth clinic, November 2010.

I was up early and went downstairs to have some tea and was laying in the hammock when Sherline came down and said there was a laboring woman at the Dome. Marie Antoinette was up at the clinic helping the woman get settled in and told Sherline to send for me. So although Melinda was going to be considered "first-on" that day I figured I was up so instead of waking her to do a labor assessment I thought I would go up there to check in. I knew Sabine had had a multip birth in the night so I went up to check on everyone. 

When I arrived I could see that the mom was in a good active labor (G4P2) - close contractions and vomiting - so I set up and settled in with Marie Antoinette and Sherline. It was about 6:15 a.m. at this point and the mom said that she had been in labor since 5 a.m. - so really not long at all.

Marie said she would like to catch the baby so I got her a pair of scrubs and put her in receiving position at the foot of the bed. I asked what she needed and Marie replied, "just to have you by my side." 

The birthing mom's Godmother was there and I could see that she had a knowledge of midwifery, an inherent skill and sense of the mom and baby and the process - she had that energy and wisdom of a wise woman about her. I found out that she had attended births as a midwife over the years. I liked her very much.

The birthing mom said that she had felt the baby move but not really that morning and I thought I would check for heart tones just for reference but I was having difficulty finding where to hear them best so I am gently palpating her belly in between a couple of contractions and it's was a bit confusing - feeling for sure there's a back here but there also seems to be a lot of "fullness" on the other side as well but doesn't seem posterior (you know, that train of midwifery thoughts and "hmmmmms..." that go through one's mind). 

I catch a bit of heart tone and it sounds good and labor is progressing really well so I just set back, get everything prepped and ready. I support the Mamma and Marie. Marie suggested to the mother to get off of her back and possibly walk or change position but the mother reported that she was shaking too much and couldn't do it. She had told Marie when she first arrived that this labor felt "strange", different from her other labors.

Sabine, who came up to check on her post partum mother, came in to help us out when she heard that the mother was pushing.

The mom starts pushing around 7:15 a.m. and it 's obvious progress but the baby isn't flying out, in fact, it's coming slow enough that I just consider the possibility of big shoulders (as the mom's belly was quite big) and then watch and observe. So slowly and beautifully a head emerges and after a couple of contractions and it rotates to an posterior position and comes out the rest of the way.....hmmmmm, I'm thinking, that sure is a small baby for a term gestation - a little baggy and wrinkly - possible IUGR - but it is a vigorous little baby and we put her on Mom's belly. It has a pretty short cord. She rests a moment and touches her babe when she seems to push again, or really, scrunch up her face as if she's getting an approaching contraction. Marie says, the placenta is coming and I think, "Gee, that's an awfully strong contraction for a placenta, and so soon after the baby!" 

So I look down and I see a bulging BOW and a head behind and I say, "that's not a placenta, that's another baby!"

Marie was really surprised and jumped back a little reporting later that she didn't know what was coming - at first she thought, placenta but then thought something "worse" but she looked into her heart and told herself she would not be afraid, she would not run away, she would stay and do her job. So as the baby emerged out gently, completely in the caul, I received that babe and laid it on the bed and then removed the membranes. This child was the most peaceful looking babe in the caul - you could see her perfectly and you could tell she was doing great. The baby was small enough that it did not break the amniotic sac at all on the way out and the baby was completely encased in the sac. It was like getting a peak into the womb. The placenta came with the baby. She barely bled at all, uterus was great, I had given her some Yunnan soon after the first babe came out just to be sure we didn't get an extra bleeding but her body was really doing all the right things.

Second baby was smaller but actually "pinked" up more quickly than the first although both babies were really quite vigorous! We got them to breast pretty quickly and it was bit of a juggle but it was also all so smooth. One couldn't have asked for a smoother twins birth. Both baby girls, fused placenta, two amniotic sacs, both head down, baby #1 5lbs and baby #2 just over 4 lbs, and both babies and mom were so strong!

Looking back at her chart I saw that her last baby died because it came prematurely....she said that she already had 2 boys at home and her family told her not to come home with anymore boys so she was pretty happy that she balanced everything out with 2 girls! She got an extra spirit to come back to her after the loss of one - it was all just really beautiful. Sherline reports that the mother told her after the babies were born that she had had a dream earlier the morning of the labor of two girls, her girls, playing outside of her home.

I asked the Godmother if she knew there were two babies because I could just see that wisdom in her being and she said that yes, she could tell but that she never said anything to the birthing mom because, as is tradition to Haitian culture, you don't tell a woman because you don't want her to be afraid.

I looked back at her prenatal chart and no one had ever suspected twins and she had been measuring appropriately and she went to term.

Anyway, there was never any hitches and after several hours everyone was ready to go home. We talked about keeping the babies warm, nursing them plenty, and having them sleep together. They were the most vigorous little babes I've seen who were that small. I never once doubted their strength, or moms, it was all flowing smoothly.

The babies are now 9 days post partum and came in for their first visit since the birth. Both babies have gained weight and are over their birth weights by about 300 grams. The mother has no complaints and her body feels good. She says she isn't too tired and finds that nursing two babies is not too difficult. Everyone who was at the birth reports feeling blessed and thankful to have been a part of this beautiful experience. One couldn't have asked for a more perfect birth to welcome the first set of twins to Mother Health International, Haiti!

Emily Baker, volunteer midwife

Meet Marie Antoinette Helen Jeune, Assistant Midwife at Mother Health International

Over the next few weeks our blog will feature the wonderful MHI team on the ground in Jacmel, Haiti. Your financial contributions help support the salaries of these team members. Thank you. Each person has been asked to write up a short story describing themselves and the work they do. Enjoy!

Marie Antoinette Helen Jeune

Assistant Midwife, Translator
Mother Health International birth clinic in Jacmel, Haiti

Marie Antoinette Helen Jeune

Marie Antoinette Helen Jeune

Marie, Melinda and a beautiful mother on prenatal day at the clinic.

I am Marie Antoinette Helene Jeune. I was born in 1981 in  Jeremie in the area of the grand Anse in the south of Haiti. I have a son who is five years old. I have been working with MHI as a translator and now I am studying to become a midwife. I am a Haitian woman coming from a long line of strong women. My people were brought here to Haiti as slaves from America in 1503. In 1804 we got our freedom. My people bought our freedom for $90 million in 1825 from France. I want to become a traditional midwife so that I can work for my country and this clinic.

I have the patience to be a midwife. The MHI birth clinic provides very good care to the women in my community during their pregnancy, birth and postpartum. The focus of a midwife is on natural methods for pregnancy, birth and postpartum care. I recognize the difference in care when I see a doctor attend a birth; it is not the same thing that we do as midwives when we work with birth and women. I am talking about the pitocin used routinely in birth in Haiti, and the other drugs that make the it very hard for the mamma and the baby. I see the way a midwife works with birth. She makes the women comfortable during labor using massage, and uses movement such as traditional dancing during birth. My passion is to become a midwife and make a difference in women’s lives. The first time I came here to work was at the beginning when Bumi Sehat started the clinic. Now the clinic is under new leadership and is Mother Health International, and when I first came here I did not know anything about natural birth. When I saw the way the birth clinic treated women, I felt so good and love within myself. I loved the pregnant women and this work. I massaged them, give them some ideas to make them happy during labor, create some dancing steps to relax the woman so she would not be afraid. One day when I was working with Kelly, I said I want to share some ways with the the mother to make her happy, to make her dance and laugh. Kelly said to me, “Yes Marie, the woman will be very happy that you do with her her." I felt so happy inside in myself, I knew that I was a midwife and not every one else knew, but I knew.

One time while a woman was laboring she asked me, “Oh marie mwen kapab fe pa sa y o wap tiye nou avan bebe sa sa fet.” (Oh Mary I can’t do these steps, you are killing me before my baby is born.” I said no, never quit, do not be discouraged. I am here and I will support you to make the steps.” She answered me afterward her baby was born, “Oh Mary I love you and sometimes when she looks at me and our eyes are together and we are connected.”

MHI midwifery model of care is a good model for Jacmel because it is hard to find good care for pregnant women. We are kind here, we treat the women with respect. The families come to the clinic and they are very happy because their women are finding good care in the clinic. The families tell me why wasn’t this clinic here before. They asked me, “Why are you working this work of midwifery? You treat us well, like the foreign midwife, are you a midwife?” They tell me I will become a great midiwfe and that makes me feel good. I hear them say, “You know Mary this clinic is very good, it is giving good care and you especially. If the foreign midwives leave you will be there here to help us. Stay strong, do not change your behavior.”

Some of the women and families ask me who are the midwives that come here, where do they come from. I explain to them they are midwives and come after the time of the earthquake to work in Haiti but they come and they plan to help the women and pregnancy for care. I explain, the damage of the earthquake brought the midwives.

I never thought about birth much before I worked here. In 2004 I was pregnant with son, my mom wanted me to follow a midwife and she gave me all the natural medicine. I was as 23 yrs old and the midwife checked positions of my baby but I never knew what she was doing and was very afraid when she touched my belly. My mom said there is not difference between the midwife and doctor. She told me to accept the midwife, let the midwife do her work, let her give me natural medicine and check my baby. When I was in labor, I lost my mucous plug. The midwife checked me and said the baby was ready to be born. My mom said to me, "Let her help you birth and I told my mom no and she said it was my decision. So we went to the hospital. She said that I would see the difference between a midwife and a doctor. I told her “I do not know but I told her that I trust the doctor.” If I was to have another baby again I of course I would do it with the midwife. 

We are working as midwives and as professionals and rarely we to bring a mother or baby to the hospital. But if we bring a baby or a mother to the hospital we treat them with respect and they will treat us with respect. The families are very satisfied, 100%, with the care that the clinic gives to the women. They like the way the midwives treat the women, very natural. There are some families that have told me that hospital, even if the woman is having a normal pregnancy and labor with no complications, that they make problems for the mother and baby. That means that they will cut the women (episiotomy or c-section). They said to me it is not the same as when we work with a midwife to do the birth. I met a lot of the girls and families telling me often the way the midwife  works because it is natural, and it is better for the birth of the baby.

First, when a woman comes to me in labor, we share some ideas with the woman and get to  know each other in labor. You can tell the woman some jokes to make her laugh and help her not stress and help her not be afraid. For the dance for the birth, I make the woman understand that it is not a game, it is to help the woman relax and help the baby get into position. Sometimes I create some steps to show the women to be relaxed, to be happy,to be laughing with me or smile with me. I explain to the women the baby wants love even when the baby is inside of his/her mom. I tell the women, let the baby know that they are something special and that everyone is going to receive them with a lot of love. This is throughout a woman's pregnancy, I explain to the baby everybody is waiting for the baby and will receive them with love. The baby needs the love.

Marie Antoinette, Haitian Assistant Midwife

(This was slightly edited to assist with the translation.) 

MHI passes the 200 mark!

Mother Health International is pleased to announce that over 200 babies have been born peacefully, and healthy at the MHI birth clinic with the support of volunteer midwives and OBGyn's from around the world using the midwives model of care.

We want to thank the greater community for your support in making this type of maternal health care service available to the women in Jacmel. You are making a difference in the lives of these women, children and the community at large. Thank you! 

Next week marks the 40th week working in Haiti and a newsletter updating you on the wonderful happenings at the clinic will be coming next week. 

Thank you again for your support. 
We continue to look for donations of support to maintain and sustain the clinic. Consider making a donation today, www.motherhealthinternational.org. 

The Mother Health International Team