Monthly Archives: September 2010

Beer, Beaches and Babies

I find myself in Qingdao (yes, of the eponymous beer), a formerly colonial coastal city almost 2,000 miles from Kunming. I say that I find myself here, because I do seem to have landed here on a whim that sounds about as strange to everyone I tell as it feels to me.

A few weeks ago I got in touch with the International Alliance of Midwives (IAM), asked who their China contact was, and emailed that person out of the blue about whether or not she knew any midwives in Kunming that I could speak to, since I couldn’t find any actually practicing midwifery.

A step back, by way of exceedingly brief explanation: in China’s zeal to lower its maternal and infant mortality rates (MMR and IMR) – a hugely worthy goal – it seems that it looked to the United States, as it does for so many things, good or bad. The government decided that the way to get the MMR and IMR out of the stratosphere was to get every birthing woman into a hospital and have her “delivered” (I know it’s common parlance, but I’m turning against it) by an obstetrician. China didn’t have a long tradition of strong, professionalized midwifery to begin with, but in the process of medicalizing childbirth in China, it basically ended dedicated midwifery education in 1994. Midwives trained in China prior to that time now function with a drastically reduced scope of practice, as labor and delivery nurses or doulas. China has made massive improvements in a short period of time to its MMR and IMR – but now has a 46% c-section rate (the US rate is 32%), which is four to five times what the WHO indicates could possibly be necessary and carries its own issues of increased risk of hemorrhage, infection and long term pain. Plus, China still has a MMR more than twice as high as that of the US. And the US MMR really sucks.

That is to say, it’s not too surprising that I couldn’t find anyone actually practicing midwifery in Kunming. The China contact for the IAM told me that if I wanted to meet midwives, I should get myself to Qingdao posthaste for a unique midwifery conference being held by a fledgling Chinese midwifery organization. So I registered on the deadline, booked my plane ticket last week, and arrived in Qingdao in the middle of the night yesterday.

Nurses in China = All Pink All the Time

I had a whole plan for how I was going to approach this weekend-long, Mandarin-only (and vocab-specific) event ; it involved a lot of hanging back, watching, and then approaching specific midwives I had identified and learned something about to ask questions.

I am so naive.

Seriously, I’ve been in China upwards of a year – you’d think that by now I would get that, in a room of 330 Chinese midwives, I am…noticeable. And as soon as I open my mouth and speak Chinese to people – in other words, as soon as people know that  I am approachable – the jig is up. I get placed at the front of the room, have my photo taken in front of promotional posters, and get sat at the head table during meals.

That last point actually worked out well for me this time (unlike other times, when the head table has been full of stultifyingly dull government officials). It is striking how similar the conversations are among Chinese midwives and American ones – the focus on the terribly high c-section rate, the general lack of prenatal education and the uselessness of the prenatal education most people are given, the lack of respect from the medical establishment, etc.

I sat through a hilarious demonstration by one prominent midwife of the breathing methods recommended by Dr. Lamaze, which are now generally discredited as being more trouble than they’re worth. Hee hee hooooo, hee hee hooooo, she puffed, as we passed the shrimp. Who can keep track of all those patterns and counting when they’re in labor?! And what if she “forgets” how to breathe – what then?!)

The midwives at the conference seem genuinely hungry for information, although I was surprised at how basic most of it seemed (as in, I basically understood all of it). And I’m having a great and slightly surreal time of it, although I have to constantly clear up totally valid confusion about who exactly I am and what I could possibly want with a bunch of midwives in Qingdao.

So, where did you do your training?

Well, I’m not actually a midwife yet. I’m training to be a doula.

Oh. So you’re a student?

Sort of. I work in public health in Kunming.

And you came all the way here just for this?!

Well, yes. I’m very interested!

And how old are you?

Twenty-six.

ALREADY twenty-six and you STILL want to be a midwife?!!

I’ll admit that I skipped out a little early on the last presentation of the day to go hang out on the beach. The beach near the hotel where the conference is being held is beautiful – clean, uncrowded, calm. Despite how relatively northerly Qingdao is and the fact that we’re half way through September, it was a perfect beach afternoon. I walked through the surf, breathing deeply, feeling an overwhelming sense of well being and a calm that I haven’t felt in weeks, since the day after the wedding. I lay on a sloping rock for an hour and stared out at Fushan Bay, which becomes the East China Sea and stretches out to the shores of South Korea, feeling the relief that comes over me when I am back in a coastal place.

I am definitely meant to live on a coast; despite the loveliness of the Kunming climate, being landlocked makes me edgy. The coasts are for me, with their invitations to immigrate, flourish and think expansively. Unless you are actually a seafarer, it’s all an illusion, of course – you’re just as stuck staring at the water as you are 1,000 miles inland. But the winds, the disintegration of the continent into the water, the sense of infinity – these are things that ease the Locked-In Syndrome of being human.

Tiny man off to the right says it all

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Floating

I woke up this morning to a storm raging outside and momentary confusion about where my husband was. It seems that the rainy season has yet to have released its grip on this part of the world.

Also, it seems that I am married.

The weeks that RP and I spent in the States are already a distant memory. Or a dream – most days it seems impossible that it all happened, that the wedding took place, that the few days we spent a year planning for have passed and that now we are back in China.

RP stayed through Rosh Hashana (l’shaha tova, happy 5771) and left yesterday evening to go back to Dulong Jiang. The fact that I’ve celebrated Rosh Hashana in Kunming for a second time helps bring me back to reality – that we still live here, that the wedding and the return to the States were fleeting joyful occasions and not the end of anything. That I am repeating events and days in China.

I need a second wind, a fresh start or a venturing deeper. I want to write here more frequently, but I don’t want to feel that it has to be about China or life in Kunming. There is so much going on in my head that I don’t write about here – daily activities that are pointing toward a potentially very different future. I have just started taking Anatomy and Physiology I, the first of three prerequisite courses to apply to the nursing schools I have in mind (Columbia, UCSF and Yale – a common triumverate due to their similar prereqs), in what will be a long path of becoming a nurse-midwife.

I’m trooping on at work, trying to assess what the coming 10 months will hold before my fellowship ends and I am left to my own devices here in China.

I try to remind myself occasionally, quietly, that I am someone’s wife now. And considering what it means to be a wife.

Hopefully the rain will clear, and there will be more from me soon. Until then: the most recent Yid in Khine video (the third of three so far – in case you missed them: part 1 and part 2 – the fourth has been made and is on its way).

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