Collected Consciousness: Village Outreach 101

So what is a Village Outreach?, after getting so many questions to explain…

My hands are definitely my best assessment tool here.

There are several villages that surround our Birth Center that we travel to twice a week to hold Prenatal clinics to avoid the women having to travel to us. This is a service that we offer to be able to reach more women.

These villages can range from 30 minutes to about 1.5 hours away, traveling on bumpy dirt roads in our Jeep (aka ambulance). We go in small teams and see the women here just as we would here.

The Traditional Birth Attendant from that village is responsible for mobilizing the women to be present when we arrive. Ideally we aim for 10 am start … but as typical in Africa … there are many, many things that usually prevent us from arriving on time. And - the women patiently wait. I’ve never, ever seen any frustration from any of them towards us. Waiting is just a part of this culture which is so opposed to any waiting room I’ve ever witnessed at home. Think of the last time *your* appointment wasn’t on time and there were 20 people ahead of you…

The idea of being seen multiple times during a pregnancy, like at home, is almost non-existent here. We are lucky to have seen them once or twice the entire time, sometimes seeing women for the first time when they show up in labor.

Our visits are much pared down to what the ‘standard of care’ is at home – doing no lab work, very basic prenatal history and at the most giving them prenatal vitamins. … and surprisingly, this works! I have only seen 2 fetal anomalies since being here (something is wrong with the fetus’ growth/development) and most babies come at or beyond 40 weeks …

Christine, our translator. Something I said was probably lost in translation

Which brings up the next point: dating a pregnancy. Who really keeps up with their period date anyway? I certainly don’t. So, it’s all a best guess. With no such thing as ultrasounds or dating scans, we do our best to gauge how far along she is – while taking into consideration the measurement of her belly, fetal heart tones, her perception (which is nearly pretty accurate for these women who have been pregnant many, many times … they just know) and our best guess. It completely erases the dogged demand to know how far along she is.

Waiting Room

Here, it doesn’t really matter. Inductions are not routine like at home and women simply go into labor when they go into labor. There is no lab work done throughout. Village birth is fairly simple: You make a baby and then you have a baby. There are no bells and whistles complicating the process -- it has certainly proven and reassured me that Birth simply Works!

The women here are extraordinarily healthy. Their physique from working so hard in the garden – and LIFE – makes them healthy and strong. The most I treat here is UTI (urinary tract infection) from dehydration and lots of malaria, which I've had to do a lot of learning about because it simply is not part of our world at home. Occasionally, there is back pain from a particularly stressful digging day – at 39 weeks pregnant! – that a Panadol easily relieves.

I have been impressed of the ease of pregnancy & birth, especially coming from a Western training where hospitalized obstetrics was my training ground. The majority of time, it really is as easy as Sex >> Baby >> Birth.