Sunday, November 25, 2007


Last week I had an amazing experience that I will remember for the rest of my life.

Driving up from Dakar after dropping off a visitor, I had already spent roughly 8 hours on the road in a hot and cramped station wagon on my way back to site. I stopped at a garage in a town near the regional house to transfer cars. Since no one ever seems to be going in the direction I do, further into the Sahel Desert, I had to wait at the garage for several hours. Upon arrival the police officer on duty decided to give me a hard time for traveling without my passport. Of course I had my Peace Corps identity card with me as always, with my passport number on it, but this guy was set on giving me a hard time. I explained to him that Peace Corps told us that these I.D.s were valid and we didn’t need to carry my passport and that if he continued to threaten to take me in to the office in town that I would get the American Embassy on the line and they would sort it out for him. After a brief yelling match and my threats, he finally admitted that because I wasn’t actually GOING into the town, but continuing on, that he didn’t HAVE to look at my passport and he would let me go…this time.

Right, I’m sure the threat of the embassy had NOTHING to do with his change of heart.

I finally got into the new car around 3:30pm. In the back seat were an older woman, a younger woman and her 7-year-old daughter and twin 2-year-old boys. I was squished in between two men in the middle seat, and then in the front sat the driver and an older gentleman. A half an hour later, the car stopped suddenly. We were in the middle of nowhere by a tiny roadside transport checkpoint. The young mother in the backseat pushed past the man in front of her and hurried out of the car. Not sure why we stopped, I sneaked a glance behind me. I saw her maybe 10 feet from the car, doubled over in pain and crouching precariously on the ground. I asked the men around me what was wrong with her. They replied, quite surprised that I didn’t know, that she was in fact IN LABOR!

Of course I blurted out something like, “What?? Now??” and jumped out of the car. As the older woman and myself ran towards her I saw that sure enough, she was in labor. Not only that, but the baby was already crowning! The woman and I arrived just in time. We guided the baby out and onto the extra material from her dress that was dragging on the ground. Right there amid the dirt, sand, thorns, and dead grass, I helped deliver a healthy baby boy. With no medical facility for miles, no tools, and only my bare hands to serve as his first welcome into this world.

Instinct kicked in and I felt so lucky for my doula experiences back in California. I thought to myself, “okay, I’ve seen birth, I know what it should look like. I’ve looked at my health worker training manual, I can do this!” I immediately wrapped him up in the only ratty cloth we could find. The afterbirth followed maybe 30 seconds later. I was relieved that it all looked normal and that it happened so fast. The baby cried right away, his passages were clear, he was alert, breathing well, and a decent size-probably about 6 lbs. I didn’t notice any meconium, the fetal fluid was clear, and the blood from the umbilical cord looked red and clean.
I wanted desperately to do this right, so I started giving orders. I yelled to the men across the street “Please, bring me a blade, and string now!” Somehow, a few moments later with this minutes old baby boy wrapped up in my arms, the birth juices soaking into my green Skidmore College t-shirt, the men came running across the street with a blade and a string in hand! I couldn’t believe it. So I instructed the woman with me how to tie off the umbilical cord and where to cut it. I pleaded with her to let me run to my bag and sterilize the blade with the Hibicleanse from my emergency mini-med kit I carry with me at all times, but my hands were full of the baby and after dropping the blade in the dirt, she had already started cutting away the placenta. I wish so desperately that I had had just a few more moments notice to set up a cloth and sterilize the tools, wash my hands and help clean off the baby a little bit.

But we made do with what little we had. Ten minutes later, with the baby wrapped up in a heavy towel still pressed closely to my body, I cooed at him. As the very first person he would ever see, he opened his eyes for the first time, and I whispered to him “welcome to the world baby boy.” I congratulated the mom and held him out to her, but she was much too exhausted and spacey to do much more than give me a half smile.

By this time several women from the surrounding huts had appeared with kettles of water and a change of clothes for the new mommy from her bag in the car. We women encircled her, trying to hide her naked body from the view of the men standing idly by as we changed her clothes and got her as cleaned up as possible. We wrapped up the afterbirth in her other clothes and put it into a plastic bag. I used a cloth to wrap around her and absorb any blood.
Literally only fifteen minutes later we were back in the station wagon on our way to the nearest village with a health post.

She climbed back into the backseat with her other three children and the older woman. I carefully sat back in my middle seat with Baby Boy in my arms the whole time. Ten minutes later we stopped again. Flat tire! Of all the times to have a flat tire. I couldn’t believe it. The four men took twenty minutes to get us back on the road. All the while I’m trying to pay attention to the baby, making sure he was lucid, breathing, and making the right “nursing” motions. I tried to encourage her to begin breastfeeding so she would release oxytocin that would help the uterus contract and stop the bleeding, but she was too tired and promised me she would as soon as we got to the health post. Meanwhile she was dealing with her other three children. She even had the presence of mind to joke with her twins the rest of the ride! I was in total awe of this woman. I mean, I hadn’t even realized she was in labor. Not a single sound the entire ride. Not a groan, or a yell, or any special requests. She literally waited until the very last second to hop out and give birth to her son right there in the dirt. It was like no big deal, like she did this everyday! I have no idea when her water broke. I assume before she even got into the car back at the garage.

During the drive the men thanked me for helping and commended my attention. They joked that even though it was a baby boy, that he would be named after me anyway. I laughed and appreciated the encouragement.

An hour later we arrived at the village of her husband’s family and the health post. I promptly got into my second yelling match of the day with a Senegalese man.

The driver, instead of driving two minutes out of his way to drop her at the hospital, he dropped her off on the side of the road, at a stranger’s house, with her baggage, and her now four children. I yelled at him in French that this was inappropriate, that she needed medical attention to make sure that she and the baby were okay, that she shouldn’t be walking and that we needed to drop her off at the health post immediately. “C’est pas normale!” I shouted out him. One of the other men agreed with me, but it was getting dark and we were nowhere near their final destination. With much protest, I handed over the baby to one of the women that had come upon the scene. I gave them strict instructions to get her to the health post, and for her to start breast-feeding ASAP. With a final goodbye the rest of us piled back into the wagon and left her to the rest of the women who were already ushering her to the back of the house to wash up.

My shirt and hands soaked with fetal fluids and blood, I spent the last hour and a half of the trip in an adrenaline pumped daze. They dropped me off at the regional house at 7pm, twelve hours after I had begun the journey that morning from the Dakar garage.

Luckily I arrived at the house and all the volunteers could not wait to hear my story (I had sent them a pre-emptive text message along the way). So I got to sit down with friends and share my joy, my awe, and my anxiety at being partly responsible for the birth of a brand new baby boy.

I’m sure that by now the story has gotten out and the whole region knows that an American toubak, named Binta Lam, helped deliver this little guy into the world. I have no idea how to find them again though. I knew the woman’s name, but not the name of the village and will probably never see them again, as we were still about 5 hours away from my town. But it’s exciting and an honor that I will live in infamy in this family’s life. Baby Boy will have to hear the story of the toubak that helped deliver him for the rest of his life.

I feel so lucky that I got to be part of such an important event. And what a great story!

All in a day’s work of a Peace Corps volunteer.


Tessa said...

Hey! Congratulations!!!! You are amazing, my dear! Incredible!

Jeff said...

Caitlin - I sing in the Gaslight quartet with you dad.

What a trip!! To deliver a baby in less the good conditions. Must have been amazing. To think of the resiliency of the woman and having three kids already.


Jeff Mech

Ronak said...

oh my lord. i'm in awe. i can't even imagine delivering a baby in normal're amazing!that is one lucky baby boy :)

Wendy said...

Wow, shmait. It's never been more clear that everything happens fr a reason. Talk about being in the right place at the right time. Isn't it amazing when you finally can put to practical use all the knowledge, tools, and skills you've spent so much time and energy learning. I know there've been times you've questioned being there...well, the next time you start to second guess how much of an impact you're making, think of this. I love you.