Cherry Love: A Case Study

This post is about five days late but still just as important. Cherry Love is one of the women who sought pre-natal care at Glory Reborn from Kamagayan. Since Cherry Love is not her real name, rather her 'work name,' I feel comfortable using it in this post. She is a very petite woman with long, straight black hair and an unnaturally pale face. She looks more Chinese than Filipino and always has a scared look on her face. She is shy and never wants to give any personal or pertinent medical information to the midwives.

I first met CL about two weeks ago during a prenatal exam. She came to the clinic with a "bantay" (an escort required to accompany patients to visits close to their due date. The Bantays help the patients get to the clinic, go to the bathroom, carry medical supplies etc). Her bantay was a boyfriend of one week. She was nine months pregnant. During her prenatal exam she was very uncooperative and had a hard time answering basic question's about prenatal vitamins and the baby's movement. She insisted she was 18 but looked closer to 15, maybe 16.

This past week, a cab pulled up to the clinic at about 7 pm. CL and an older, stumbling woman emerged. CL was covered in cold sweat, her hair matted onto her face. She was wrapped in a towel and was wearing the same red dancing top she had on at her previous two visits. She was disoriented; tripping over her own feet and help her cell phone up to her face with no one on the other line.

Hilary escorted CL onto an exam table and CL immediately resisted any treatment or touch. She pulled away and thrashed as Hilary attempted to complete an internal exam to see how far the labor had progressed. Her track marks up and down her inner elbow and forearm were undeniable. After determining she was 4 cm dilated, Hilary demanded that CL shower, change into a hospital gown and try to calm down. Her bantay at this visit was actually the "Mamasan: of her house; the woman who houses prostitutes for a particular pimp and receives roughly 30% commission of the nightly revenue. The bantay was so out of it as well she was hardly acting as any type of caregiver.

Finally at two am CL gave birth to a five pound baby girl whom she refused to name. The first few hours of life after a baby is born are critical for mother/child bonding. The baby receives essential nutrients and antibodies from the mother's breast milk and learns the touch and voice of the mother. CL, so high on meth and possibly other substances, refused to touch or breast feed her nameless baby. Luckily, a mom staying at the clinic with her jaundice baby was able to provide breast milk for CL's baby. (Her own baby couldn't have the breast milk until his billirubin levels went down).

Knowing that CL is both incapable and unwilling to care for her baby does nothing to prevent her from leaving with the baby. The idea of social services and child neglect charges don't exist here. Babies born to women from Kamagayan are generally "raised" by the Mamasan and live in the boarding house with all the other women. They then grow up into the children we met while visiting Kamagayan with Father Heinz- parent less children with no sense of schedule, boundaries or direction.

The morning after giving birth, CL signed a form to leave against medical advise and had a midwife carry the baby out with her as she left. Yesterday CL returned for a routine check up exam with her baby and boyfriend. The baby had not gained a single ounce and during her two hour visit didn't cry once. She lacked muscle tone but still responded to stimulation. CL presented with high blood pressure and early signs of pre-eclampsia. She kept on insisting that she wasn't using drugs or alcohol but her scars seemed to tell a different story. Throughout her pregnancy she rarely complied with medical advice and this situation seemed no different.

The reason I titled this blog a case study is because these types of cases occur so frequently here. CL could have actually been considered a fairly compliant patient in that she even made a choice to pursue pre-natal care. Despite the fact that Father Heinz covers all medical expenses, none of the other multitudes of pregnant women we saw during our night walk in Kamgayan have showed up at the clinic.

As for the silent, nameless baby, CL couldn't have made it any clearer that she will be neglecting this child. Here in Cebu, the health care providers have no effective power of linkage to any child protection agencies or social service support. Hilary has tried many time to report neglect, starvation and abuse and never once had a successful outcome.

For families in the US who struggle to bear children and look to international adoption, the Philippines presents very few options. Although there are millions of children here in need of active parenting and safe homes the infrastructure to get the children and transfer them to adoption programs is either completely derelict or was never instituted.