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A Midwife's Experience in Panama

by Kate Layman, CNM

On the first day of October 2011, I had the great fortune of joining a medical group in Bocas del Toro, Panama.  The Floating Doctors Team is a nonprofit 501 (c)3 with the mission of delivering healthcare to isolated coastal communities throughout the Caribbean. Before arriving in the Archipelago del Bocas, the group had been active in Jamaica, post-earthquake Haiti, and Honduras.   After weeks of reading their Facebook page, combing the website, and brushing up on my Spanish, I embarked on discovering a new country and delivering healthcare out of my usual role at the Birth Center.

I landed in the township of Bocas, a patchwork of colorful buildings and tributes to the “Irie” existence. Dusty streets lined with hammock-strewn patios, fruit stands, and businesses pulsed with life.   I soon realized the stunning landscape truly reveals itself when you get out on the waterways woven among the islands.  Motorized boats and dugout canoes traverse these thoroughfares. Gazing over the side through crystal clear water, glimpses of stingrays, schools of fish, and a white sandy bottom race by.   My hopes were confirmed for an amazing adventure.  

The home base for Floating Doctors was a 76-foot vessel called The Southern Wind.  Her nooks served as pharmacy, occasional exam room, sleeping quarters, and mission control for the group.  The troupe of volunteers was remarkable and diverse.  We were a collection of physicians, nurses, public health researchers, sailors, a pro-surfer and a midwife.   Life on the boat was a buzz of activity and comedy.  I often felt like I was on a floating medical hostel with moments of The Life Aquatic with Steve Zissou.  Unfortunately, we were missing the sauna room, but the soundtrack was just as good.    

The population in this area is incredibly diverse.  The presence of banana plantations and proximity to other Caribbean nations produced a mix of West Indians, Latinos, and more recently ex-pat retirees from all over the world.  Various indigenous populations also inhabit the far reaches of the islands and made up the majority of patients we served.   

The group executes two to three clinics a week in the surrounding archipelago.   The most common ailments I encountered were gastrointestinal parasites, respiratory infections, and fungal skin infections, byproducts of the climate and lack of infrastructure.  Public health disparities abound.  Although fortunes from the Panama Canal provide free healthcare services to all Panamanians, a lack of access to care persists.  Few people can afford the transportation from their isolated village only to encounter extreme bureaucracy and prejudice from the system.  As a result, most of the people we met used a combination of traditional healers and medical professionals.

One of my most gratifying experiences was working with the residents of a local nursing home.  The Floating Doctors attend to the patients twice weekly and take the wheelchair-bound residents out for a walk around the village in the early evening.  Before this project was started, some of them had not been out of the nursing home in four years.  The life that breathed into them from waving to kids in the streets and feeling a part of the community was inspiring to watch.  It is not just the very young that thrive on love and attention.  We all need that human connection for survival.

Some of the other highlights of my trip included meeting and talking with local midwives, those who worked in the hospital and village based birth attendants.  Surprisingly, it was not unusual to hear from a woman that her mother or grandmother was the person that helped birth her children.  I enjoyed a homestay with a village baker where patrons started coming to the living room window at six am to buy their morning pastry.   The group was led on a medicinal plant walk with a traditional healer.   A legacy of medicine men, our guide described how he chooses remedies for a patient based on their constitution, psyche, and how the climate might have affected the plant that year.  He was entirely my impression of a holistic practitioner.  

I think about how my trip connects to what we do at the Birth Center and realize that relationships, community, and a healthy respect for nature enrich the experience.  I may have left with more questions than when I arrived in Panama, as if my inner compass was gently shaken and conventional thoughts recalibrated.  I find myself seeing the world and her difficulties with fresh eyes and I feel renewed.  If you have any interest in joining or contributing to the efforts of Floating Doctors, please contact them at floatingdoctors.com or on Facebook.

  

News from the Board

by Kaaren Haldeman

It was great to see so many WBWC staff, families, and supporters at our birthday party! Despite the chilly weather, we had a wonderful show of love for all of the hard work our midwives, nurses and other wonderful staff have done to give us another great year. Happy Birthday, WBWC!  The Board has been busy with board development, and we hope to have some new faces to introduce in the new year. We're excited about what the next year will bring as we march along toward our goal of a new building. Happy Thanksgiving!

 

Ever Wonder About Our Logo?

By Claire C. McKiernan

            Take a glance at the artistically rendered WBWC logo. What do you see? A womanly figure as the stem of a flower? Step back, and do you notice the vague shape of a uterus and fallopian tubes? Certainly, it’s both feminine and clever, but it’s much more than that, too.

            The woman is self-explanatory, but what of the flower? The flower featured in the logo is an iris. The iris grows, is cultivated, and is renowned for its beauty and greatly varied colors all over the world. Symbolism of the iris includes references to wisdom, faith, hope, friendship, valor, passion, royalty, trust, purity, courage, and admiration. Whew!

            Additionally, this ancient plant has a rich historical background. According to Greek mythology, Iris was the messenger goddess of the rainbow (in Greek, "iris" means rainbow). She traveled between the lands of gods and humans to deliver the messages of the gods. Since the rainbow’s arc in Greece could be seen from the clouds to the sea, she was also believed to supply the clouds with water to replenish the Earth.

            The iris is symbolized in the fleur-de-lis of France, where it has been used since the 12th century, became synonymous with the French Monarchy, and is the national symbol of France. Fleur-de-lis literally means “lily flower,” but the iris was known as a lily until the 19th century and the emblem is, in fact, an iris. The fleur-de-lis is seen extensively in the artwork of France, Italy, Spain, Switzerland, Canada, and America.

            Most likely originating in Africa, the flower was a symbol of power in ancient Egypt and was placed on the scepters of rulers and on the Sphinx. The three petals represented faith, courage, and wisdom. In China, the iris is seen as a dancing spirit similar to a butterfly. In Sri Lanka, it is noted for its elegant beauty and represents faith, hope, and wisdom. In Japan, the iris is an expression of heroic deeds. The Israelites used it as a source of perfume and a symbol of purity.

            The iris has religious meaning as well. Medieval paintings are rich with the symbolism of the iris. In Christianity, the iris, along with the lily (often used interchangeably with the iris), symbolizes the Virgin Mary. The three petals can also be seen as the sign of the trinity (Father, Son, and Holy Ghost), as well as symbolizing faith, hope, and charity. In Hebrew, Iris is a commonly used girl’s name and refers to purity. Some references indicate that the Muslims brought the iris to Spain in the 8th century.

The fleur-de-lis or the iris is used as an emblem, in the coat-of-arms, or in the flag of regions in France, Italy, Spain, England, Scotland, Belgium, the Ukraine, Bosnia, Jordan, and Croatia. In Canada, it is on the coat of arms or local symbols for the provinces of Quebec, Nova Scotia, and New Brunswick. Here in the U.S., the fleur-de-lis is in the flag or seal of the cities of St. Louis, Louisville, Detroit, New Orleans, and Baton Rouge and the states of Louisiana and Missouri. The iris is the state flower of Tennessee. Additionally, the fleur-de-lis is used on symbols for sports teams (i.e., New Orleans Saints), fraternities and sororities (i.e., Kappa Kappa Gamma), universities (i.e.,Washington University in Missouri), cars (i.e. Chevy Corvette), and even in the US military (i.e., 256th Infantry Brigade Combat Team). It is used as the World Scout emblem, as well as by mariners in the compass rose, where it points north. 

            Clearly, the iris has universal appeal and as such helps bring us all together. It has wonderful symbolic meaning, and for some it has religious, ethnic, regional, or even specific organization or club significance. So, next time you notice the WBWC logo, think not only of your experiences at the birth center and the wonderful midwives and staff that help you, but also of the deeper and more individual meaning that the iris symbol may have for you.

HUG Your Baby

Are you interested in finding ways to calm and connect with your newborn? Do you want to learn important skills to help your baby eat and sleep well?

Come to a free HUG Your Baby class!
   
Jan Tedder, a FNP from UNC Family Medicine with thirty years of experience, teaches her HUG Your Baby parenting class at WBWC free of charge. Classes meet the second Thursday of every other month, from 6:30 - 8:00 PM.

The next classes will be offered Thursday, December 8 and February 9, 2012.

For more information, give us a call or check out http://hugyourbaby.com.

Elisabeth Jane Shyshnyak

 by Amy Shyshnyak

My birth story starts out as many do.  I had a dream of having a little girl, and that dream was coming true. We took a Bradley class, prepared as best as we could, saved money so I could stay home with her, and visited the WBWC for all of our prenatal visits. My pregnancy went great. I was healthy, and aside from aching feet and incredible heartburn, I really felt like it was an easy pregnancy.

Christmas rolled around, and all of my family was in town, hoping I would go into labor while they were still here. Two days after everyone left the time finally came. December 30, 2010 was the night. I began to have contractions about 10 pm, and I crawled into bed next to my husband Max. We talked about how this could be the last night it would be just the two of us in that bed. It made me kind of sad, but it also made me excited because we had been waiting for so long!

Things began heating up rather quickly. The contractions were coming fast and furious, and I was so confused. I was thinking to myself, “This can’t be the real thing! It is happening way too fast!” At 1 am, we called Leigh Ann. She told me to take a hot bath, take a Benadryl, crawl into bed, and try to get some sleep.  I crawled into the tub and couldn’t stand it. The contractions were coming so hard and fast I just wanted to be in my bed. At 2:30 my husband, who had paid close attention in our birthing class, recognized I was reaching time to push. He called the WBWC and told Leigh Ann we were on our way! She couldn’t believe it!

Off we went. I had 2 more contractions before I could reach the car. We live 35 minutes from the birth center, and I began to wonder if we were going to make it.  We were so glad it was the middle of the night, because I-40 was completely empty.  Max went 100 mph all the way down I-40 with his flashers on. I just kept yelling that I wanted to push, and I think it made him drive faster. We made it to the birth center in less than 20 minutes!

Forty-five minutes after we arrived at the Birth Center, Ellie joined our family. It was such a relief to have her in my arms. My first thought was, “We did it! We did it!”

During the physical assessment, Allison noticed that Ellie had a connected frenulum all the way to the tip of her tongue, also known as tongue tie. I had no idea what that meant. Max then told me that he was tongue-tied, as were as his brother and father. Little did I know what the next 3 months had in store for us.

Ellie was unable to latch properly. When she was able to latch the best way she knew how, she could not transfer milk well. Many kids who are tongue-tied are never able to nurse. She was sucking for 45 minutes to an hour and getting almost nothing. She was so hungry those first few days, and all she did was cry every time I took her off the breast. We had no idea what was going on. She lost over 10% of her body weight those first few days. When Kim came on day 3 for our home visit, she gave us donor milk.  She showed us how to feed her through a syringe using our pinky finger. Ellie was so happy to finally get some milk! I began pumping and taking supplements to try and make enough to keep her satisfied. I was pumping after each feeding and then supplementing her with what I pumped. This went on for almost 2 months. I was totally exhausted, but I wanted to nurse so much.

After multiple trips to see Dr. Hedgepeth, our chiropractor, and a Speech Therapist, Ellie finally began transferring more milk. Dr. Hedgepeth was able to do adjustments on certain spots around Ellie’s jaw, neck, and head muscles to help enable her to suck more efficiently. She worked with her soft palate and sometimes her back. Our Speech Therapist taught us exercises to do at home, which also helped Ellie’s suckle. She explained the different bottle types.  She showed us we needed the simplest type and kept us on low flow nipples so Ellie would work harder to get the milk out of the bottles. This in turn strengthened her suckle. It took a lot of patience and time, but in the end it all helped. I am so glad I didn’t give up, because now she is 10 months old and eats like a champ. I am off all supplements and plan to nurse until she is ready to wean. It has been such a comfort for her, and I have enjoyed it so much. I am thankful for all of the help from Ellie, our LC, Nancy, and the continued encouragement from Leigh Ann and Kate. Although Ellie never has latched like other kids, she gets what she needs and is so happy and healthy. Now when I grab my pink Boppy pillow and say, “Do you want mommy’s milk?,” she smiles and laughs and starts crawling all over me. I love it!

It was a long road but worthwhile indeed.

What's New at the Boutique

Bravado’s Essential Nursing Tank

Mothers often come into the Boutique looking for nursing bras - something they can wear during pregnancy, as well as after; something versatile and affordable. A nursing tank may be just the thing!

Bravado’s Essential Nursing Tanks come with a built-in bra that gives you full support. The high quality cotton/spandex fabric stretches and retains its shape even after washing. They are great for nursing in public, as well as during the night. The tank provides tummy coverage, while the discreet nursing clips allow for easy breastfeeding access.

Bravado Essential Nursing Tanks are available in sizes 34 B/C to 44 F/G. These tanks come in a variety of bold colors like the turquoise above, pastels, as well as black and white.

Come by the Boutique to try one on!

Sweet Potato Burritos

This simple and delicious meal is a favorite in nurse Ellen Shrader’s household. It can easily feed a family of four, and the kids can help prepare it!

4 sweet potatoes
2 cans black beans
2 cups brown rice
1 large onion, diced
1 large red pepper, diced
Juice of one orange or 4 tbsp OJ
4 cloves garlic
2 tbsp olive oil
2 cups shredded cheddar cheese
Burrito wrappers
2 tbsp cumin
1 tbsp chili powder
Pinch of cayenne pepper

• Preheat oven to 350^oF. Bake sweet potatoes whole until tender, about 1 hour. Peel, mash, and add cumin, chili powder, and cayenne to taste.
• Cook brown rice in 4 cups water.
• Sauté onion, red pepper, and garlic in olive oil until tender. Add black beans and orange juice. Let simmer 5 minutes.
• Put 4 bowls out in front of you, one each for sweet potatoes, rice, black beans, and cheese. If the kids want to participate, they can make their own burrito and wrap it up.
• Put burritos back in the oven for 10-15 minutes until cheese melts. Serve with your favorite salsa!

New Arrivals

Sally Louise Uecker – 7 lbs.,13 oz. – September 17 (pictured above right)

Marek Francis Stolka - 8 lbs., 4 oz. - October 2 (pictured above left)

Felix Henry-Gottschalk – 7 lbs., 9 oz. – October 4

Alexandra Mae Lyn McCreery – 6 lbs., 2 oz. – October 5

Zoe Joan Ogallo – 7 lbs., 12.5 oz. – October 10

Oliver Higgins – 9 lbs., 5 oz. – October 12

David Bobbitt – 9 lbs. – October 13

Paige Reilly – 7 lbs., 6 oz. – October 13

Alaina Faith Overton – 7 lbs., 11 oz. – October 14

Dorothy Yonuschot Sexton – 8 lbs., 5 oz. – October 16

Simon Gard – 6 lbs., 12 oz. – October 16

Logan Scott Dice – 6 lbs., 10 oz. – October 17

Caleb Jace Lee – 6 lbs., 14 oz. – October 19

Alaina Grace Zdeb – 7 lbs. – October 20

Clair Angélie White – 7 lbs., 10 oz. – October 21

Karsyn Analee Rice – 7 lbs. – October 25

Bodhi Gabriel Hernandez-Dowd – 6 lbs., 5 oz. – October 26

Ezra Ryan Breakey – 8 lbs. – October 27

Emily Jane Roberts – 8 lbs., 8 oz. – October 31

Welcome to the world, sweet babies! Congratulations to these wonderful families!

 

If you would like your baby’s birth announced in the next newsletter, send an email to missy_swanson@hotmail.com with your baby’s name, birthdate, and weight.  Feel free to send a picture, too!