One of the most memorable experiences of our final community practicum was the births that we were apart of in the Janiuay community. Shawn, Sarah, and Chantelle were eagerly waiting 24 hours a day for the short notice to run to the clinic and assist the midwife deliver the baby, perform baby care, monitor, and assess the mother. No matter what we were doing, we would drop everything and run for the deliveries. We were able to participate in a total of three births over our two day stay in the community rotating through the required roles during the process. Jaclyn was struck by a plague of E Coli and ameba, despite precautions, putting her on bed rest for one of the days we were in Janiuay causing her to miss two births. Our first call came in the late afternoon when we were at the staff house so we quickly put on our uniforms and grabbed our bags while one of the Filipino students stopped a tricycle outside the house. We jumped in the tricycle and rushed to the clinic not knowing what a community birth would entail. We were quickly able to distinguish the differences in the birthing process between the Filipino culture and what we have experienced in our own communities in Canada.
In Canada, pain medications are commonly used in the labour process, we may even call it the norm. However, the Filipino women do not use any pain medications and see pain as a normal part of the process that they must manage on their own. We were forewarned about this but seeing the women cope with the pain in a natural way during the labors truly put it into perspective. The women were very stoic and made little to no noise unless asked a question; we were surprised and commended their strength. Another significant difference we quickly picked up on was the that the women were alone in the delivery room and the husband or significant other waited outside. In Canada we allow two family members in the room to support the pregnant women at this difficult time. We strongly encourage a support person and have shifted towards an emphasis on family centered care because it has proven to be beneficial for the client. Over the course of our stay in the Philippines we noted that their culture has a strong emphasis on family which left us dumbfounded that they do not have any family members in the room with the patient. There is a lack of space in the clinic rooms which can influence this rule along with their traditional nature. The births we witnessed took place in the community at the health clinic therefore we can not generalize our findings through out the Philippines. We observed that the labour room was small, had basic resources, and dated equipment; it was very primitive. Also, the births that took place here were performed by midwives. This was a very new environment to us because we are used to the obstetrical wards in our hospital in Canada, so we learned to use what they had available. Another prominent difference was that the women are discharged from the clinic approximately 6 hours after the birth of the baby. In Canada however, they are required to stay in the hospital for a minimum of 24 hours.
By taking in all the differences of the labour process and their way of doing things, in regards to the birthing process, we knew what to expect for the two births that were yet to come. We were informed that the majority of births occur at night which proved true when we were awoke at 02:30 am to make a mad dash to our second birth. We all jumped out of bed, got ready in a matter of a few minutes, and took off running down the street to the clinic because there was no transportation at this time. Our instructor followed behind and yelled for us to slow down because she could not keep up. She jokingly emphasized that us Canadians are taller so one of our strides equals two of hers. Our last call came at 06:30 in the morning on our last day, where we repeated the process. It left us exhausted but was a great way to end our exposure in Janiuay and is something we will never forget.
Clamping and cutting the cord Jaclyn giving a back massage
All photos posted with permission