Pregnancy and Birth Overseas- Richelle in Quebec and also Niger

Well, I’ve had 5 partial or complete pregnancies and 3 births in our country of ministry: one in Quebec, Canada and 2 in Niamey, Niger, so it is hard to know where to start!

My first pregnancy/delivery in a foreign country happened in Quebec, Canada. We were studying the French language before heading to W. Africa. The language barrier was really my only initial concern. I had a fabulous doctor who was very patient with my mistakes: he asked me if I was planning to breastfeed; I thought he was asking me about my summer plans… and I proceeded to answer accordingly. I was horribly embarrassed, but my doctor was very kind and gracious. Being pregnant in language school (and taking final exams with baby in arms) seemed to endear our family to many teachers and students; older people from the traditionally Catholic country appreciated the fact that we were having our fourth child. Experiencing pregnancy and delivery in your host country is an incredibly bonding, door-opening opportunity – to meet people, to become established in your community, to trust the Lord even when you have no clue what is going on all around you, and to live an authentic and transparent testimony because in labor, pretty much all is laid bare… (No pun initially intended, but then I thought about it for  a moment.  (-: ) After 5 days of labor, 3 in the hospital and the good part of a day on pitocin, our healthy 9’11” daughter was born just minutes before the doctor arrived to prep for a c-section.  Even with the incredibly long, painful and frustrating labor, it was a wonderful experience and opened our hearts to the possibility of having a baby in W. Africa.

We found out we were expecting our next child just days after we’d purchased plane tickets to return to the States for furlough. Since I’d be home midway through the 2nd trimester and it was my 6th (5th full term) pregnancy, I skipped prenatal care in Niger and she was born in the States. I did find the first trimester and the nausea/fatigue typical of the beginning of a pregnancy to be much worse (probably partly due to prophylactic medications for malaria) and the excessive heat of Niamey.

Both our 6th and 7th children were born in Niger. Niger is very poor and has limitations as to what is available medically. Women had regularly had their babies in Niger in times past, but after a few very bad experiences in local clinics and a missionary hospital that could no longer accept missionary patients, women had essentially stopped considering that as a possibility. Our 6th was a bit of a surprise, and was due just a month before we were scheduled for another 6 month furlough. Because of that timing and after much prayer and counsel, we decided that we would stay and I would have the baby in Niger. We researched a few of the clinics and based on the recommendation of a missionary midwife (who worked out in the bush), decided on a doctor and a clinic.

By this time, language was no longer an issue – but culturally, things were very different. The doctor was comfortable with my husband being present for the delivery; the midwives who worked with her weren’t as much at ease with that idea. As a result, we had decided a friend would accompany me. The clinic was clean, but it certainly was not a labor and delivery suite like you might find in the States, there were no pain medications available and if a child was born with problems so significant that he couldn’t be stabilized for an emergency evacuation, there was little that the doctors and midwives would be able to do. Simply put, the consensus was that it was a safe place to have an uncomplicated delivery. Since none of my deliveries had ever been “complicated,” we were comfortable with this fact, and were ready to choose to accept God’s sovereignty in any possible outcome. Culturally, I had to remember that the doctor or midwife was the “professional expert;” asking questions or disagreeing with something they’d decided or wanted to do could be seen as rude or disrespectful and could impact care. You are expected to labor silently, through all stages of labor. If labor isn’t progressing rapidly enough, midwives will use all sorts of methods to help “force” it along; fortunately, that was not an issue in either of my deliveries.

I had to bring all of my supplies – medications (I’m Rh -), mosquito net, towels, diapers, soap, everything to care for the cord, etc… things I’d need for the baby and for myself post partum as the clinic did not supply anything non-medical. After the baby was born, we found out that we were supposed to take care of the placenta. Fortunately, they had mercy on us and didn’t require that of the “white folks.” I stayed overnight – and was locked into the wing of the clinic where my room was. If I needed help for something, I had to ring the “emergency room,” who was not always able to respond promptly (my IV that they wanted to keep in place because of the Rhogam I’d need the next day kept falling out as I was trying to care for a newborn and swat away the mosquitoes. I’d brought everything I could think of that I’d need, but not a mosquito net to protect the baby.) Not only was it important to have someone there for labor and delivery, it was essential to have help that first night in the clinic.

All in all, it was a fabulous, and very inexpensive experience having our son in our country of service, and the people to whom we minister love the fact that he is a “vrai nigerien!” When we found out that number 7 was on her way, there was no doubt in our minds that she’d be born in Niger, too. This time I knew what to expect and was also more familiar with the culture. One huge difference was that midwives were quite happy to have my husband accompany me. In the intervening years, other expat women had chosen to have their babies at this same clinic, so the medical staff was becoming more accustomed to “Western” ideas regarding labor and delivery. And it was a good thing he was there, because the midwife was out making herself a cup of tea when our daughter decided to arrive; she came running in immediately, but it was “daddy” who actually delivered her! We tried to convince the clinic that we should get a discount on the price because of that fact; they didn’t agree!

Health concerns for me which could have necessitated taking the baby early demanded that I return to the US for the birth of our last child. Knowing the lack of adequate care for preemies and considering the higher possibility of that occurrence made the decision obvious, but it was a decision made through many tears and after much prayer and consultation with the doctors in Niamey who knew us and who had been caring for our family for several years. I truly wrestled with God about this, even after my husband had already made the decision. It also meant splitting our family up for 3 months: I came home early in the third trimester with 3 of our children while my husband remained in Niger with the other 4, and did not even meet his little one until she was almost 2 months old. After that experience, I have an immense respect and burden for single mothers and for women who, out of necessity, must walk through that experience without the presence of their husband. God was so good and provided for us wonderfully on both continents, but it was an incredible challenge, from the really practical (I had to shovel the driveway while in labor to get the car out so we could head for the hospital) to the emotions involved with walking into labor knowing there could be scary complications and not having my best earthly friend there with me. So, as crazy as it sounds, with all the advances, comforts and options available here and the experience of 7 other deliveries, it was the hardest one. Yet as always, God was so faithful, so true and He provided marvelously in ordaining this circumstance that drove me straight to Him.

Richelle, thank you so very much for sharing your birth experiences and encouragements with us! Does anyone have any questions for Richelle?


6 Responses to “Pregnancy and Birth Overseas- Richelle in Quebec and also Niger”

  1. 1 Ashley L. April 8, 2010 at 6:35 pm

    Thank you so much for your stories! They are fascinating and so encouraging! How did you find adjusting to life with newborns while overseas? Did you have a lot of help within your community? How did you prepare for the transition beforehand?

  2. 2 Nancy DeValve April 9, 2010 at 8:08 am

    I loved Richelle’s descriptions. She did a good job describing it all. I had my first baby in Niger and had one of those bad experiences where the midwife tried to hurry along and force the delivery, then badly handled things after the delivery when the placenta wouldn’t deliver. They almost lost me, though thankfully our son did just fine and is, as they say, a “vrais nigerien”. I had already decided to have a drug-free delivery, so that wasn’t a problem. In the end the delivery was induced, but I had no pain medicines. As Richelle described, missionary women had to stay with me 24/7 for the first two days of my week-long stay because nurses there only administer medicines and come in an emergency. The baby sleeps in your room and you are on your own to get him when he needs to be nursed, changed, etc. If you had a good delivery that is not a problem, but I could barely move so it was a real challenge for me to care for my baby.
    After that awful experience, we purposely had our 2nd child in the USA and I had a wonderful doctor and a good experience. Again the placenta wouldn’t deliver, but the doctor didn’t let the situation get out of control. I felt good within two days after that birth whereas it took me almost six months after my first baby to feel good again.
    I think the main difference is that Niger wasn’t really ready to handle unusual cases, complications, or emergencies whereas the American medical system is prepared (sometimes over-prepared) for all eventualities.

  3. 3 Sarah April 9, 2010 at 1:33 pm

    Wow. I really enjoyed reading your experiences, Richelle, and how the Lord was faithful to take care of you and provide for what you and your family needed. Thanks so much for sharing…I have a LOT of respect for you and others like you (Nancy) who have given birth in the location/conditions that you both did!

  4. 4 Richelle April 12, 2010 at 1:16 am

    @Ashley – Actually, my hardest adjustment was with #5 who was born in the States, hubby left when she was only 10 days old (our oldest was only 7) and I joined him in Niger 2 months later, bringing the 5 kids with me.

    Overseas, maybe because of cultural issues, (they expected women to stay home and just take care of the baby), coming home with a newborn seemed almost effortless. I also had house help who cleaned and cooked, which was huge! I could focus on the things that I had to do and leave the rest to her… and not only was that her job, but she truly seemed to enjoy serving our family. In the States, people fix meals for a week… but then it kind of seems like you are on your own, expected to care for the new one and then keep up with the crazy schedule of life in America… ugh!

    I don’t know that I consciously prepared for the transitions beforehand. We had 8 kids in just over 14 years… raising support and always traveling to churches, moved to Quebec, moved to Niger, had two furloughs with the transitions back to the States and then back to Niger… our life seemed to be one continuous transition and we just rolled with it as it happened. Having new babies in our home was just a normal thing and right now, it seems wierd, an even bigger transition, not having another one on the way, kwim?

    @Nancy – Wow! I’d never heard that part of your story before. I can’t even imagine…

    @Sarah – thanks for your kind words. 🙂

  5. 5 Stephanie April 21, 2010 at 3:20 pm

    What interesting experiences you have had, Richelle! You strike me as being very brave. I can’t imagine giving birth without my husband by my side (and silently too!).

    Questions for you:
    1. Do most Nigerian women give birth in the hospital?
    2. Do most Nigerian women give birth sans drugs?
    3. Is water birthing an option?
    4. How did you stay quiet/not scream? 😉

  1. 1 Pregnancy and Birth Overseas- An opportunity to share! « Missionary Moms Trackback on April 29, 2010 at 3:25 pm

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