Glory Reborn

Disclaimer: this post is about the birthing center I visited this week....those readers not medically inclined may be bored with the medical jargon, but there's nothing too graphic, don't worry.

So on Thursday last week I went with Marlys to Glory Reborn (www.gloryreborn.com), a free birthing center nestled in the heart of Ceby City. As we walked up, I saw at least 20 pregnant women sitting in chairs to the side of the clinic, some there for education classes and some there for a prenatal check up. The clinic is in an old apartment building. They have two levels of small apartment space. I found myself having to get used to the "openness" of things here - front door stayed open, windows open, mere curtains seperating me from women being triaged, most people barefoot as people here leave their slippers (flip-flops) at the door. We were greeted by a friendly staff woman when we entered. We then waited for Hillary to come show us around. Let me introduce Hillary to you - she is, in a word, amazing. She had a strong vision for this birthing center after a mission trip to Cebu 10 or so years ago. She moved out here with her husband in '03 to start this place from the ground up. Since opening they have successfully delivered over 1700 babies...no demises or maternal death. Praise God! Through the tour and lengthy discussion with Hillary, here are some things I found out...

They deliver about 37 babies/month. No epidurals for these birthing ladies! If they really really want something, they can have Demerol IM. For repairs, lidocaine unless a 3rd or 4th degree, in which case they revert to something stronger. There are four doctors that work with the clinic - they are staffed at a hospital, but will attend high risk deliveries at the center. The place is run by midwives and nurses, the head midwife lives in an apartment adjoining the center.

Screening is significant for patients they accept. They like to know all history possible, significant things being HIV, Syphillis and Gonorrhea, previous pregnancies/deliveries, the usual stuff. They rarely choose not to accept a woman - really only two cases: if you're greater than 7 months and/or a VBAC unless she's has a previously successful VBAC. The women are also dischared from the clinic if they miss 2 appointments. Hillary informed me that word gets around the communities fast - you want to get in at the clinic, and you MUST go to your appointments. Rarely do they have to discharge women. Good medical care is hard to find...and free good medical care is virtually impossible to find...these women learn quick. (Oh, there were days we all wished we could discharge at Presby..."I'm sorry, you'll have to go to the OTHER hospital because you've not attented all your prenatal appointments. Thanks and have a great delivery.") At one of the city hospitals, there are three patients to a bed. Then add in the "helper" to care for the patient - usually a family member or friend - and the babies...that's over 9 people to ONE bed. At the federal hospital we went to today, there are 5 laboring mammas to a bed. Next time you have a patient complaint about the TV remote not working, inform them they could literally be sharing a birthing bed with 2-4 other laboring women, in a room full of beds. The wards here are literally a huge room with tons of beds, some curtains, and women all over. No birthing suites here! At the center, there is one small room for deliveries - two beds and two monitors, and one small room for postpartum moms - two beds as well.

Initial tests include a CBC, T&S, GBS, and a UA. STD's are tested on an individual basis. *Important note - the rate of their premature babies is significantly reduced when they treat STD's during pregnancy. The mom's all received their prenatal vitamins free from the clinic, and they are also told to bring with them to each appointment one cheap item from a checklist - a syringe, bulb, cord clamp, etc. - so at delivery they have the few needed supplies already there.

They do care for high risk patients. Lots of women have GDM. Preterm labor is rare. They will vaginally deliver breech babies, unless it's the first of twins. They have had 100% success with their versions...in my three years of L&D I saw a few successful turns (maybe this is because their babies here are 5-6 pounds at delivery?). If complications during delivery, they will be referred and taken to a private hospital (they used to refer two hospitals, until they found out the women they sent were being turned away if they were too busy...at this same hospital the patients were given a list of anesthesiologists they had to call up and bargain a price for them to come in and to the c/s, if no one agreed, there would be no c/s...can you imagine?!?!). If they deliver vaginally, they stay at the center 24 hours, c/s deliveries stay at the hospital 3 nights. They will do pitocin drip inductions at the center - but not for primips. Continuous monitoring for inductions. They will also AROM - monitoring for 30 minutes after, I think. Intermittent monitoring if everything looks ok.

Hillary also informed me that condoms are never used here and the Filipino mentality of acquiring HIV is: I'm in the clear as long as I don't get pregnant. Sheesh!

So there you have it. No whirlpool tubs, no epis, no MAC, no 4-SERV, no JCAHO, no fetal demises, no labeling speci hats and barf canisters...just lots of babies! (Sounds kinda good to me...kinda.)

Hope things are well at good ole' Presby Birthing Care...miss you ladies!