Find a warm cuppa joe, get comfy and settle in for what
might possibly be the longest blog post – EVER. (Brevity has never been one of my strengths...)
I wandered into work yesterday on a mission to find out about a
particular baby...
His mama came in a few days ago like a four alarm fire; her husband driving
like a tsunami was on his heels and layin’ on the horn loud enough for all of
St. Lucia to hear. By the looks, and
sounds of this woman, I was prepared to meet her baby in the hallway. Her delivery, however, was just the
opposite. Once within the confines of
the ward her labor shifted into low gear, her contractions spaced out some and
she found “relief” in some of the deep breathes in between. Her labor song was
robust, loudly sung and was like a train rumblin’ down the tracks. You could hear it coming from far away as you
shudder and turn your head the other way while covering your ears as you wait
for the windstorm that follows the train as it passes by. And, like a game of dominoes the Rasta woman
next door would begin her own sweet song, making its way to the 16 year old
laboring alone in an observation room in the labor ward.
At which time the woman in labor room one would begin
again. It carried on like this for some
time.... The midwife switched on a small radio as if to drown out the sounds of
three women getting’ down with their birth songs. The addition of the small whining radio was
more like the buzzing, electric drone of a mosquito in your ear: incessant,
diabolical & eternally frustrating.
The four-alarm fire lady was continually and without fail chastised
for her birth song. (One, of many things
that break my heart here on a daily basis.)
I have witnessed great love here among the midwifery crew at Victoria
Hospital. I mean no disrespect here, but
I have also had the unfortunate opportunity to witness the absolute opposite,
with consistency, from a couple of women in particular. It’s so challenging for me to appreciate
where some of these midwives have misplaced their compassion.
Are they tired? Certainly they must be. These midwives do, on average, at least 100
deliveries per month. In March of 2011,
they delivered 168 babies; only two handfuls were cesarean births. They are
understaffed and underpaid, full stop.
Is it some cultural incompetency on my part? Is my ignorance getting in
the way of me seeing the verbal insults and tongue-lashings as anything other
than just that? I have seen an abundant
of warmth among the majority of these midwives, who are also underpaid and
overworked as equally as their bitter counterparts and yet, they move forward
with laboring women from a place of respect, some measure of patience and with
a patient’s best interest at heart.
I digress... The woman in labor room one was fully (eventually)
and set out to push out her baby.
Exhausted, she gave her best efforts; chastised with every push by the
midwife attending her. “Push
harder!” Women here have the shortest 2nd
stage I have witnessed to date, routinely and without fail thus far. So it baffles me why you would offer anything
other than your kindest and most enthusiastic support for someone who is
working very hard to push her baby out!
(With particular regard for first time mothers who have never had the
experience of doing such an epic thing before.)
When all was said and done, it took her less than 30 minutes to push her
baby out. It was clear that she was
“out of gas” toward the end and her baby arrived rather slowly but without
complication.
He arrived; limp, onto the receiving blanket. “Why is he not
crying?” his mother asked. “You made him
tired,” replied the midwife. He was left
to lie there as he was dried off & stimulated until he let out a short and
quiet cry. His cord was cut and clamped, and I handed him to his mother for the
60-second obligatory “look see.” She
melted, clearly in love and adoring of her first child. Reluctantly, she let her son go & I
wandered across the hallway with him to perform the newborn ritual routine administration
of Vitamin K & Tetracycline eye ointment (mandatory for every child-no
informed consent-no questions asked).
As I carried him to the warmer in the room across the hall I
found myself feeling resentful that these women are not given more time with
these new souls before the business of poking and prodding begins. I have to work hard to imagine if I were as
busy as these midwives are from time to time that some of my practices would be
augmented to meet the busy demands of any given day. You just never know when another “four-alarm
fire” will be wheeled through your door.
However, I hope that allowing for the unadulterated bonding between a
mother and her child will always take priority, unless life or limb is at
risk.
It was clear that all was not healthy and bouncing about
this baby boy. He was pink, his vital
signs were appropriate, his lungs sounded ‘wet’ and thus he was suctioned. He
was also tremulous as if he was struggling with a most exaggerated
startle reflex. I administered the
necessary bits and pieces, monitored his vital signs and tidied him up a bit. Dressed, warm and with an oxygen hood (for
some mildly high respirations) I left this little boy under the warmer and ran
next door to meet another little one (a 35+ weeker whose mother
received no prenatal due to her experience of “being shunned” at the clinic in
town.)
By the time I returned to his side the pediatrician had
stopped by to take a look at both of babies.
Doc said to take him to his mother to nurse to see if he would settle
down. So, I wandered down to the pantry
bed where his mother was resting (yes, pantry, a.k.a: dining hall-the 32 bed
ward was chocked full), assisted as this little boy attempted to nurse (rather
unsuccessfully, even though his sucking his fingers might have indicated
otherwise) and shared with the Dr. what I thought. She said she would swing by after she wrapped
up with the near preemie that had just arrived.
I had been asked by the mother to call her husband to let
him know that they had a son and to come when able. I have not heard a man so deeply moved by the
news of having a son. He asked me a
million questions about his son and told me how proud he was as this is his
FIRST child. “Is he cute?” the father
asked me. “Your wife says he looks like
you.” I replied.
The doctors are still uncertain about what may be going on
for this baby boy. Among some points of
discussion: an anomaly with the baby’s fontanelles, perhaps some Trisomy,
though not Down syndrome (T21). The extreme
tremulousness remains. They have done a
blood work up, though no DNA karyotyping as the expense falls to the family. They did a brain scan here at VH today for
him and should have results sometime in the next 24-48 hours. They have had access in the past to a
neurologist from Martinique, though I was told today: “We may no longer be
using his services...” So, unless the family can come up with some measure of
cash to get to the bottom of it all, they will be left with nothing but
ambiguity and questions that will likely remain unanswered.
I wonder how many women and families here are left to wander
without closure when things like this arise?
How many are left to deal with these unforeseen events in silence and to
whom do they turn for help in trying to make sense of it all. I have seen so many silent tears shed within
the walls of VH & do my best to offer my kindness, soothing words, a warm
heart and a gentle touch.
I am reminded that I am only here for some deep breaths....
and with a few more off again I will go back to the comforts of what I know. I am here to witness, to watch and
learn. These women will be left here to
labor alone, receiving what appears to be an obligatory tongue lashing from
time to time as they make their way through some of the most intense moments of
their days. It is my hope that more than
some may be lucky enough to have the great fortune of coming into the ward when
they will be blessed with some measure of compassion and warmth from the
midwives who believe in sharing a kind word and a gentle touch.
It is also my hope that (sooner rather than later) these
babies that make their way are welcomed into the open, warm & loving arms
of their mothers and not sent to lie under the artificial heat of a
warmer. To rest safely next to the
strong beat of their mother’s heart will offer immeasurable comfort for both
parties.
Send a little prayer, shout out and bit of warm love not
only to the women on the maternity ward but also to little baby boy as he makes
his way into another day.
Signing off with a bit of a heavy heart....
Victoria Hospital on my way home yesterday
On the brighter side of things... This handsome boy & his mama were discharged home yesterday afternoon.
