Saturday, April 28, 2012

You’re ANIMALS, all of you!

I had the pleasure of spending some quality time with a laboring mama this week.  A lot of time.  More than seems to be the average here at Victoria Hospital.  In fact, Paula & I had the opportunity to spend a virtual eternity-a whopping 10 hours- with this woman. We showered her with love & compassion.  We offered her support, encouragement & all the healing touch that we had to offer a laboring woman.  At one point, one of the midwives wandered into the labor room.  She looked at the woman standing upright against the bed (it isn't often that you'll find a woman in labor doing this here), her eyes then turned to me leaning over next to the woman and with a teeth sucking smirk (a usual and frequent custom among St. Lucians) and a sideways smirk, unimpressed, she left.

This woman was laboring hard with her third baby.  She was tired.  Beyond tired, actually.  There were several intense points at which her eyes grew wild, unfocused and absolutely panicked as the urge to push was beyond what she thought she could manage.  She said, on more than one occasion: “She’s coming!  The baby is coming!” On exam however, it was evident that she had too many centimeters to go before she could give the big, good push. We were prepared for her to surprise us & push her baby out despite what my fingers said was going on...  She wouldn't be the first to do such a thing.

We tried position changes, massage, essential oils, verbal encouragement, etc. All of which did not do much to encourage her baby girl to make her entrance.   It was her third girl & we figured she just needed to make her own way in her own time.  She has two sisters to compete with after all.  This woman was not particularly keen on this child’s en utero independence, she had already been laboring for nearly 10 hours and she was over it.  Her last birth had taken just about 6 hours from start to finish and she was taken by surprise with what felt like a marathon labor to her.

The whites of her eyes had turned red with exhaustion, eyeballs turned toward the sky, she prayed, loudly, to her God.  She prayed that He would not forsake her, she asked for forgiveness for all of her sins.  She begged that He would have mercy on her.  She begged that He might ease her suffering and that He knew better than any that she had experienced enough suffering in her life....  She then begged, once again, for the doctor to cut her.

She was sedated instead.  As well she was given Buscopan to encourage continued cervical dilation. She wandered in-between waking and “sleeping” before and after each wave of pain washed over her body.  She was eventually augmented with Oxytocin to encourage labor to proceed along the “normal” trajectory.  However, I think that normal left the building hours before.  She sat at 8 cms for over 5 hours, with a baby that refused to come down.  On exam, her baby’s head was hanging close to the stars, maybe kickin’ her feet out over the edge of the big dipper.  In those moments, one is left to wonder what the “hang-up” is.

She begged, once again for the doctors to cut her and to take her baby.  “I cannot do this any longer!!!”  How many times have we midwives & doulas heard women make that very statement?  Just about the time women say such things we work to reassure them that their babies are “just around the bend.”  At what point do you listen with your ears wide open, and appease them.  When is enough, enough? How exactly do you differentiate those women who simply need to ask vs. those that really mean it!  For most midwives in the states, this means a transfer of care.  For the midwives here in St. Lucia, it means a mix of Pethidine (Demerol) & Phenergan to ease the pains of labor before a consultation is made.

At the peak of her frustration and ever-waning desire to continue onward she uttered: 
“You’re ANIMALS! All of you!” 

When I saw her the following day I am certain she had no recollection of what thoughts she shared in those moments where she felt forsaken.  Her smile was bright, she was a woman renewed and refreshed by a short nights rest.  Proud and beaming with her beautiful baby girl in her arms she sang praise to the moon and back for the care-full attention Paula & I paid to her.  Her kind words, soft brown eyes & bright smile were enough to remind me that my time here has, indeed, made a difference in the experience for the women I have had the pleasure of sharing time & space with.  A debt of gratitude, once again...
Proud mama headed home...

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