When we arrived at the clinic, we saw a few of our women, Amanda, Davian and Heather, helping a young girl who was in labor. I was proud to see them holding her and coaxing her to breathe and drink water. None of them had any experience, but one of our other women, Sarah, a doula, had given them instructions while she attended an emergency C-section taking place at the same time. Amanda told me that the young mother had been distressed when they arrived. Alone, she was crying out to God, afraid that she had done something wrong and that this pain was her punishment. Seventeen years old, her name was Miriam and this was her first birth. As is the custom, the mother-in-law attends the birth, but there was no one. No mother or auntie to tell her what to expect or remind her to breathe or scream, or provide the wisdom of their experience, only her younger sister who mostly stayed away until after the birth. Miriam was clearly terrified, in pain and very much alone, so Suzanne and I joined in with the other women to support her in her birth process.
Standing outside in the hot sun, naked, except for a short piece of cloth that covered her from the top of her breasts to the bottom of her buttocks, she was swaying in pain, often dropping to all fours, clawing at the earth and clutching her belly. With each contraction, she would grab onto our arms or legs, squeezing tightly until the pain subsided. She looked wild-eyed and panicked, and we kept encouraging her to breathe when the contractions came. She reeked of sweat, blood, urine and shit, all of which was smeared down her buttock and legs. We searched for a wet cloth to wash her but were told that unless she brought one herself, there was none available. All the mothers are responsible for providing their own clean cloth, water, food, birthing wrap for the baby, as well as a plastic garbage bag to lie on for the delivery. She was 9 centimeters when I arrived, and we knew this baby was coming soon, so we brought her back into the delivery room.