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Announcing Babymoon Inn’s New Clinical Director

March 29, 2016
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So far, 2016 has been a year of exciting growth and change at Babymoon Inn. During the past year, we solicited feedback about how we could provide even better care while reaching still more families who may previously have not considered birth centers or midwifery care. In listening to the thoughtful feedback from our families, who primarily expressed the desire for a more holistic model of care with full-scope midwifery (to include gyn and women’s primary care), we have expanded our program of care to include hospital births (both planned hospital births and transfers from the birth center) and have expanded our midwifery team to include a broader skill set in both alternative medicine as well as gyn and women’s health.

It takes a passionate and committed team to provide the excellent holistic care we strive to offer our families. And, that passionate team needs strong clinicians! After a national search, we are so pleased to introduce Maribeth Diver MSN, CNM, who has been one of our part-time midwives for the past few months, as Babymoon Inn’s full-time clinical director. Maribeth brings to Babymoon 15 years of wide-ranging experience in midwifery and looks forward to utilizing her holistic and evidence-based approach to care with the families we serve.

Maribeth is a true believer in out-of-hospital birth for healthy, low-risk women, and was previously a midwife and the clinical director of a high volume birth center offering home, birth center, and hospital births. She is also an accreditation specialist for the Commission for the Accreditation of Birth Centers, performing site visits at birth centers across the country.

Maribeth has spent time in Ohio, New Mexico, Colorado, Seattle, and Boston. Her experience includes serving Amish families in Pennsylvania and working as a volunteer midwife in Laos for two years. She currently lives in Scottsdale with her daughter, Liana, her parents, and her two dogs, but she plans to move to Central Phoenix this summer.

Maribeth will be an integral part in continuing to realize our vision to support women before, during, and after their pregnancy and birth. If you haven’t had the chance to meet Maribeth at a prenatal appointment or a Babymoon event, she is a full-scope midwife who is happy provide your well-woman care as well. We are thrilled to welcome Maribeth as our new clinical director – we know you will love her as much as we do!

A huge thanks to our interim clinical consultant Tanya Belcheff, who assisted us in our search and strategic planning for the practice growth and birth center care.

BIG news from Babymoon Inn…

January 20, 2016

Babymoon has BIG news.  We could not be more excited to announce a significant addition to our current program:

11196234_1053340168027635_3605429687964902431_nBabymoon Inn’s entire program of care is now available to women who require or choose hospital birth.

Babymoon Inn began with the intent to be a vehicle for women to access midwifery care.  And for more than four years, Babymoon and our midwives have touched countless lives and been witness to the creation of countless new families.  But it’s also weighed on our hearts that we couldn’t offer this care to MORE women. Our new program allows us to further our mission of providing loving, evidence-based midwifery care to every woman. 

What this means for our current birth center clients:

  1. Continuity of care if your low-risk status changes during pregnancy. Mothers whose low-risk status changes before the birth of their baby will now remain under the care of Babymoon Inn midwives and will subsequently birth at the hospital, also under the care of Babymoon Inn midwives.  The Babymoon Inn love, care, and support remains the same – only the location of the birth changes.  Your Babymoon midwife and Babymoon doula will be your birth team at either St. Joseph’s Medical Center or Banner University Hospital.
  1. Continuity of care in the event a transfer is necessary during labor. “Transfer” can be an intimidating word to families who plan to birth at Babymoon Inn, and we understand that.  Under our new program, if a mother is in labor at the birth center and circumstances require a transfer to the hospital, the mother will transfer to the care of Babymoon Inn midwife at the hospital.
  1. Meeting our hospital team! Our midwives with hospital privileges will be seeing mamas in our office each week.  This means that if an intrapartum transfer of care is necessary, you will be transferring care to a Babymoon midwife you already know!

What this means for future clients:

  1. Midwifery care for more women. Mothers who are not eligible or interested in birthing at the birth center can now receive Babymoon Inn’s entire program of care and then birth at a hospital.  This includes mothers seeking a VBAC, mothers who have conceived through IVF, mothers for whom hospital birth is a safer option, and mothers who prefer a hospital birth for personal reasons.  All of these women now have access to Babymoon’s entire program of care – full-scope midwifery, childbirth preparation classes, prenatal massage, doula support, basic birth photography, and more.
  1. A choice of birth locations. Birth centers provide a comfortable, safe place for low-risk women to give birth.  Evidence has repeatedly and overwhelmingly confirmed the safety of birth centers and the high rates of patient satisfaction regarding their experience.  But there is a multitude of reasons why a woman may need or choose to birth in a hospital as well.  Some women may have added risk factors making hospital birth necessary, others may feel more comfortable in a hospital environment, and others may desire midwifery care but still prefer the pain-relief options available in the hospital.  Under our new program, Babymoon Inn can now embrace ALL of these women and help them have the birth desire in the location they desire.
  1. Babymoon’s providers will now be contracted with most major insurance companies. The facility itself (the birth center) may still be considered out-of-network. Our team works hard to maximize your insurance benefits and request gap exceptions to have our facility covered in-network as well, but we are not always successful in this regard.  If you desire Babymoon’s program of care but your insurance will not cover the facility, you now have the option of receiving care at Babymoon and birthing at an in-network hospital with a Babymoon Inn midwife.

We are so excited to move forward with this addition to our program! Please feel free to call us at 602-314-7755 or email inquiries@babymooninn.com with any questions or to set up a tour.

 

Oct. 1: Show your birth center pride!

September 9, 2015

Babymoon Inn is a proud member of the American Association of Birth Centers.  Babymoon and our fellow accredited birth centers are thrilled to be hosting this year’s AABC Birth Institute in Scottsdale.  This annual conference provides an opportunity for birth centers to network, receive up-to-date information, and continue to work together to grow this important industry and improve maternity care.  It also provides a chance for our families to show their birth center pride at the AABC Birth Institute Parade of Families!

Has your life or journey of motherhood been positively affected by Babymoon Inn? If you have birthed a baby here, seen our midwives, attended one of our classes, used one of our doulas, attended Inn Mommies or a Nest event, or even benefited from the amazing community in our Inn Mommies Facebook group, then we invite you to come join the Parade of Families!  You are ALL Babymoon Inn families, and we proudly claim your kiddos as #birthcenterbabies!

On October 1, we’ll gather at 6:45pm at Maricopa 1 at The Scottsdale Resort at McCormick Ranch. Then all the families will have a fun parade across the conference stage.  After the parade, please join us back at the hospitality suite – hosted by Babymoon Inn – for food and family fun. We would love to see as many families possible showing their Babymoon pride!  This is a great time to put those babies in their Babymoon onesies or rock your own Babymoon Inn t-shirt!

You can RSVP through our Facebook event here: https://www.facebook.com/events/1001760869845051/  Please contact Bailey@babymooninn.com with any questions!

We hope to see you there!

Birth centers

Your Birth, Your Birth Team

June 9, 2015

Assembling your birth team is one of the most important steps in your journey toward birth and parenting. If you’ve chosen the midwives at Babymoon Inn birth center, congratulations! You’ve already made a choice that research has shown leads to better outcomes for both mom and baby.   You’ve increased your chances for a spontaneous vaginal delivery.  You’ve decreased your chances for preterm birth, instrument-assisted delivery, episiotomy, and Cesarean birth. You’ve also surrounded yourself by care providers who are there to love and support you if these things do occur.

So who is on your Babymoon birth team?

Babymoon Inn Midwives and Monitrices. This probably goes without saying, but labor and birth at a birth center is different than it is at a hospital. At Babymoon, you will have a midwife and a monitrice present throughout your entire labor. The midwife does not arrive at the last 20 minutes to catch your baby, and your monitrice is not dividing her time between several mommies, performing myriad clinical tasks. Your support team is there from start to finish. Our monitrices are present to provide physical and emotional labor support from the moment you arrive at the birth center. Their clinical skills as nurses add an extra layer of comfort and safety to the birth center experience, as there is always one clinical member of staff available for mommy and one for baby. This is not the industry standard, and Babymoon prides itself on providing the best in both labor support and in clinical skills and knowledge.

Alejandros Birthday 067Your Birth Partner.   Gone are the days of anxious fathers pacing the hallway while mom mysteriously gives birth in a room down the hall. While you have to do what is right for your family, most couples who choose a birth center plan to have both partners involved in the process. We welcome and encourage partners to participate in every part of your Babymoon experience: appointments, groups, classes, and of course the birth itself!  Ready, Set, Birth™ – our original childbirth preparation class – will prepare you AND your partner for what to expect and how you can work together labor and birth.

Your birth team may be very well be complete at this point. A loving and skilled midwife to provide top-notch, evidence-based care. An experienced monitrice to give you physical and emotional labor support. And your birth partner, whose love and emotional connection are unmatched by any other member of your birth team. For most families, this is the perfect combination of people to provide the loving support needed for a beautiful, natural, unhindered birth at Babymoon Inn. Additional members of your birth team may include:

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Family and Friends. When you invite family and friends to attend your birth at Babymoon, they become a part of your experience. Our Ready, Set, Team™ class is designed for expecting couples to sit down with their friends and family and determine how each member can be an asset to the birth team. We encourage families to be thoughtful about who they choose to be a part of their birth, as the Babymoon experience is an intimate one, and the people you invite to attend your birth will have a direct impact on its outcome.  Visit our calendar to see when our next Ready, Set, Team class will be held.

Older Siblings.  Big brothers and sisters-to-be are welcome at the birth center. When younger children are present, it is best to have a friend or family member in attendance specifically to tend to your other children’s needs. Talk to your midwife ahead of time about how to include your children in the birth experience and what conversations to have at home to prepare older siblings for the big day!

Doulas.  We welcome doulas from the community with open arms. Your Babymoon midwife and montrice will be present at your birth and are passionate about providing personalized, hands-on support, but our doors are open to doulas should you choose additional labor support. If you have built a relationship with a doula and would like her to attend your Babymoon birth, she is welcome! We encourage you to bring your doula to your 37-week appointment at the birth center so that she may familiarize herself with the environment.

Birth Photographers. Basic birth photography is included in our services. Should you choose to bring a professional photographer to your birth, they are welcome at Babymoon. Please email inquiries@babymooninn.com or ask in the office if you would like a referral to one of Babymoon’s preferred birth photographers.

For questions about services or classes offered at Babymoon Inn or The Nest at Babymoon Inn, please contact inquiries@babymooninn.com or call 602-314-7755.

Why Babymoon?

May 19, 2015

It’s a question we hear all the time during tours, through inquiry emails, and in person. Why should I have my baby at Babymoon Inn? What makes Babymoon different? Is it “worth” paying more out-of-pocket?  Here’s just a short list of reasons so many families choose Babymoon’s program of care.

Research has shown that midwifery care leads to better birth outcomes. The Babymoon midwives collaborate in a weekly chart review meeting to assure the highest level of care for our families.

Research has shown that midwifery care leads to better birth outcomes. The Babymoon midwives collaborate in a weekly chart review meeting to assure the highest level of care for our famili

1.  Our midwives offer evidence-based care. A 2013 Cochrane review found that midwives improve birth outcomes. Women whose pregnancy care was led by a midwife were less likely to have pre-term birth, an episiotomy, an instrumental birth, and regional analgesia. They were MORE likely to have a spontaneous vaginal birth. Women who saw midwives for their pregnancy also reported higher maternal satisfaction. The authors’ conclusions?  “Most women should be offered midwife-led continuity models of care and women should be encouraged to ask for this option…”

2.  Birth centers are safe and offer a high quality of care. The National Birth Center Study II, which included more than 15,000 women planning to give birth at birth centers, found that the Cesarean rate for women receiving care in birth centers averages 6%. To compare:

“The Cesarean birth rate in this cohort was 6% versus the estimated rate of 25% for similarly low-risk women in a hospital setting. Had this same group of 15,574 low-risk women been cared for in a hospital, an additional 2934 Cesarean births could be expected.” – Stapleton et al., 2013

The rates of intrapartum and neonatal mortality rates were comparable to studies of low-risk, in-hospital births. There were no maternal deaths in birth centers in this study. The authors’ conclusions? “This study demonstrates the safety of birth centers and consistency in outcomes over time despite a national maternity care environment with increasing rates of intervention.”

3.  “It’s evidence-based care…with a hug.” Our midwives and nurses love our mamas. It’s that simple. Your appointments will last 30 minutes to an hour. Your midwife at Babymoon knows your name. And your partner’s name. And your dog’s name. And your shower theme. And the colors you are debating for your nursery. (She may even be the one to cast the deciding vote!) Our midwives KNOW you. They know what is happening in your life. They know about your fears and concerns and will spend nine months showering you with love and support so that you head into birth and parenting feeling confident and empowered. Read more about why our families choose midwives here.

Babymoon Inn provides a doula for every mother. Our trained doulas are also registered nurses - giving you the benefit of someone trained in labor support but with clinical skills too.

4.  Our nurses are trained doulas who provide you with continuous labor support. Your midwife and doula are present to support you throughout your entire labor and birth. Your birth team consists of women who are passionate about birth and serving women, and they will be by your side providing continuous physical and emotional support. Because our doulas are also registered nurses, you have the piece of mind knowing that there are two clinical members of our team at your birth. While this is not the industry standard, we feel strongly about adding an extra layer of safety and comfort by assuring there is always one clinical staff member present for mom and one for baby if necessary.

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This little one snoozed right through her professional photo shoot at Babymoon’s bimonthly postpartum party.

5.  The support doesn’t stop when the baby arrives. After the birth of your baby – whether it occurred at the birth center or at our transfer hospital – the support continues. Our midwives will see you at the office at 2 days and 6 weeks postpartum. At around 2-3 weeks, you’ll attend our “postpartum party,” where you will meet all the other families who had babies around the same time you did. You also join our Babymoon Inn Mommies Facebook group (don’t forget to post pregnancy and birth announcements… we LOVE them!) and come to our weekly Inn Mommies support group at The Nest. You’ll meet other mommies, laugh, cry, plan play dates, and find your tribe. You’ll come to the many events held at The Nest and Babymoon Inn: crafting classes, Empathikids Yoga, clothing swaps, cookie exchanges, and more. We feel strongly that you are supported not only through pregnancy, but through your journey as parents too.

IMG_81126.  It’s in the details. Join us for a tour and enjoy a light breakfast and our complimentary Choices in Childbirth class. Step into our office and grab a glass of freshly brewed iced tea or cucumber-mint infused water (did you know we grow our own herbs in the office?). Have a seat and enjoy a muffin, some almonds, fresh fruit, or a packaged snack while you wait for your appointment. Don’t forget to schedule your free prenatal massage! After baby arrives, be sure to take home your embroidered Babymoon Inn tote bag, a pink or blue Babymoon Inn onesie for baby, and your handmade baby name bracelet. Grab a screenshot of that “Welcome Baby!” post on Facebook, and return for your postpartum party to enjoy brunch and have a complimentary newborn photo taken by our professional photographer. We want every aspect of your experience – from the moment you take your tour and every moment thereon – to be exemplary. We strive to provide superior service, top-notch prenatal care, and endless postpartum support. And snacks. Those are endless too.

dwj_NvY6b8MwMp4yK4ZF_juzLmN-AK9vMKgB6StFyH4,Rcr4Gjx-zn0eH4TiD-UThzlOWR6bwfq-Fnbc78IgeSk,CMSuRPHKWPmODUxyC0l1XE526AhxQofMW42XHhevPP07.  You don’t always get a do-over. A significant percentage of Babymoon clients are families having a second or subsequent child who didn’t get the experience they had hoped for with prior pregnancies. Sometimes they knew about all of their options but made what they felt was the best choice at the time. Sometimes they didn’t know other options existed aside from the one they chose. Regardless, they now come to Babymoon because they want something different, and we work hard every day to provide the experience they are hoping for: a personalized, family-centered, empowering journey of pregnancy and birth. This birth counts too. And it’s almost never too late to change providers if you are unhappy with the care you are receiving. We would much rather see you for the first time at 36 weeks pregnant rather than when you come back for a subsequent pregnancy after having been disappointed with your first birth experience.

Our doors and hearts are open, and we welcome you to come in and experience what Babymoon Inn has to offer to our families and to the community. Visit our Web site at http://www.babymooninn.com or call 602-314-7755 if you would like to see our facility and learn more about our comprehensive program of care.

Jen’s Journal – Day 5 Haiti 2015

May 6, 2015
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Day 5 Haiti

We were scheduled to attend mobile clinic today and I was grateful as it as in Cabestor because that is the location of the new Midwives for Haiti clinic. The Land Cruiser was loaded up with 10 of us and all the supplies for the clinic. We drove for 2 hours over very rough roads. I called shot gun to they and help with my car sickness issues.  I was able to sit next to Leona who is such a lovely young woman. She is here for a year as the in-country program coordinator. It was really nice to hear her story and her passion for international development.

We arrived in Cabestor and toured the new birth center facility. It will have a clinic and birth room downstairs and staff quarters upstairs.  It is on the grounds of a church compound that includes a large church, the brother’s house and a large school for the community children.  The children were so curious and beautiful. It was clear they had visitors in their community infrequently.  Many women were already sitting on some benches waiting to be seen. As we set up the mobile clinic women continued to arrive.

One of the most amazing parts of mobile clinic is the education the midwives provide to the women. They bring poster boards with pictures. They share with them danger signs for eclampsia.  They teach them about nutrition. But most importantly they teach them that their lives matter. It is truly best described as witnessing feminism in rural Haiti. They explain to the women that they need to put a little money away each week any way they can. That way if they have an emergency during their labor or birth they will have money for a moto transport to the nearest hospital which in this case is over an hour away by vehicle.  They warn them that if they need a transport and do not have money put aside to pay for it they may die. And if they die their husband will just find a new wife.  It sounds harsh but it is their reality and to empower these women to value their own lives and not depend on others to value it for them is an amazing gift.

Once the teaching is done their are four stations; blood pressure and weight, social and medical history, fundal height and heart tones, lastly medications.  Fatima, Kimberly and I began by taking all the blood pressures and weights. There were about 30 women and 5 postpartum women with their babies.  Then we moved to the belly check station.

  The consistent issues and malnutrition and hypertension.  They go together in Haiti.  Many of the women had walked very long distances and I noticed none of them brought water. It was so hot and humid there are not words to describe the amount of sweat pouring down our bodies.  When I asked them if they had enough food to eat in their homes not one of them replied yes.  Most ate what they could grow or procure.  Breakfast for most that day was a yam.  There is just simply not enough food or resources. It is difficult to witness.  All women got a month supply of prenatal vitamins and folic acid and most needed medication for their blood pressure.  The babies surprisingly looked healthy and thriving. They are all breastfed. Period. And there is no such thing as a hooter hider. Women breastfeed openly everywhere you look in front of anyone and everyone. It is not a thing. It is a fact. It is beautiful.

After clinic was done we were invited to eat at the church with the staff. It sounded like such a good idea. It was not.  We ate a simple Haitian meal of rice and beans, a small beet and cabbage salad and a single small piece of meat (probably goat). I stick to the vegetarian selections in Haiti which usually keep me pretty safe. We loaded up in the vehicle and the drive was beautiful and then about 30 minutes in my stomach began to hurt. Really hurt. I took pepto bismal and a zofran. We finally made it to Mirabalais and stopped at a gas station that happened to have a bathroom. The diarrhea was like a scene from a bad movie and I was the star. It was hot and awful and dirty in the bathroom.  Thank god I had my pack of tissues.  Also awesome to walk back to the care filled with ten people in it all having had to wait for you in the hot car. They were all so kind.

About thirty minutes later we stopped at little roadside market by the river so the mobile clinic midwives could buy some fish for their families. They hung the bags from the side mirrors so we did not have the fish smell in the car.  I started thinking I was not going to make it the last hour home so I should try and go again.  My awesome driver said he would take me as there were no filets available. We walked by the river towards some bushes literally 20 feet from a lot of people who thought it would be interested to see my white booty. As I walked farther to try and find some privacy I began to look down to watch where I was walking and realized this was were everyone came who had diarrhea. I began to wretch and realized this was not happening and walked back to the car. I think I must of looked grey as Ronell took his own money, bought a cold water and poured it over my head. He used his big strong hands and was rubbing it gently over my face. It literally made me gently cry as it was one of the most considerate and kind things anyone has ever done for me.

I some how made it back to the house and got sick a couple more times and just rested the remainder of the evening. I visited with the ladies about their days and experiences from a horizontal position in my bed.  I wisely skipped dinner and just tried to take care of my body. Key lessoned reinforced: don’t travel without Imodium.  Just sayin.

Jen’s Journal – Day 4 Haiti 2015

May 2, 2015
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Day 4 Haiti 2015

It was an early morning as our hospital shift began at 7am. I braided my hair, ate some oatmeal and hopped on the moto to the hospital.  It has been so nice to reconnect with the translators and see pictures of their children.

Upon arrival to St Therese Hospital the memories of previous years came rushing back. It is difficult to express the degree of disparity in all facets of life between Haiti and the US but particularly in the realm of healthcare.  As I walk past the droves of patients and families one thought continually resurfaces that it all starts with poverty and the subsequent malnutrition.

 Just outside the Maternity unit is the pediatric unit. There are three separate pediatric units. The first room is for malnourished babies.  There were probably 10. Many of the mother sit out on the bench and nurse their babies because it is so very hot in the unit. Very little airflow and unbelievable humidity. One woman clearly had AIDS and so did her child. They were both so emaciated.  Her babe lay naked across her lap, lethargic. Both of their eyes were full of life and yet haunted.  One little boy was so protein deficient and malnourished his body had third space all his fluids, so he was so swollen his legs and arms and abdomen looked like they had burns on the them from the skin separating from the swelling. Other children were so emaciated they looked like they had a grey color.  Their little hearts beat so fast some of them get so tired from the effort to live that they let go.  But some get better. A young pediatrician from Ireland had been there since August and was so compassionate with these babies and mothers.  She explained that for the ones that get better there is a program in town that provides the families with peanut butter and it literally is saving lives.

After giving Fatima and Kimberly a tour of the hospital it was time to get to work.  The postpartum, antepartum and post c/s rooms were all full. They are three separate rooms with about 10 beds in each room. There is no such thing as privacy, no curtains. Few chairs for family. Many family members sleep on the floor next to the their loved ones.  The families must bring them food and water. Many families come from hours away.

The first woman in labor was having her first baby.  When she first arrived she was three centimeters and working hard.

 She had good support with her sister, husband and her mother in law.  Most of her labor was spent walking in the hall in the courtyard in from of all the visitors of the hospital.  While she labored beautifully many other women came and went.

 Two women came in with post c/s wound infections.  One of then was an abcess and the doctor came and open her incision and put her on oral antibiotics. In the US we would have put a drain in and put her on iv antibiotics.  I hope she does ok.  A woman brought in her baby with polydactal (extra finger) and had tried to tie string around them at home after her home birth but the baby was miserable. The Haitian midwife numbed the fingers, tied them off with suture and removed them with a razor blade.  The babe was calmed immediately after the procedure and the mom was so thankful.

A woman arrived having pain after falling in the shower on her abdomen.  She was very worried because she had lost her two other children.  She had a c/s with her first and when that child was a year old it became ill. She brought it to the hospital. She was full term with her second at the time and she started bleeding while at the hospital.  They checked heart tones on the baby and they were rapidly dropping but the electricity was out at the hospital so she could not get a c/s and the baby died before the power came back on hours later.  Her first child later died. She was rightly concerned about her current pregnancy. In Haiti after three c/s they tie your tubes even if you have no living children or don’t consent. They believe the risk to the mother for future pregnancies is too great. It took two hours to talk one of the two doctors to come in and do her cesarean.  In a country with a population of 10 million there are only 100 obstetricians. Mom did well and baby was born alive but clearly not 37 weeks. I assessed babe to be 34 weeks. She was flaring, retracting, working to hard to breath with too high of a respiratory rate.  She had no creases on the bottom of her feet and weighed about 4.8 pounds.  Luckily Ohio State University opened a low level NICU last year that actually had one of it’s four beds open and was able to care for the baby. Just over a year ago that baby’s survival rate would have been very low. Baby’s here have to be able to suck, swallow and breath to stay alive.

 We had a 17 year old girl come in for a post rape assessment. She had to have an exam in order to have her police report filled. She was a virgin prior to her assault. We ordered labs for HIV and syphilis. It broke my heart. There was no emotional support offered for her. There are no services. She was very stoic.

A woman came in labor with twins and the first was head down so she would birth vaginally.  She was very tearful and rightfully scared. We offered her as much reassurance as possible.  There was a woman in the antepartum unit screaming in pain for hours.  She was 8 weeks pregnant.  She had been diagnosed with h.pylori bacteria which causes ulcers. She had hyperemesis and was having severe abdominal pain.  There was an ordered for two antibiotics to treat her h.pylori and an iv antacid but no pain relief. Her screams were primal.  I assessed her and her blood pressure was dropping her pulse was rising. There was a mobile palpable mass inn her gastric region. You could feel her aorta bounding through her abdomen. It took over an hour to get her pain medication, which did not touch her pain. I eventually ordered an ultrasound to rule out a bleeding ulcer or bleeding esophageal varicose veins.  There was no way to tell if she had just simply eroded her esophagus with the tools available to us but it became very apparent that if we did not find the source of her pain and treat her she would die.  She looked me in the eyes and repeatedly asked to die.  We did the best we could for her and eventually got an internal medicine doctor to come and care for her. I was not able to see the case through as our interpreter were working over at this point and it wasn’t fair to keep them from lunch.  So we loaded up our supplies and hopped on our moto taxis back to the house for lunch.

It was a lot to process so we came home and ate lunch while attempting to cool down.  We spent the next couple of hours sorting medical supplies we had brought and got them put away.  Midwives for Haiti had huge trash bags filled with motes pads donated so we sorted all of those into small packages to give out at mobile clinic. We had beer and relaxed on the patio discussing our thoughts on global property and particularly development in Haiti.  Pippa had invited a midwife named Kate over for dinner who was here with Zami Lasante (partners in health) since august. Wednesday will be here last day here so Pippa made a popover dessert of some kind that was lovely.  Leona’s boyfriend dropped into visit with her. He is an engineer from msppp working here for a year from France. They are very sweet together.

It was another long day without access to the kids or to email with the Internet broken but I am surviving, learning, growing.

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