About two weeks ago I (eternitysojourner) was blessed with the rare opportunity to witness the struggle of labor and the miracle of birth. I witnessed birth for the first time when I was in high school as a nursing student. The second, third, and fourth births I witnessed were right here in Hadhramaut, as a birth assistant for the free birthing clinic here, operated by a (wonderful) certified nurse midwife and (also wonderful) midwife trainee from the u.s. Under their tutelage, I felt like I was a nursing student all over again because I had only worked with the elderly in the past.
Alhamdulillah (praise be to God), I remembered a few of the pertinent skills of a nurse but learned a lot of new skills like listening for a fetal heart rate, assessing a newborn, the risks involved when holding the hand of a woman who is in the peak of her labor, etc. The clinic is temporarily closed (or so we hope) because our midwife is currently abroad, but I feel like those few months prepared to attend the recent home birth of my dear friend.
The normative practice of birth here in Hadhramaut is for women to brave their way through the birth at the overcrowded public hospitals, have a midwife deliver their baby at home or deliver their babies themselves at home (hard core, right?). Unassisted home births may be rare in the states but they are quite common here. The challenges of this reality gave birth to the free clinic. Pardon the pun. It was apparent that mothers and babies were undergoing avoidable challenges and preventable fatalities during unassisted births- perhaps because of a lack of resources and/or information. Before the clinic, prenatal care meant going to the hospital if you have a problem, not having routine assessments every few months. One of the greatest accomplishments of the clinic, in my opinion, was the prenatal care it offered. We were able to preliminarily assess if a mother was showing signs of gestational diabetes, pre-eclampsia, iron deficiency, blood type incompatibility, etc. The clinic was a harmonious marriage of between the best of “the west” and “the east”, with respect to the birthing experience.
All of these experiences gave me a sense of what happens during pregnancy and what happens in the last hour or so before delivery but the actual labor process was unknown to me. Because we share a two-family home, I was able to witness most of my friend’s labor and observe how it developed. In the absence of the clinic, we were able to develop a prenatal care plan with a nurse and the local clinic. My friend previously had a C-section, so everyone and her mama (literally) told her that she had to have another C-section and that a natural birth would not be possible. Being the brave warrior that she is, she did her research and trusted the spiritual insight of our elder, teacher, and guide who is from and resides here in Hadhramaut.
Her first day of labor started after the morning prayer at dawn and continued consistently, though manageably, through most of the day. At this time I thought, “Hey, this is not too bad”. We were talking, eating, walking around, reading and listening to Qur’an, etc. In the mid-morning she had dilated 2 cm. and by the end of the day, after the night prayer, she only progressed to 4 cm. The nurse informed her that she would most likely labor through the night and have the baby by the following day. I went to sleep anticipating that I would check on her after the dawn prayer in the morning. At around 2 am, urbndervish heard my friend’s husband knock on the door. When we answered the door he said “I need you to come now!” and quickly returned to his wife. I got dressed and as I got closer to her room I didn’t hear a sound. This made me think that we weren’t too close to delivery because usually mothers are squirming, groaning, grabbing and the like just before the delivery. At this point, I was somewhat nervous but not too nervous until the moment I saw my friend; I saw that she was wearing “the face”. What face? The face of a woman trying to preserve her sanity as she experiences the most physical pain she’s ever felt in her life. The face of a woman who’s becoming desperate in her mental, physical, and spiritual attempts to cope with labor. The face of a woman who has to know that she’s getting closer to the end because she doesn’t know how much more she can handle. Yeah- that face. No smiling, no talking, no eating- just laboring.
I went to phone the nurse who, alhamdulillah, only lives a few minutes away. I told her the details of what my friend’s husband told me “She’s having contractions every two or three minutes and they’re lasting more than a minute each and she feels like she has to push”. So, I, with my amateur birth assistant self, am trying to function despite my racing heart and the anxiety that this baby may be due to arrive before the nurse reaches. I thought to myself, “I cannot do this alone”. My friend’s husband is with her during her labor, applying pressure to her back and encouraging her, so I try to go and do something productive with myself…I go to make ablution (ritual washing before prayer) and hope that I can at least pray Salaatu’l Hajjah (The Prayer of Need) but before I can finish washing my feet I hear a scream “MY WATER BROKE!!!..IT’S EVERYWHERE!!!…MY SOCKS ARE WET…TAKE THEM OFF… I’M GOING TO HAVE THIS BABY ON THE TOILET!!!” I nervously yell back, “I’m coming. I’m coming.” And now I’m starting to think, “Dear Lord, what am I going to do if the baby comes before the nurse does.” I go to my friend and take her back to her bed. Her shoulders are tense and her footsteps are light. I can hear her loud and clear now. She reaches the bed and I confirm that she’s not yet crowning but she does want to push. I try to tell her to hold on because the nurse is coming (good advice, right? I’m sure the baby was thinking “Yes, aunty. Of course, I’ll wait for the nurse to come. That’s a great idea!”).
I call the nurse again and tell her about the water breaking and the urge to push and that she needs to come now. The nurse yells to her boys in Somali to get dressed quickly so they can walk her to our building. Still in a panic and with the very real realization that this baby is really coming soon, I start to recall and reenact my birth assistant duties. Get the clamps and the scissors, line the bed, get fabric to receive the baby with, get sterile gloves, get the suction bulb, etc. I’m trying my best to think straight but I’m trying to prepare myself to drop everything to receive a baby if I see an emerging head.
Alhamdulillah, the nurse comes in like a pro. She checked my friend and affirmed that the delivery is close. She orders me to listen for a fetal heart rate, which is pumping strong, masha’Allah (what God wills), and I try to assure my friend that the baby is fine. A natural birth post C-section is what my friend has been talking about, thinking about, preparing and empowering herself for, for the past few months but now is the moment of truth- the moment of certainty. What will happen is about to happen and we don’t know yet what that is. The nurse was very “hands on” and for a moment we thought she would get that baby out on her own. 😉 She was pushing my friend’s stomach and making room for the baby’s head to emerge. We all know that this baby is about to come and my friend is pushing with the contractions. The nurse is front and center, my friend’s husband to her right and I’m just behind them both, somewhere in between. The recitation of the Qur’an was playing in the background and we were all reciting different recitations of prayers and remembrances: La ilaha illallah, La howla wa la quwwata illa Billah, Allahumma salli ‘ala sayyiduna Muhammad wa ‘ala alihi wa sahbihi wa sallam. We were all calling on God in the best way we knew how at the time when the Divine was most needed.
The head emerges facing downward and for whatever reason I played the role of sports caster announcing to my friend every play by play. “The head is out” “The baby’s fine” “She’s a girl” “She’s beautiful” “You did it” “Everyone said you couldn’t do it and you did it”. We were all saying many prayers of gratitude. Back to my birth assistant tasks- I suctioned the baby’s mouth, wiped her, pass the clamps and scissors. The nurse offered my friend’s husband to cut the umbilical cord after it stopped pulsing, which he did. I wrap the baby and listen to her breathing and heart rate.
Shortly after the birth we heard the adhan (call to prayer) for tahajjud (voluntarily night prayers), and once the baby was wrapped up, her father performed the tradition of saying the call to prayer in the baby’s right ear. After we weighed her (3.3 kg or 7.3 lbs.), we all heard the adhan for the dawn prayer. In this princess’s first hour of life, she heard prayers of remembrance, three adhans, and Qur’an recitation- what a way to start your life- in the loving arms of people of faith. Five minutes or so after her birth, the nurse asked what time is it. My new baby niece was born a few minutes before 3 am.
When another dear sister/friend of mine had her baby several months ago, she told me “This may sound cheesy but after the baby was born, it was all peace and love”. I have an understanding of what she means. Once the anxiety of uncertainty was lifted, we were able to breathe deeply and take in the beauty of what we experienced individually and collectively. All you felt was serenity from the Divine and gratitude to the Divine for ordaining what was beyond our ability to micro-manage.
My friend wasn’t quite ready to move or nurse, so I sat holding the baby by her side and the nurse was sitting not too far and we were just relishing in the moment. As with the previous births, how meticulously and completely developed the babies are amazes me. The fine curve of their cuticles, the softness of their nails, the pucker of the lips, the symmetry of their little noses…subhan’Allah (glory be to God). It’s so humbling to witness the complexity of our design- that our bodies perform their created functions without our conscious management in a manner more excellent that what we can attempt to produce with our conscious minds, hands, and tools. Ajeeb (amazing)!
The process of birth is such a paradigm for achieving so many of our life goals, especially our spiritual aspirations. We start with the seed of a sincere intention, followed by the sincere actions that follow that intention. We nurture our goal and have patience on the path towards the goal- its challenges, its difficulties, its joys. We struggle with our selves when the time demands for such struggle and then give birth to the fruit of our struggle’s product. When we struggle against the lowness of our selves and the obstacles of the material world, we attain the bliss of pleasure and contentment. This is the nafs al-mutma’innah (the contented or reassured soul). You’ve struggled to subdue the self’s lowness, to elevate it, and to bring it into accordance with the will of the Divine. After this struggle, the self is content- pleased with and pleasing to its Maker. May Allah grant us the serenity of this contentment and make easy for us the labor that it entails- ameen!