Nicaragua: Giving Birth along the River

I can’t imagine giving birth in a jungle.

Picture yourself, however, as the typical girl in the Rio San Juan area of Nicaragua. You finish school, probably around fourteen, and live in a small village– perhaps one like Las Colinas (the hills) or the prosaically named Kilometer 20.

You meet a nice guy, probably don’t get married, and find yourself pregnant like the majority of your friends.

You’re a long way from an obstetrician, or any physician for that matter.

The closest clinic may be in the small town of Sabalos, or the spot more frequently visited by tourists, El Castillo. Five doctors serve this area in the southeastern corner of the country, just north of Costa Rica.

According to statistics from UNICEF , infant mortality rates in Nicaragua are high: 23 in 1000 pregnancies. The maternal mortality rate is equally disconcerting: 170 per 100,000 deliveries.

The closest ultrasound machine is up river at Boca San Carlos, the county seat on the shores of Lake Nicaragua. It’s a two-hour emergency drive from Sabalos over a bumpy road; a rapido boat can get you there in about an hour, but do you really want to risk delivering in a narrow ship?

(One woman made it to San Carlos, but had to stand in line for eight hours to get an ultrasound. The screener told her the baby died, probably while she stood in line).

Who can help?

In El Castillo, where Flavio Rodriguez, a general physician, runs a small medical clinic; the delivery table and the ER room are the same spot.

He doesn’t perform caesareans; too dangerous. And nearly everyone gives birth without any meds.

If you’re like most women, you’ll gain about 10 kilograms (22 pounds) during your pregnancy.

If you’re enlightened enough or the above statistics unnerve your family, you leave home 36 weeks into your pregnancy. A small maternity home in Sabalos houses you, so you’ll be close to Flavio and his colleagues when the time comes for the birth.

Casa de Materna was established in 2004. The clinic where normal deliveries take place is up the road.

When I visited in 2011, eight women were in residence, they can house up to 17. Two women rocked in cane-backed chairs and passed the time on a warm tropical morning.

Several times a week a Peace Corps volunteer visits to encourage them. The women happily greeted me and gave me a tour of their humble quarters, just off the main street of Sabalos.

The two communal sleeping rooms share a common bathroom with several cold showers.

The women share their household duties, simple because they have so little.

They cook outside in the hot climate. The kitchen is a simple counter with sink and stove. Women bring food with them–mostly fruits and vegetables. Everyone in this part of the world eats a lot of  plantains and pico de gallo: rice and beans–which together make a complete protein. They do their own laundry by hand.

A learning time before birth

26% of women in Nicaragua deliver without any medical attention. The time they spend in Casa Materna is an opportunity to receive health information they can use.

We brought the women sunglasses when I visited (we were there for an eyeglass ministry). The Peace Corps translator explained their need.

She performs a 15-minute simple HIV test developed by a local nurse for the new arrivals. She also discussed how to deal with domestic violence–emphasizing it doesn’t have to happen.

After a normal birth, a woman stays in the Sabalos clinic for 24 hours. She then walks home with her newborn.

Through funding given by Rotary International, a surgical clinic is being built in 2017. The Nicaraguan government will send medical staff to help once building is done.

Cataract surgeries, emergency appendectomies and caesarean deliveries can then be performed in Sabalos.

If you would like to help, or know someone who could–particularly in obtaining an ultrasound machine– contact me or the San Juan Rio Relief committee:  sanjuanriorelief@cox.net

It’s about having healthy babies, right?

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