Enlarging Borders

Remember several years back when The Prayer of Jabez was all the range amongst Christians?  Everyone was doing the christianese thing: buying the book, jumping in, and maybe a little hesitantly praying the prayer.  

“Oh Lord that you would bless me and enlarge my borders…”  

Praying that prayer felt a little bit like singing 'Oceans' for the first time…”Spirit lead me where my trust is without borders. Let me walk upon the water, wherever you may call me.  Take me deeper than my feet could ever wonder…”

Let’s be honest. Those are just downright scary things to say.  Most of the time I think enlarging my borders sounds overwhelming, demanding, and stretching.  If I’m honest, I don’t like change and enlarging borders is usually a whole lot of change.  If enlarging borders means adding new people and new relationships, I tend to think more emotional energy and time will be required of me.  If enlarging my borders looks like adding a task or an event, I usually give a deep inner sigh and dread it for a while before embracing it and moving on.  I know having my borders enlarged isn’t all bad, all scary, or all overwhelming...it just takes me time to accept, adjust, and embrace the change the comes with border expansion.  Often after adjusting and embracing the new border, I realize how ridiculous it was to be so hesitant and full of sighs in the first place.

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We’ve been enlarging our borders a little at the Maternity Center lately.  With the help of another missionary in PAP (Port au Prince), we’ve been able to establish a relationship with a government maternity hospital.  They’ve graciously allowed us to come in on Wednesday mornings to teach the women in their postpartum ward about breastfeeding. I’ll just say this…I do not have very many positive experiences with any third world medical system. Being somewhat on the ‘inside’ of that system scares the crap out of me.  It’s usually a system where I’m hated and a system I usually find very unjust, among many other things. 

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 Breastfeeding is, unfortunately, not the norm here.  There are a lot of cultural beliefs that hinder successful breastfeeding.  In a country where milk is expensive and potable water sources are lacking, exclusive breastfeeding can often be the difference between life and death for babies. At Heartline Maternity Center, we are passionate about teaching our women to breastfeed exclusively and successfully. We are intentional about educating, encouraging and helping them in this. Women who give birth in hospitals are often told little bits of information here and there, but the medical system here isn’t one of education and support. 

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We’ve only been at this lactation support thing at this government hospital for three weeks now.  The first week felt scary, intimidating and overwhelming.  It’s kind of a big deal to, tactfully of course, give someone a lot of information that is exactly opposite of what their culture believes is true, followed by asking them if you can grab their boob and their baby to help them get this show on the road. The second week was slightly more familiar, but the teaching still felt awkward and useless.  Being culturally appropriate requires greeting and making conversation with each woman in the room. A power point and a lot of information didn’t seem like it was making any headway.  One of our Tete Club members, April, is a great guitar player and suggested we write a song with all the teaching facts we wanted the ladies to know.

So, yesterday afternoon we sat down to write a song about breastmilk and colostrum and what transpired was totally fun!  All the main points we wanted to teach were incorporated into a fun tune with some amazing vocals! 

Today, we had breakthrough! We tried our song out this morning and it was a hit! Most of the hospital was singing along while the postpartum ward was filled with dancing nurses, doctors, and midwifery students. It’s a catchy enough tune that the lyrics get stuck in your head!  I’m sitting in Miami airport and I keep catching myself singing, “Kite bebe souse l.” (Keep the baby sucking.) Whoever thought songs of boobs and milk would be so catchy?!?

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We asked one of our sweet Momma's, Mica, from the Maternity Center to join us too. Mica went through our program this past year and found her way to the Maternity Center when she found out she was pregnant as a result of rape.  This momma was forced to step down from her position as worship leader at her church after becoming pregnant. She struggled during her pregnancy and questioned her ability to truly love her baby based on her circumstances. Her sweet boy was born sometime last April and she has become an amazing mother who truly loves her little man. She has also been leading worship for child development on Tuesdays at the Maternity Center and it has been such a sweet picture of redemption and healing. Mica will graduate from the program in October and we’ve been doing some early grieving over her departure.

Seeing how this 'border enlargement' has unfolded has me now rolling my eyes at the initial hesitation I had.  I’m thankful to have team members who say things like, “This is uncomfortable, intimidating and scary, but let’s just do it. We’ll do different things and figure out what works.”  They are right. Having my borders enlarged isn’t usually a place of great comfort, but it is a place where God can do some awesome things. I’m glad He still moves and works in spite of my hesitation and resistance. We love that we are able to involve this momma from our program as well. Her story is one of redemption, and through redemption, her borders are being expanded to love and care for other new moms. 

I’m sure I’ll have endless opportunities to work on my response to border enlargement in the future. Praying the prayer of Jabez and singing ‘Oceans’ isn’t going to become any less weighted and I’ll still struggle with border enlargement from time to time, but for Wednesday’s lactation support group (or whatever it is we are called), I’m embracing it. 

Song writing 

SoIL

Endless, winding, two-lane roads lined with corn and soy bean fields are my scenery as I pull into the driveway.  The quaint farmhouse with a red door and white picket fence are my sign that I've arrived to the arms, the many arms, of my family.  There are many of us...seven girls and five boys to be exact.  We don't all live in this cute little house anymore.  Actually, I've never lived here. My parents moved in after I moved away six years ago. There are only six of the twelve Johnson children still living at home.  Six still sounds like a lot kids to most people, but it feels like so few to those of us who are oblivious to the normal chaos of life with so many people under the same roof.

I always enjoy coming back here...the pace of life is slower even with such a large family, believe it or not.  There are exactly two stoplights, two decent restaurants, and a Walmart in the closest town with a population of 5,500. Life is much more laid back here. I look out the window and see miles of cornfields instead of miles of subdivisions (Texas) or seas of people and mounds of trash. All that green is breathtaking and the stars at night are big and bright deep in the heart of...SoIL.

As much as I love it here, I usually feel a little out of place. Everyone has a routine and my routine is nonexistent here.  The slow pace of life eventually catches up with me and I realize I'm terrible at doing nothing. I try to tell myself to just be still and soak up this time of rest where nothing else needs my attention. It works for a few days before I start to feel a little stir crazy, so in the midst of my stir crazy, nonexistent routine of rest, I end up having conversations about life with six and eight year olds that go something like this...

Abraham, 8 years old: "Bethany, why aren't you married yet? Are you ever going to get married?"
Of course he can't wrap his little mind around why I'm not married. All of my younger siblings 17 years old or older are either married or soon to be married. Two of them even have babies.

Me: "It's just not time for me to be married yet and I'm happy with that.  Why do you think I wouldn't get married someday?"

Abraham:  "Because you're too old."

I can't help but chuckle. I am old in his little world.

Hadassah, 6 years old, adds: "I don't think you'll get married because people don't like your job."

I laugh again. She's probably right. Goodness, I don't know if I'd want to marry someone who has my crazy midwife lifestyle.  I love hearing their thoughts on life.  They are pure and there's no chance that they'll withhold their opinion for fear of offending me.  I'm certainly not easily offended, nor am I desperately desiring to get married and start a family.  Their honest words are more comical to me than anything. Their sweet little voices and view of life on the porch swing that cool rainy evening make me grateful for this little time of nonexistent routine.

What's Happening

In just a few short days I’ll be jumping into my “summer” in the good ol’ US of A as most everyone there is wrapping their summer breaks up.  My original plan was to return to the states June 1st and spend a few weeks visiting family, friends, and churches for support raising.  Scratch that.  As we (the midwives at the MC) looked at the coming months, June seemed as though it was going to be a little crazy with all the mommas we had due. With that in mind, I decided to push back my travels until the end of June to keep us from being short staffed during the busy months.  Ditch that.  I tried a few times to buy plane tickets, but thanks to occasionally sketchy Haiti wifi, my tickets didn’t go through and plans changed again.  My sister and one of my dear friends from midwifery school decided to get married in August. 

So…here I am. August is quickly approaching and it’s strange to think of leaving here to live in my other reality for the next 6 weeks.  Sometimes I find it hard to fathom that my life, as I know it in America, is actually part of my life. The past 7 months have brought a change of perspective.  In the Fall I came to Haiti thinking I would be here for a short time and then return to my life in the United States.  After only 3 months and the mindset that I’d be returning to what I had left in the US, returning didn’t seem like such a strange thing.  Since I returned (to Haiti) in January, my mind has made the switch…I live here. I’m no longer visiting Haiti…I’m visiting the US. 

Living in Haiti means encountering a lot of people who come and go, many of whom you may only see once. Hence you’re always asking or answering the same 20 questions.  “Where are you from? How long have you been here?  What do you do here?  How long are you staying?”  And my very least favorite question, “How’s your Creole?”  The "how long are you staying" question always gives me slight pause…I mostly want to answer, “forever.”  However, one really wise ginger midwife I get to work with always says that saying we’ll stay forever shouldn’t really be ‘a thing’.  She’s right.  Things change, God leads, some doors open, some close, and saying I’ll stay forever doesn’t keep me open or flexible.  Instead of answering, “forever” I usually end up saying…”I don’t know, but I hope it’s a long time.” 

Thursday morning, while pregnant bellies waddle through our little maternity center door, I’ll be getting on a plane to fly back to the land of big highways, air conditioners, hot water, corn fields, green trees, my sweet family and lovely friends.  I’m thankful I get to visit my other reality filled with so many wonderful people and thankful I get to return to this reality.  I can’t wait to see and connect with so many of you!

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In other news, I’m a terrible blogger as you’ve noticed.  Actually, I don’t think I even get to hold the title of ‘blogger’.  Let’s just say I’m terrible at keeping you up on what’s going on here.  If you’ve been following me or anyone who works in Haiti, you know we all ended up having Chikungunya.  The acute phase was basically the most miserable I’ve ever been.  That is long over and now most of our community continues to suffer from residual arthritic pain.  It has been discouraging and downright depressing at times.  The studies about longterm ChikV symptoms in the chronic phase have not been encouraging.  We moan every time we see another article or study on it.  The numbers are not good, but we are praying and hoping that those statistics, from other countries, will not be the case for our community and our little Caribbean island. 

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Here are some news highlights in pictures…

My last few blog posts where about a baby named Marvens who suffered from Chikungunya.  Many of you followed and shared his story while praying we’d see a miracle. We did! He’s doing amazing! 

  I get to see sweet baby Sofoni and her momma Guerda everyday. Everyday I'm still in awe of the miracle that they are.  Guerda lost seven babies before giving birth to Sofoni.  You can read her story here. 

As always, births continue.  Our last several births have been uncomplicated and quick! One of our recent moms arrived fully dilated and when I told her she dilated fast and could push whenever she felt like it, she responded with, "I went fast because I walked here."  We teach, during prenatal education, that walking and being active in labor can help decrease the length of labor.  I love it when the education we do makes a difference! 

I've written before about taking moms home once we 'discharge' them.  It's always humbling and eye-opening. You can read about it here, here , and here.

Tuesday's Child Development program and Thursday's Prenatal program continue weekly. 

The new maternity center is slowly, but surely taking shape.  This new site will eventually be an extension of what we do in the current maternity center. 

Last, but not least, I had my first visitor!  My sweet sweet friend Krista came,  brought lots of fun goodies for us, loved on us and our mommas, and snuggled lots of babies.  I LOVED every moment of having her here. 

A Miracle

This happened today. Marvens went home with his sweet dedicated momma. He has been seizure free for one week! Thank you all for praying! He's an amazing little miracle and I am in awe. 

A Call to Prayer

The past two weeks we've had constant flow of Chikungunya victims arriving at our door with high fevers, severe bone-breaking pain, dehydration, and tachycardia (higher than normal heart rate).  It's a vicious mosquito-borne virus and I detest it. It's debilitating and no respecter of persons.

A week and a half ago we had three babies born in eighteen hours at the MC. I think we broke our record for most babies in the shortest amount of time.  The days following broke a few more records we didn't know about. Two of the babies born in that eighteen hour time period exhibited symptoms of Chikungunya within 48-52 hours after birth.  Though Chikungunya has a very short incubation period after being bitten by an infected mosquito, 48-52 hours was too quick. Considering both mothers of these babies presented with signs of Chikungunya during or shortly after labor, we believe their babies contracted Chikungunya via vertical transmission.

One of the babies who contracted Chikungunya, via vertical transmission, is Marven. I'm quite inadequate to tell his story.  It has so many more factors than just his battle with Chikungunya. To give you a better picture of his story, it begins with his momma, Christella. She has three other children and the heartache she experienced with them during her pregnancy was more than I want to tell you about here. Christella bonded beautifully with her new little boy in the days following his birth. When he started showing signs of Chikungunya, she held him, talked to him, and cared for him around the clock. It might not seem like a big deal...every mother would do that, right?  It's different here.  That's most often not the case. Holding babies close and soothing them isn't really a thing.  We have to do endless education to get the skin-to-skin and a baby needs its' mom idea across. For Christella, that was just instinctual.  I never had to prompt her to feed her baby, never had to encourage her to hold him rather than set him on the opposite side of the bed. She was the first one to notice his strange body movements 36 hours after his Chikungunya symptoms started.

After watching a few "episodes", I was fairly sure he was having seizures. Scary. Watching a little baby seize is enough to break my heart into a million pieces. The care this little guy needed is so beyond my knowledge and skill level, but there really weren't any other options of places to care for him. Hospitals are full and turning away Chikungunya patients.

This is the part where I could write a book on how deeply grateful I am for our Dokte Jen, her heart for Haiti, her wealth of knowledge, and her ability to remember every medicine we have. I could do some serious technology product promoting as well. Thanks to Jen and technology we spent the next 24 hours trying to get his seizures to stop. Marvens has been seizure free since Friday night!

Yesterday was a heavy, scary day of unknowns. As we waited for the sedative effects of phenobarbital to wear off, we didn't know if Marvens' hypotonia (lack of muscle tone) and lethargy were due to the effects of medicine or damage from seizures and encephalopathy (disorder of the brain). As 24 hours without phenobarbital came and went and the hypotonia and lethargy remained, there were a lot of unanswered questions and crashing hope. Christella became increasingly discouraged and asked that we quit giving Marvens all medication because she was scared of how it was effecting his body. She understands we can't promise anything, that we can only try our best and that seizures can do damage. The possibility of having a mentally disabled, epileptic child here is completely overwhelming. It's hard to get medical care for the basics sometimes, let alone something as complicated as this.

Christella agreed to let us give Marvens another 24 hours of seizure medications. This morning I was so relieved with the improvement he had overnight. He is moving, breastfeeding, and awake and alert for periods of time. Tonight we are 72 hours seizure free, which means it's time to come head to head with more unknowns. Will he have a life-long seizure disorder? Will the effects of encephalopathy be life-long? We will be taking Marvens off seizure medicine tonight to see how he does.

The unknown is scary.  We've seen God answer our prayers over the past few days as medicines have stopped seizures, lethargy has faded, and he has started breastfeeding again. Will you pray with us tonight? Pray he will have no more seizures and that in the coming months, as we watch his development, we'll see normal developmental progress.

"When all else is unclear, the heart of trust says, as Jesus did on the cross, 'Into your hands I commit my spirit.'"- Brennan Manning
So I'm committing this night  into His hands and asking Him to help me trust.

I've thought about these words much over the past week.

Mothers

Our mothers, regardless of how we may feel about them, play a large role in our lives.  We may be people who have been loved and nurtured in wonderful and profound ways by our mothers or we may be people who wish that were true.  Regardless of what our relationship has been or is with our mothers, we know it is significant.  

For those of us who have been nurtured, cared for and loved by our mothers, we see the difference it likely made in our lives.  Occasionally we get glimpses of what our life could have looked like without the loving care of our mothers and we are endlessly grateful for the part they’ve played in who we have become.

For many of us, our lives have been impacted by loving, caring, and nurturing women regardless of their mother status. Some of these women have been mothers, friends, aunts, grandmothers, and sisters.  We’ve been encouraged, inspired, loved, treasured, and pushed to deeper places by these women.  

This Mother’s Day we want to honor the women who have graced our lives with love and joy by giving you the opportunity to provide life-saving care to women who will impact the lives of their children and others around them.

Mother's Day is right around the corner, if you are anything like us, time has gotten away from you. We are excited to offer you a beautiful way to honor those you love. This is the perfect honorary gift for future moms, friends, adoptive moms, sisters, foster moms, stepmoms, single-dads, or those that are longing to be a mom.

With a donation in honor of your favorite Momma, we will send her a personalized card letting her know you are thinking of her this year.

A donation of $15, $25, $50, $100, and $2300 will do the following:

$15 - Provides the basic medications needed at a birth for mom and baby

$25 - Provides for a day of postpartum care for one woman

$50 - Provides for the supplies (and upkeep of equipment) for one labor and delivery

$100 - Provides for one month of early childhood development classes and support

$2,300- Provides for one woman entering the program in the first trimester, lab-work, necessary monitoring, medicine, prenatal care, educational classes weekly during the entire pregnancy, labor and delivery at Heartline (with a reliable transport option if an emergency dictates transport), 48 to 72 ++ hours round the clock postpartum care, six months of weekly classes and scheduled post-partum monitoring of mother and baby

With your donation of $15 or more, we will send the woman you wish to honor a personalized card (similar to the example above) via email.

To donate in honor of your favorite woman, please go to this page:

http://heartlineministries.org/product/general-donation/

You may donate by PayPal or Credit Card.

After you have donated, you will immediately receive an email confirmation of your donation.

Complete the following steps:

1.                    Make a donation at the link above

2.                   When you receive your email receipt forward it to tara.livesay@heartlineministries.org

3.                   Include:  The name of the woman you want to honor (My sister, Tina got the example card above) - The email address you would like us to send the card to.  (We will blind copy you when we send it.) All cards will be sent on May 10 or 11, if you have a preference please note when you would like the email to be sent. Please also include the name of the donor/gift giver if you wish to disclose that information.  The subject line will say, "Sarah wanted to honor you this Mother's Day" if you share your name, please share it as you want it used in the subject line.

Your donation makes a difference in the life of Haitian mothers.  Your donation honors the work and sacrifice of the woman you want to recognize.

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To meet and/or pray for some of the women in the program, you can go here.

Heartline Maternity Center and our programs are unique. Yes, we offer a incredibly needed and valuable (life-saving) services. More than that though, we offer love, relationship, friendship, and time. 

We meet women early in their pregnancies. We meet women that are living in a country with thehighest maternal mortality rate in the western hemisphere, where 2 out of 3 of their friends deliver at home without a skilled birth attendant. Because of that, we meet women in a country where the risk of dying during child-bearing years is unusually high and the chances of losing the baby are just as daunting. 

We are able to spend 7 to 9 months of a woman's pregnancy getting to know her story, her needs, her unique situation. Prenatal care is rare for Haitian women, we are thankful to offer the same quality prenatal care in Haiti that our friends and relatives in North America are receiving. By the time a woman delivers her baby with us we know the details of her biggest challenges in life, and we know how to support her in a personal way as she delivers a new life into what oftentimes amounts to hardship and chaos. 

During labor and delivery a woman is able to do the miraculous work of bringing her baby into the world in a calm environment where people offer nurture, gentleness, kindness, and love. If you have visited a Haitian hospital or walked through a crowded neighborhood in Port au Prince, you understand the vast difference our birth-center environment offers a woman.

After delivery we are able to walk with her as she does the work of bonding.  In cultures of poverty this doesn't come as naturally as it does for those of us living with material blessings galore. We love, encourage, and stand with the new mother while she begins to nurse her baby and bond to him or her in the process. We encourage mothers that God has given them the skills and heart they need to love, serve, and raise their children.

We offer education and ongoing support for the first six months of her baby's life.  We teach about child-spacing and safe and effective methods of birth-control, in order to empower each woman to take the lead in their own health and future.

We are human and we make mistakes, we are not perfect, but we try hard to get it right when we're walking along side our Haitian friends. We work diligently to withhold any judgment and simply offer a place of safety and love and grace to a woman that is coming to us from a life of difficulties we will never fully understand. 

We are so grateful to have never lost a mother in our delivery room - but we are even more proud to share that the women that enter our doors feel valued and honored and loved --- and that is the reason you want to consider supporting Heartline Maternity Center when you give in honor of someone you love this Mother's Day.

In which I should know to never say never

I'm the oldest of 12 children. My parents experienced three pregnancy losses prior to having children and were told they would likely never have children. Once they finally had a baby (me), they never stopped...until they got to number 12 that is. The first four of us were born in four years. I turned 4 years old just two days after baby number four came into the world. My mother had her hands full and I quickly learned that, at age four, I was not a baby any longer. I would go to the cradle, pick up my crying baby sister, and rock her in the big green rocking chair we had.

 I grew up fast as evidenced by the fact that I caught my first baby and became a midwife at age 18. I have never felt cheated out of my childhood or grieved my early maturity contrary to popular stereotype of how I "should" feel. I have, however, discovered that I do have certain tendencies that are highly likely a result of birth order and having so many younger siblings. 

One of those tendencies being how I feel, or rather how I have felt in the past about teaching. I tend to think it's easier and way more time efficient for me to just do it (whatever it may be) rather than teach it, especially if it means you didn't do it right the first time and we have to go back and do it again. 

 

Because there is such maternal healthcare crisis, the world over, there is a huge need for midwives. “In 2011, UNFPA and 30 partners published the State of the World’s Midwifery 2011: Delivering Health, Saving Lives. The report, the first of its kind, surveyed 58 developing countries that together account for 91 per cent of the world’s maternal deaths. The State of the World’s Midwifery Report found that up to 3.6 million lives could be saved each year in 38 of the countries surveyed, if an additional 112,000 more health workers with midwifery skills were practicing in communities and backed up by a functioning health system.” - WHO & UNFPA

I attended a midwifery school that placed a heavy emphasis on international midwifery and maternal health care worldwide and encouraged us, once we graduated, to go out and use the needed skill of midwifery to share Jesus.  Naturally, since there’s such a large need for midwifery, most midwives practicing third world find that the most effective way to help reduce maternal mortality is to teach and train midwives.  During our community development projects in school, we would fabricate plans to reduce the maternal morality rate in a specific area. These plans usually included training both national and international midwives.  I, however, made it very known that I did not like teaching, never wanted a student, and never intended to train midwives.

Most of the accomplished midwives I worked with while practicing midwifery in the US acted as prectoprs and trained midwives.  I was constantly being asked to precept for someone and encouraged by other midwives to take on a student. No. No. No. Always my answer, “no.”  I did not want a student.

 

After being in Haiti for a few months, it came up that Tara, one of Heartline’s long-term staff members and (almost licensed) midwife, needed a preceptor to be able to finish her clinical requirements once she returned from furlough.  I knew it was coming…the question in which I’m asked to be a preceptor and always answer without hesitancy, “no!”   Except for this time before the automatic “no” came a pause.  My thoughts, “It’s just a few clinical requirements.  It’s not like overseeing a student’s entire midwifery education.  I can sign my name on her last few required births.”   Okay, I resigned to my always “never” answer.

I’ve come to realize that my feelings toward teaching are not really how life goes.  (Duh!)   Easier and more efficient ways of doing things in life are usually never the soul-deep, fulfilling, or grace-giving ways of doing life.  So I’m learning, as a teacher, to slow…that my rush and easy efficiency only empty my soul of the depth and wonder of a moment. 
 I’m learning that,
“In our rushing, bulls in china shops, we break our own lives.” –Ann Voskamp  
 And sometimes the lives others too.

I’ve come to love this teaching thing that I so insistently would never agree to. This morning I sat next to Tara and watched her do amazing things as she helped guide a new life into the world. I sat beside her while I watched her mad sewing skills do way more than sew clothes.  Last week Beth M. and I did the same thing. I love how much learning something new and conquering a new skill brings such a sense of deep thankfulness, accomplishment and wonder to a moment.

Ann Voskamp says, “In this endless cycle of grace, He gives us gifts to serve the world.”  I love the gift of teaching and learning in midwifery and I’m thankful that it indeed serves the women of this world.