tangiyu tumas (thank you very much)

I am back home, readjusting to a first-world life and the SF time zone. I thought i would give everyone a final Vanuatu update.

I attended a total of 26 births in Vanuatu. I was the primary midwife for 19 of the 26.

Of the 19 mommas i was primary for there was 1 vacuum extraction by an OB, 1 cesarean section (obviously by the OB) and one set of vaginally born breech twins (the OB caught one and let me do the other) with a grand total of 17 vaginal births. One momma had a VBAC (a vaginal birth after a cesarean birth). One mom had a serious postpartum hemorrhage and several had minor postpartum bleeds. One mom had a two minute shoulder dystocia.

Ultimately, two babies were named Michelle. One baby was named Kent for my brother and one named Francisco for San Francisco. Thankfully, and luckily in at least one case, there were no fetal or maternal mortalities in my 19. There was one neonatal death of a baby whose birth I witnessed. His mother rolled on top of him in her sleep. The vacuum extracted baby had an erbs palsy (nerve injury from the vacuum extraction). I resuscitated one baby and wished that I had resuscitated another...

There were 249 total babies born during my 7 weeks. 12 of these were born by cesarean section making the percentage of cesarean births 4.8%. Considering that there were 2 planned cesareans so that grand multips could have a tubal ligation at the same time, one placenta previa and two breech cesareans this brings the number of other cesareans to a very low number. The cesarean rate in the US is at an all time high of 31.3% (in 2006 the most recent data) and rising.

Of the 249 births there were no maternal deaths but sadly 8 babies died. There were 3 stillbirths, 3 premature babies, one whose mother rolled on him and I don't remember the reason for the last. None of the deaths were in labor or related to their births.

One baby was born with a significant spina bifida. The week before I arrived two babies were born with anencephaly.

There were no cases of preeclampsia or gestational diabetes. I think this is at least partly because it there is not much screening. There was a lot of preterm labor. They do not screen for GBS and no babies died of infection (somewhat surprising given the state of cleanliness in the hospital and the opportunities for cross contamination).

Overall, it was an amazing experience. I am so happy that I had the chance to do this. Despite the occasional difficulties and sadness it was wonderful. I hope I get to return again in the future.

Thank you to everyone who donated supplies or money for supplies. You made a significant difference in midwives', mommas, and babies lives. Thank you so much!