Going Solo

"I am not feeling good at all. What has happened..." she shook her head and shut her eyes "Nye Koraa."

I was on the other side of the desk, sitting dejectedly, feeling guilty about a situation I didn't have much control over.

Ma, the 75 year old midwife, continued. "It should not have happened like that. You see?! Ah! They should have called me! Ah! Akua, why did they not call me?! Leaving you alone to deliver the baby! If something would have happened, do you see, it would have been no good at all. Hmpf."

The case had come in at 11 p.m., the first night my friend Simone, from the US, was in the village. We were in our room, in the maternity ward, admiring the new short haircut I had given her earlier that day. Our car had broke down on the side of the road on the way home from the airport. We made use of our 3 hour wait and sat in somebody's corn field, chopping off her waist length locks with midget sized scissors. By the time we were finished our sweaty bodies were plastered in flecks of hair. We looked like true mammals.

"I like the way it's layered back here" Simone said, pointing at the digital photo I had taken of the cut. "It feels sooo good! And short! I wish there were mirrors in Boamadumase!" We laughed at how vain we felt, snapping at least 10 pictures from different angles.

A few minutes later Efreeyeh came in with a laboring mother and we abandoned our chitchat to go see what was happening.

"First stage Akua, 1 cm. I'm going home. It will take too much time." She said, snapping off an exam glove and throwing it down into a little plastic bucket. She was in her pajamas.

"Is this her first?" I asked.

"Yes, she's a primip. As for this one, she will deliver in the morning time. I need to get some rest but I will be back in a few hours to check."

"Okay." I said, believing that to be true.

The next day I tried explaining to Ma. "She was a primip at 1. We thought it would take a long time."

"But if you would have called me I would have washed up and come. Kaisy, as for birth, you can never tell! You cannot say 'this woman will deliver then' or 'that woman will deliver at that time'. You see? Ah. It's too bad. You cannot guess these things. Birth is unpredictable! I learned this very early in my training, which is why I never leave the mother's side. Where is Efreeyeh?"

I knew she was going to yell at her, admonish her, make her feel small. The matriarch was going to reign, call upon her servants and bark at them for their foolish ways.

"She's behind the clinic, at her house i think. I'll go get her."

When i found Efreeyeh I told her to watch out. Ma was angry, fuming, like an over boiled kettle. She said not to worry, if we could only work our stories out the heavy burden of blame could lighten, with a white lie here and a white lie there.

"But ah! You should be happy Akua, you are a midwife now, and a roadside barber." She slapped my arm and walked in to face her destiny.

But I'm not a midwife, yet, and, i wasn't happy. It wasn't until 3 days later that I could see the situation as a gift.

The night of the delivery, I woke from my sleep with the same feeling I had experienced with the woman who birthed on the side of the road. Something felt imminent, the air was still but heavy. It had only been two hours since she arrived, and if we were lucky she would be at 3-4 cm, only a third of the way to pushing. I jumped up and sleepy eyed, walked into the labor ward. The mother was panicking, walking in circles with a distraught scared look on her face. I asked her to lie on the exam table and in broken Twi explained I would be checking to see her progress.

My fingers immediately ran up against an object, something fleshy feeling, semi-hard, like a huge overripe grape.

"Its her bag of waters." i thought, confused. i paused, and tried again.

it doesn't feel like a bag of waters.

Simone came in, with inquiries. A flash of feeling, a frantic electrical current, zipped from my head to my toes. "Can you please go and get Efreeyeh. She's going to deliver soon. Go fast!"

First night in the village and just like Radhika, she was already head deep in the maternity life.

"I don't have any shoes! And, where does Efreeyeh live?"

"She's in the back house, all the way behind the clinic. Take these-" i said, slipping out of my flip flops, trying to clear my head. I ran over and started gathering everything i would soon need for the delivery.

Simone was gone when the woman started pushing. Everyone was gone. The woman was scared. I was scared. I tried to pretend that I wasn't and I told the woman to push with all her might, but really, I wasn't ready for the baby to come. The words came out of my mouth, but they were a lie. I wanted some back up, some support, some people to share this huge responsibility with.

What if something happens?

A slick line of black hair began to emerge. I couldn't think like that anymore. I had to work, to stretch, to support her perineum.

Again, i said, again. Push. Chim. Chim. Chim.

The room felt very lonely. Vacant, even.

Her mother arrived, ran in the room and chanted in her ear. "Chim, chim, chim!" But she was the most nervous of us all, and succumbed to her fight or flight instinct. Before we knew it, she was gone.

Somewhere in my consciousness I noticed my legs were shaking, a lot. They were visibly wobbling back and forth like I was a cartoon character, or a circus performer about to fall off the tightrope. But the shaking stopped at my waist, and from there up, my hands worked and my mouth spoke and my brain thought. But I didn't let it think too much. I wanted to let everything be.

She pushed again, with her legs flopping out, her feet slipping off the table. I usually hold their legs, i thought, feeling disconnected from my current position. But i focused back in. The strip of black gave way to a circle, and the circle gave way to something with more dimension. It was the head.

The head was completely out and still no one was around.

I prayed to God, out of instinct. I said please. Please. Please. It is all that would manage to come out, as I swiped my fingers around the baby's neck checking to see if the umbilical cord had wrapped itself.

It hadn't.

Thank you.

I grabbed a hold of both sides of the head, pulled lightly, then with more force. I moved my hands down, then up, then splatter pop squish squirt- the child was out.

As if in response to my need, an enormous scream escaped the child and he wiggled on the table before me. I began to clamp and cut just as Simone and Efreeyeh came skidding in to the room. Their presence gave the shake in my legs permission to travel, to make its way up my torso, into my hands, through my voice, although when I tried to talk nothing came out. I didn't know how to feel, or what I was feeling.

It wasn't relief at having someone there. It wasn't happiness at having just done this. It wasn't gratitude for a normal delivery. It wasn't anything, but weird and mixed up and uncomfortable. There was still work to be done, and I wanted to do none of it. I wanted to run, but I moved, with the baby around the room. Washing, weighing, wrapping. With the umbilical cord as I slowly tried to pull and deliver the placenta. "You do the rest." I said to Efreeyeh.

"Oh my God." Simone kept saying as she peered around at what was going on. "You just delivered that baby."

But i didn't feel confidant, or sure, or good. I had a glimpse into the reality of what a midwife is dealt. A midwife guides, she prays, she connects, she reaffirms, and what I now realize, she doubts. I didn't want to doubt, to think about the whatifs, that potentially life and death could rest upon my knowledge, in my accuracy, on the competency of my mind and my skills. "But remember" the head nurse Vic mentioned to me later in conversation, "a midwife prepares. She prepares to reduce the worrying. And with experience and education Kaisy, you are preparing. Little by little, you are preparing. You have done well."

I couldn't sleep that night.

Why do i want to do this? I tried to chase the thought away. Don't I love this?

3 days later, sitting around, the voice came in to my head.

It was a gift. It said.

I had been given the weight of responsibility that occurs with this vocation.

At once, seeming so light and free and beautiful, the word vocation, the idea of a calling, suddenly took on a different flavor, more weighty and serious. I was changing my engagement ring for a wedding band and I saw the full seriousness of the evolution of the relationship.

No going back now.

Midwife, the word hung bright and heavy in my mind. And it hasn't left.