But (and there's always one), let us take a moment to reflect on why we force women to come to hospitals for delivering their babies, against their social, cultural, and religious bondage. Is it because the nurse and the doctors shouldn't have to answer for 'home deliveries'; or because the ASHA (Accredited Social Health Activist) wouldn't get paid if the delivery happened at home; or because the 'policy-makers' have devised a 'targeted'approach to institutionalize delivery; or because we want to ACTUALLY ensure that the mother and the baby are both healthy?
Forget the reasons and the motivations. Let us talk about what happens when a pregnant woman does reach the hospital. And we are not talking of an ill-equipped sub-center. We are talking of a Rural Hospital, with a special labor room and the works. What do you expect? A smiling staff to reassure the mother, a doctor who tells her don't worry we are here, and cute pink and blue blankets? Oh, sorry to shatter your image...the reality is a sweeperess screaming at the mother for choosing this day to do this as she had to go home early, a nurse who without realizing that the mother knows only the 'Gondi' language, screams at her in Marathi and gets angrier as the mother doesn't follow her directions, and a doctor who keeps repeating that 'these' women don't want to deliver on time and just want to come and sleep in the hospital.
So began the story of the labor at about 8 in the morning. It was her first....through the day she struggled without anyone telling her what or why and.....wondering if it would ever happen. Reaching the labor room at about 3:30, her saree lifted and pulled away, she lay on the Mackintosh on the delivery table, on the stains of the births past, too harried to say anything, too insignificant to complain. Even as she tried to pull the saree down to cover herself, the door to the labor room remained ajar, with peons, and random people walking in and out. I had heard of hospitals stripping a human being of everything that he or she values and I could see that in action. Even an expectant animal is spoken to or caressed before you approach her, but no, no such frivolities for her, the nurse walked in, casually gloved one hand and while talking to me, inserted it into her vagina. A hello would have been nice.
Only 'two-finger' dilatation, who told you to lie down? She thundered (again in Marathi), walk around the room, and don't dirty it! This continued till about 4:30 when the mother after lying down, getting up, walking, lying down..and so on finally decided that she was too tired and lay down. The nurse picked up a used plastic apron from one corner of the labor room being used as a waste disposal site and put it under the mother (who is going to clean the Mackintosh later???). While the mother cried with pain, the women stood around joking and making a joke of everything, from the mother's tribe, to her illiteracy, to her lack of sense due to which she was anemic and weak. 2 women from an NGO active in the region were also made fun of, for speaking softly 'as if this type of patients understand such language'.
The final push was just after 4:30 when the doctor walked in started screaming at the mother to put pressure, fair enough, all doctors have done that in some delivery or the other. Then he started slapping her thighs and legs, also something that I have witnessed before. However, things got a little unusual when he got onto the bed where the mother was, with his shoes on! Now he was standing on the delivery table, with shoes on, legs on both sides of the mother's head and pushing or rather boxing the abdomen down with all of his body's force. He also repeatedly held the mother by her hair and shook her head. Quite a few moments of drama. I was shocked however, when the nurse decided to do an episiotomy and, forgot, to administer local anesthesia! It is only when the mother cried out in discomfort that she realized and asked the junior nurse to bring in an anesthetic.
At 5 minutes to 5, the moment of truth arrived with the baby crowning, and all of us in the room holding our breath, as we could see a bluish tinge to the face. The tears were flowing freely, however, emotions got released when the magical sound started. SHE CRIED!! The lady from the NGO involuntarily started clapping and me, well I was, as they say, in love at first sight. She opened her eyes, the most beautiful eyes I have ever seen, and let out a scream that made the tears faster and the smile wider!
The crazy staff behavior however, continued, with the nurse refusing to let the baby feed till the placenta had come out, and then pulling out the placenta via wrapping the cord around a scissor. There was no difference in that nurse and any dai in the village, except she was trained and NOT supposed to do this (and maybe the dai would have actually done a better job).
The mother was okay, she had survived miraculously; the baby was just too happy eating her hand, or her mom's breast, or the cloth she was wrapped in, depending on the situation; the nurse and doctor wanted to run away without being spoken to and definitely didn't want to give their names; and the sweeperess was cursing everybody for making such a mess. The women from the NGO were also busy assisting breast feeding and examining the child; and I was left all alone to think about what is more important, the end or the means?
P.S.: No photographs this time, respecting the privacy of all involved. The girl is a beauty though. :)