Wednesday, January 30, 2013

Day 3: Haiti

Day 3

This day was Saturday, a free day at the clinic. No prenatals or classes scheduled. I slept in a little but not too much as I knew I needed to go check in on Medaline and probably discharge her. Not being woken by Martha let me to believe that her contractions stopped and she had slept. I was right and after she had some breakfast, oatmeal, I sent her home with a prescription for a syphilis, and HIV test plus and ultrasound order with instructions to do them all on Monday and return for a prenatal on Tuesday unless the bleeding worsened or she was in labor again. She happily agreed. I ate breakfast and some Benadryl and Tylenol for the cold and promptly fell asleep on the couch in the family room where I slept for 90 minutes or so. I woke disappointed that the power was out again, but Mary invited me to go on a walk 1/2 a block away to the cemetery which had manicured lawns and huge shade trees. I agreed and here I am now.

I think I am going to take this time to describe MBH the best I can. It is a large concrete building painted a pale yellow and white. The yard is compound like everything else in the neighborhood, probably .5 of an acre. There are three doors on the front of the house. The one on the left leads into the kitchen which has a refrigerator, oven, back up propane powered cooking station and falling apart cupboards full of dishes and pots and pans all covered with clean cloths or mesh screen to attempt to keep out insects. A wall of 5 gallon water bottles for the water cooler lines one side. If you continue through the kitchen you enter the court yard where they have the outside kitchen to cook, do laundry and wash dishes. Dishes are washed in three large tubs. One for soaking and cleaning, one for rinsing, and one for disinfecting with bleach water. Through the second door on the front of the house you enter the teaching and post partum room. Four single beds line the walls. There is a baby care and weight station and pictures of teddy bears and nursing mothers on the walls. The room is separated by another little entry room by a navy blue drawstring curtain. Yesterday this room was full with Mama Baby class participants, Mamba baby families, and postpartum families, about 20 in all. Through the blue curtain is an entry room from the postpartum room, kitchen and reception area. It has one bed there for triage and treatment plus a child sling scale where the child sits in a special cloth that is suspended from the ceiling on a scale. There is a small cabinet with pregnancy tests, HIV tests, glucose tests, thermometers etc. When you enter through the third door on the front of the house you enter a screened porch. This is where the mothers sit to wait to be called in for appointments. You don't make exact appointments. You tell them to come in 4 weeks and they come back around then. The first to arrive gets the seat closest to the door and is the first called. So they begin to arrive around 8 am and by 9 am when it is devotional time we have 10-30 women there. That room leads into the small reception area with a desk and an armoire that holds medications and vitamins. To the immediate right is the garage which has been converted into a large store room for supplies. On the far end of a reception area there is another bed that is used for triage or as an extra prenatal space. To the left is the hallway to the kitchen and postpartum rooms as well as the stairs to the upstairs. Just past the storage under the stairs is a labor room with the MBH logo painted on the wall. Two beds and a bathroom plus a supply shelving area.  From reception to the right there is a single labor room decorated with birds. A bathroom. A double laboring room decorated with painted flowers. There is also a hall way that leads out the back of the house to the grounds keepers’ home. Up the stairs opens into a great room with a small desk and office supplies. There is a large family sized black table with benches and two love seats and a coffee table. Shelves along the walls hold books and food supplies and condiments that belong to the midwives and other house staff. There is a door that leads to a covered deck. I spend a lot of time out here and often nap there. Off the great room is another large room called the over flow room. It holds overflow baby supplies and medications that will get too hot in the garage plus 3 more bunk beds for over flow staff. I often sleep on the top bunk as a breeze from the deck on the end makes me feel less clausterphobic.  Off the great room are the midwives quarters with a bathroom and 4 sets of bunk beds. Mine is a bottom bunk in the far corner away from both windows. Thus the closterphobia.  Another midwife room off the great room leads to Mary’s room where the directors stay, there are two beds. There is a bathroom and a third bedroom which has four bunk beds where the site manager, Santo, who I have not met yet because he is out of town, sleeps. The yard has a huge empty swimming pool, a chicken coup, two green houses and plants everywhere including beans, peas, tomatoes, corn, egg plant, lettuce, greens and other plant foods. Trees of mango, papaya, banana and sugar cane are also around. The whole house is very clean. The cleaning woman wipes the walls and mops every floor with a bleach solution every day. Building materials are difficult to come by so paint is chipping, windows need caulking etc. but they keep things very clean and tidy and I feel very safe even with all of the insects around. I am hoping for a few labors to come in today.

Chicken Coop and Banana Trees

Green Houses and Mango Trees

Women Waiting for their Prenatal

Birth Room with MBH Logo

Sun Room Birth and Prenatal Room

Birth Room Birth and Prenatal Room

Flower Room Birth and Prenatal Room

 Laundry is almost always drying around the Clinic yard


Papaya Tree

Staff Family and Dinning Room


Swimming Pool- This made me laugh because there is almost a page in the volunteer handbook about how you need to dress modestly when you are using the swimming pool :)

Passion Fruit Vine

When we got back I spent several hours napping as did the other midwives. We then decided to go for a walk up to the rock quarry about half a mile away. We stopped by the MBH children’s library and met the family featured in the you tube video. We saw many different people, animals, and houses. When we got to the quarry rain water had collected to form little pods where people were bathing and animals were watering. We climbed a steep hill and we were able to see all around us up the mountains to the east and the ocean to the north. It was very beautiful.

When we got back a labor was there a first time mom named, Tetalley. She was very sweet. We had spaghetti for dinner and mom and her sister Nahnah walked around. We told them to come and get us when things got more intense. I crawled into a new bed under a mosquito net out on the porch and waited. Around 10 Martha came and got me and told me she was active. I went down and found her rolling in bed with the pain. We got her centered and I did an internal exam and found her to be 100% and 5 cm. Her mother had shown up by that point and kept pulling up her skirt and opening her legs wanting her to push out the baby. I finally got her to leave her alone and she labored with us holding her hands, rubbing her back, and putting water on her belly. Around midnight she said she had to poop and I checked her and found her ready to push. Martha went and got Mary and they were going to turn on the generator when a miracle happened and the power went on. She had a very tight hymeneal ring. I was worried about her tearing on the birth stool so she pushed a few contractions there and then we moved to the bed. She would not have torn except for a nuchal hand that popped out. Baby had great apgars and cried eagerly.They worked beautiful together and grandma was so happy.

 I ended up needing to suturing her up a bit. She showered and then we moved her to the postpartum room where we worked on breastfeeding. I crawled into bed at 2:30 but still didn't sleep well as the baby was up often during the night and I went down to help the mama. She was exhausted and a little shell shocked which is pretty normal for a first time mom no matter where you live.

Photos of individuals shared with permission that was obtained prior to taking photo.

Sunday, January 27, 2013

Birth Photography for St. George and Cedar City Utah

I have had the privilege of working with Rachael Steele of Steele the Moment Birth Photography several times. Here is her fabulous facebook page.  If you are interested in birth photography I would highly recommend looking at all of the wonderful local options. The photos will be something you will cherish forever and everyone I have ever spoken to about them have found them well worth the cost. Below you will also find some beautiful examples of her work. I was at several of these births as a second midwife to Laura Hopper another wonderful local midwife resource. 

Here is my interview with Rachael:

When did you first become interested in photography?

I have always had a fascination with the idea of being able to photograph and freeze moments in time…a fascination that started very young and was inspired by many artists including Anne Geddes. I remember even at about the age of thirteen, setting up a fur rug to take a picture of my newborn sister, as well as a close-up picture of a beautiful flower and thought somehow that I was going to put it together to make this beautiful piece of art! Not quite sure how I thought I was going to do that to be honest, haha. Yet the desire to make art out of a precious new life while at the same time capturing all her little details forever was definitely already there at that point!

What about birth photography?

I first heard about birth photography from a fellow twin mom on the twins forum actually! I had just started to really get into the world of professional photography, and as I also had such a love for the whole birth process (but no desire to be any kind of medical personnel) I could not believe what I was hearing! Two of my passions all wrapped up into one! And not only that, the whole idea of the sentiment behind it…I am a very sentimental person. Yes, I save everything. I wrote every single detail down in a pregnancy journal with both of my pregnancies, did baby books, kept little sentiments, had hand and foot molds done, etc. Everything I can get my hands on to sort of capture those little details that are so soon forgotten. What a wonderful idea, to be able to preserve those memories and at the same time, allow the support team to work with mom and not even worry about taking pictures! Phenomenal! Not only did I wish I had thought of it with my births, but I wanted so badly to be able to provide such an invaluable service to as many families as I could.

 Tell me about the first birth you attended whether you took pictures or not?

Well, the first birth I ever attended would have been my oldest sisters. I was probably 17 or so and just there to support my sister. Even at that young single age I remember being a little bit shocked since I had never really seen a baby be born before, but I have been so amazed since then and continue to be amazed at the human body, the things that it can create and the hard things it can do! I attended several other family member births after that and it never ceased to amaze me. Following a long period of training and being mentored specific to birth photography I took on my first birth client, a dear friend of mine where I was able to photograph her breathtaking home birth. It was such a remarkable thing to be a part of. And from that moment on, I knew it was my calling in life to be able to preserve these special memories for people. 

Why would someone want birth photography?

As one of my birth photographer colleagues says, “Because they only take their first breath once.” You know, this is the hardest thing for me to answer sometimes. I know the answer…but it is hard to describe. Each one of my clients could tell you, but kind of like having a baby, you will never fully understand until you have had the experience. For many mama’s it is so very healing and empowering to be able to actually see the work and the labor of love they put in to bringing their child into this world. To be able to see the love and support that surrounded them throughout the whole process. To me, there is no greater gift a person can give themselves, their baby, and their posterity than to have professionally captured those fleeting moments.

Why hire a professional?

As much as it would be nice to be able to have just anyone record your story, the sad truth is that many of those special moments will be missed, and those moments are things that you cant get back. As a professional birth photographer I am trained to hone in on the details and quiet moments that matter the most, often times they are little bits of importance that the average person may not catch as “important” but is very much a part of the journey. Many people may think it’s just the difference in the camera, but that is not the case. Yes…I have a nice big camera, but it is just a tool, and knowing how to use it properly is what makes the difference. I chose my camera and lens’s specifically to be able to capture great images in low light situations and have been trained in just about every aspect/scenario that comes along with birth. The difference in training as not just a professional, but a professional birth photographer is of immense importance.

Can't dad take pictures?

Words cannot describe! Please if I may share a link that will show you exactly what moments you would have missed if dad were behind the camera instead. As a member of the International Association of Professional Birth Photographers, a group of us got together to share our best images that just begin to describe the answer to this question. Please, enjoy our video “Hold her hand, not the camera” 

What if I don’t want pictures of the baby coming out?

This is what makes birth photography so great! It is totally up to you how much or how little you want in your photos. Either way, rest assured you will have a complete birth story start to finish regardless of what you choose. It is purely personal preference. Some people want images they maybe even just want to keep to themselves to see the hard work they did, some may just want the images of babies head coming out where you cannot see anything else revealing, and then some choose to wait until baby comes up for their first breath. There is no right or wrong choice; it is absolutely up to you!

What about modest pictures?

Again, it is completely up to you how you want the images to turn out. There are almost always angles I can use to take the images in a way that it is as modest as you would like it to be. I am always very conscious and respectful of the birth space and my clients’ privacy and do everything I can to make it comfortable…more like a “fly on the wall” kind of experience.

What if I do want pictures of the baby coming out?

Absolutely. I have no problem with however my client decides they want their images taken. 

What type of editing do you do?

Well, to start off…each of my clients gets a folder of color images as well as a folder of black and white images. Many birth photographers will just do black and white, but often times I find that I absolutely love the color image and I don’t want to take that away. For that reason, I provide both. So it is up to my client to decide which ones they like in color and which ones they like better in black and white. As far as actual editing, I “process” each of the images a certain way, I don’t ever “touch up” the images. I won’t remove things out of the photo or change anything in a way that does not depict the trueness of the actual experience. Most of what makes the images what they are, is the way that I actually “take” them in the first place. It’s true there is cropping and tilting and converting to jpg format, etc. and all my images go through a similar process, but it’s all just a way to get the images into a usable format. 

How do the doctors and midwives like working with you?

I have a really good working relationship with a lot of providers including midwives, doctors and nurses. I have worked with a lot of them in the area so most of them are familiar with me and it has been a great experience! I have had both midwives as well as doctors tell me that they actually really enjoyed being able to see their job from that perspective as well.

When do you like to get called to the birth?
Basically once my client is in active labor I want to be there. For most home births, I will show up shortly after the midwife does. I want to be there soon enough to get “laboring” shots as well as pictures of those moments when their support members are there for them and helping them through their progress. I want to be able to get detail shots before hand also, in a way that sets the seen. Pictures of all the stuff that is out and ready for baby, maybe what other family members are doing while waiting, the weather, the date on a newspaper or calendar, and things like that.

What if I have a c-section?
Well, in general the rule is that as long as it is not a complete emergency and the doctor and anesthesiologist are okay with it, then it is allowed. There are no actual policy’s set in place at our local hospital that prevents photographs from being taken, as long as there are no photographs of any actual procedures. Even if something turned into c-section and I was not able to photograph that part of the birth story, there is still a story to be told. Even if the birth story images went from mom and dad walking into the OR, a picture of the empty room they were in and a picture of the clock at the time, then a picture of them coming out with their new bundle of joy. Then a lot of times they can wait to do the length, weight and footprints til they are in a regular room, so everything is still there and the story is still complete.  

Tell me about the difference in shooting photos at a hospital birth verses shooting a homebirth?
Really there isn’t much difference as far as my job goes. The hospital ones I do tend to mostly be medicated, not all, but most. So those ones are easier to gauge how long I have. But that’s not always the case. The only other difference besides the “security” at the hospital is that the lighting is usually always the same in the hospital, very 2 dimensional. Because of that, I shoot a little bit differently in order to create 3 dimensions. Just technical stuff though. Each birth is different regardless of whether it is in the hospital or at home.

Do you do maternity and/or newborn photos?
Yes, absolutely! I specialize in maternity, birth and newborn. I have packages for each so you are able to combine either of those options together, which makes it nice for my clients to sort of be able to build their package how they want between those options.

Tell me about the birth where you learned the most about taking birth pictures?
Oh gosh, that’s a tough one! I’d say I have several. No matter how long a photographer is in the field, you learn something new at every single session I think. For me it was important to learn everything I needed to know about taking birth photos, before ever stepping foot into a birth to “practice” on, as birth is not something you can retake if you miss something. But if I had to pick, I would probably say some of my “firsts”. For instance my very first home birth, my very first hospital birth, first twin birth, first c-section, etc.

How long after the birth do I have to wait to get pictures?
I will usually give you a sneak peek within the first 24 hours of the birth. That way you have some beautiful images you can share with family and friends immediately to announce the birth of your new little one! I always say 4 to 6 weeks for the CD of all 150 to 300 images, although I have gotten them back within a couple of days. It sort of depends on how much work I have at the time. But is never beyond the 6 week mark and usually by 4 or sooner. If you need images for birth announcements, etc. I am always really flexible with emailing you a couple if you would like.

How much do you charge and what is included? 
Well, I always tell my clients in the beginning that it may be something you need to save up for. I do take payments as well, but it is along the lines of wedding photography (except that a wedding photographer isn’t on call 24/7 like I am ). Right now I am currently charging $400 for the birth, and have packages that include either the newborn or a maternity session for $575 and my “Whole Bundle of Joy” package which includes a maternity session as well as the birth and newborn sessions for $750. (These are my current specials that require a $100 deposit to hold at that price)

Any final words?

I just want to emphasize how priceless and invaluable birth photography is. No matter what your concern, I have never once had an unsatisfied customer. It definitely isn’t something you will regret! But I can’t tell you how many people I have talked to that never quite get around to booking their session until it’s too late and they say how much they had wished that they had done it. For me, it’s not an option. Not just as the professional birth photographer, but as a mother myself. My next birth, no matter what the obstacle, I will make sure I have my birth documented in a professional way so I can freeze those moments in time so the memories can always be fresh in my mind.