Of helplessness and power struggles.

I wasn't going to post anything today. It was going to be a break. I've been posting so often that I've been neglecting my reading for school! But such is the life here--things never stop.
There was a first today. And the more I think about it, the more shocked I am. I witnessed my first stillbirth just about an hour ago. Can you believe I've been to over 200 births and this is the first death? That's excellent! It's wonderful statistics for me, but surprising considering the number of women I see are/have been malnourished etc.
So anyway--yes, a stillbirth. It was a little boy. Very little boy--3 lbs 9oz. He must have been dead for a couple days because of the quality of his skin and the umbilical cord. Cause of death is IUGR, or Intrauterine growth retardation, when the baby just isn't nourished enough. The placenta was tiny too--about the palm of your hand. Normal placentas are about the size of a dinner plate (sorry for the visuals...)
The mother came in pushing, got herself up onto our delivery table and pushed him out. She didn't have any indication beforehand that he wasn't alive. We tried to resuscitate him, but not for long as we quickly realized there wasn't a chance to revive him now. And then he just lay there. His little toes all porcelain white and his baby-belly small, but round and soft. His mouth gaped open as his head fell to the side and I thought 'Oh. So this is death.'
The mother mourned a little. Not much. I think I appeared more devastated then she let on to be--but how could her heart not be breaking?
Then the story started to unfold; her mother has TB, oh, and her husband too. Did they forget to mention that? And yes, she (the mother) has been suffering from a cough for a while. I note the families appearance--dingy clothing (when Filipino's are compulsively clean), holes and thread-bare tops, worn feet and hands, tired eyes and gummy mouths. It all started to add up.
I had a lot of experience with very poor people when I lived in Mandaluyong back in 2005. The clinic I worked and studied at was in proximity to Welfareville--where some of the poorest people in Manila live--(besides those who live on the streets). Those were our clients and so thread-bare clothing and calloused feet was pretty standard. But here, in Antipolo, most of our clients are lower class, yes, but upper-lower class...? Not quite middle yet.
As I'm thinking about this, Diana, our newest and very lovely, sensitive midwife, looks at me as she's examining the baby. Then she turns to the mother and asks 'Did you have a fight with your husband?'
God. Can it get any worse?
The baby's head was fractured and...well we just couldn't make sense of the bones we were feeling and not feeling.
I just sat back into one of the waiting-room chairs and...well, frig, I just sat. I was helpless.
How do you battle poverty, disease like TB, lack of education, malnourishment, abuse, everything?!??!
And then I look at his mother, Jennifer, and I want to go to her. I ask the midwives, "How is she?" and they say "Her b/p is 110 over..."
"No, I mean," and I don't know the word for 'broken heart' in Tagalog so I say "in here," I point to my heart. "How's her heart?"
Diana nods and says, "Yes, she's been crying. She knows he's dead."
And I'm fighting everything in me to go over to her and say "I'm sorry." but I CAN"T! I just can't! I know I'll LOSE it and probably embarrass her and her family and the staff here. So I slink off like a coward and drink my cherry coke in my room with the fan blowing on me going over what I was going to write about this on my blog. God, I'm lame. I'm not being hard on myself, I'm just being honest. I suck.
So, now they've taken his body away to prepare it for burial. His mother is still here. When I left the room she was sipping at some soup, coughing here and there.
I wanted to take a picture of his little feet--they were like a marble sculpture; bluish-white, precise and creased and just as cold. But I didn't feel like asking if I could take a picture of their dead baby. The timing seemed all wrong.

So, from one extreme to another. Another midwife I'm working with, she's really great. She is. But it's become very clear that we're having a ping-pong game of power struggles. I gave up a while ago because she's been here longer etc etc. But it's still hard sometimes. I'll put time the time of a birth as 11:34am and she'll correct it to 11:35am. Things like that. And that's fine. She can exercise her autonomy and authority as much as she likes. As long as it doesn't interfere with her patient care.
I just found it funny that in the case of life and death, we're so helpless, but we're sure to correct a workmate so we can be accurate when we record the time of death.