Saturday, January 25, 2014
“Madam, you need to step out of the delivery room – you are too soft.”
I am not sure that I have ever been called “soft” if my life (except for maybe my waistline). But I was judged harshly and labeled severely by two nurses last night in a labor and delivery room at a local hospital in Swaziland.
It all started at 7:30AM when I dropped off one of the young woman who lives at the Kibbutz at the bus stop to go and have her last prenatal appointment before her expected due date of February 3rd. For the sake of privacy I will call her the Girl. I was heading north to deal with a very serious family situation with one of our new children and the Girl was heading south to her appointment. Almost five hours later I was finished my run around and was heading home when I got the call. My Girl was in labor! I was traveling with my longstanding partner in adventure, Susan Page, and so we dropped off the first baby at home and headed south to see how the Girl was doing. The rest of the blog is a likely poor attempt to explain what childbirth in a local hospital in Swaziland looks like.
I promise you that I would rather not relive it in order to write it, but to honor the Girl and all the other women who have given birth here and will in the future I will put pen to paper (or fingers to keys) and share my experience with you. They are heroes.
First let me say that this was a nice hospital. It is government run, but is clean, tidy and reasonably new. Women in labor either walk to or are dropped at the front gate and picked up a day after the baby has arrived. No one is encouraged (or allowed) to stay with them, walk with them or wipe their brow. They are on the long and painful path of the unknown, alone.
The women are told to go find their post-delivery bed and put their bag of clothes on the bed. They then take off their street clothes and wrap a cloth around their naked body, usually a piece of Swazi cloth or a flag-like material. Then they wait. As labor comes on they move from the hallway to the floor. From the bathroom (with no toilet paper, soap or doors that lock for privacy) to the outside entrance area where there are bushes with freshly washed underwear hanging to dry. Vomiting ensues and the pain continues. There is nothing for the pain and no chance of avoiding the inevitable – the natural delivery of a baby with no epidural or other reprieve.
When the mother feels like she is in full labor she walks down to the “Labour Ward” and lies on one of four beds, her “private area” facing towards the entrance of the main hallway (with no door on it) and waits for the nurse to come and do a pelvic exam to see how far she has dilated. Until the baby is ready to “crown” she must stay out of the labor ward except to be checked. When she enters for her examination she is given a disposable sheet to so that she does not dirty the heavy plastic cover on the bed and is reminded to keep that with her at all times as she will only get one of them. Several times yesterday I found my head spinning when I walked down that hall and glanced in that room, only to see women spread-eagled with nurses determining their fate (or expected time of their baby’s arrival). Not something I need to see again.
With hours of pain and agony behind us, we thought for sure that the baby was ready to come only to find that the mother had only dilated 3 cm. We were back to the hallway to watch these young women writhe in pain while we white people measure the length of contraction on our iPhones. Surreal. I digress.
When it looks like the woman (or Girl) is about to pass out from the pain or asks you to have a C-Section because she can’t stand the pain any more, it is time to go in to the Delivery room.
The Girl asked me if I would go with her in to the Delivery Room. Why? Because the other women who live at Project Canaan told her that if you scream or cry out at all, the nurses will beat you. She thought that if I were there maybe they would not do that to her. Against my better judgment I agreed.
PG Rating on the rest of today’s blog.
I followed her in to a stark white room with three delivery beds, all facing directly down the hallway for the world to view all that was going on (!). She went to the far bed, which provided the most privacy. She removed her cloth and crawled up on the table, butt naked. There was another naked women on the bed next to her who looked dead (she was not). I am not sure what stage of labor she was in, but I suspected from the gurney waiting outside the room that she was waiting for a doctor to arrive to head to the operating room for a C-Section. Doctors don’t deliver babies here, nurses do all that work. Well, the pregnant women do all the work, really.
The Girl handed the nurses the cloth she had been carrying around with drops on it from prior examinations. She lay on the hard plastic bed, again, totally naked and the nurses showed her how she was to pull up on her own legs when she felt a contraction coming. There were no stirrups. She looked at me and was terrified. She said, “Auntie, I can’t do this!”
I assured her that she could do it and that it was almost over. The baby would be here in minutes and she would be ok. I rubbed her arm, held her hand and squeezed tight as she took her first attempt at pushing the baby out. It was then that I was asked to leave the delivery room.
“Madam, you need to leave the delivery room,” the nurses said.
“Why?” I asked with surprise. I was doing a great job of keeping the Girl calm and hopeful.
“Because you are too soft,” both nurses said at once.
What? ME too soft? I quickly backed up against the wall and held my ground explaining that I had promised her that I would be there for her. And then I said,
“And if I leave her, you will beat her.”
They laughed out loud, totally agreeing that my accusation was correct. Then pointed to the hallway where I was to wait. Timing was good and another contraction came along so we all focused back on the pregnant one. They told the Girl to pull up and hold her legs and could see that the head was there. Without giving me a chance to look away they took the end of a scalpel (i.e. a razor blade with no holder), did the episiotomy and then told her to push again.
Up until that point I was so overwhelmed by everything going on that I failed to question why one of the nurses was standing up on a stool beside the table. I looked at her and saw that she was there to push down on the Girl’s belly and help push the baby out. She pushed with both hands, and all her might, but the baby wasn’t coming. They paused. I stayed quiet and the Girl and I looked at each other. The next contraction came, and the same thing was repeated over and over again. After some time the baby come slipping out (with a long skinny head from the birth canal) and we saw that he was a perfect baby boy. That was a surprise because the ultrasound told us to expect a girl.
The worst was over, the placenta was delivered and I stepped out of the room with the baby just in time to miss the stitching up of the Girl. All of this was done with no pain medication or anesthesia. She didn’t scream, or cry out even once. And as I write this I am still amazed at the fortitude and courage of this terrified 17-year old girl.
The plan was and is for this baby to live at the El Roi Baby Home. The child was conceived by rape and the Girl wants nothing to do with the baby. She moved to the Kibbutz to avoid gossip and hopes to leave us once she has healed so that she can go back to school. We named the baby “Jerry” in honor of Captain Jerry Coffee who is visiting us this week (his wife is Susan Page, who was with me through this life-changing event). Jerry is a loving, caring, kind man and a hero to us all.
Yesterday was another tough day in Swaziland, but much easier for me than all of the women around the country having babies. I have never liked being called names, but being “too soft” to a young girl in active labor is a name that I can and will live with.
I hope that I can be the first to make that change in other parts of my own life.
Live from Swaziland … Baby #50 has arrived!
PS - the total cost for labor and delivery of little Jerry was $3 USD.