Monday, May 17, 2010

The public hospital experience from the eyes of my Mother

don't speak Portuguese... I can say thank you, good morning and tell you all is good. I needed more than those phrases when I disappeared into the Maternidad to be with Rachel when Luka was born... a lot more...but it was all I had, along with a smile and optimism. Only women were allowed in and Rachel wanted me there... I was too pleased and excited to be concerned. Like many Americans I assumed everyone would be able to communicate with me in English. Silly me... why should they. I was allowed to stay during the birth as well as overnight because she was going to end up having a C-section. Her doctor cut through the red tape at the front desk so I could accompany her in to wait for surgery... after an interrogation, presenting my passport, the bag search at the front desk and the candy and pillow confiscation, by some of the most intimidating women I have ever run into before or since, Rachel and I stepped over the thresh hold  into the 1950's for Luka's birth. The hospital was spotless, the staff was pleasant, her doctors were wonderful, the beds had hand cranks, the IV poles had claw feet and the IV bags were bottles. I haven't seen IV bottles since nursing school... a long time ago.

They wouldn't let me go into the operating suite with Rachel... no room in the inn. I use the term suite loosely, it was a closet. I was ushered into the hall after watching Rachel waddle away into the unknown. One last photo... one last kiss... one last reassurance. I was devastated and hardly noticed the women laying in a row on gurneys, struggling through their various stages of labor, on the way out. There was one old stool with wheels at the end of the first gurney in the row and I had the impression that the doctor would slide from bed to bed on her stool ready to catch each baby as it popped out. Hopefully they would be born in order. It could have gotten confusing and messy. If I could have seen faces I might have recognized a few of the women that would eventually be in the five bed room with Rachel later... but the parts I saw all looked alike. I was afraid to leave the hospital and go out into the courtyard (I use the term courtyard loosely too... open space between buildings covered with a corrugated roof, with benches.)  waiting area with Daniel, his family and Rachel's dad. I was afraid I wouldn't be allowed back in. I sat alone in the hall, peeked into the open door of the delivery area and paced. When I heard a deep throated cry I knew it was Luka. His cry sounded like Rachel's when she was born. I was standing at the door when the anesthesiologist came out and gave me a thumbs up and held is hands out like he was was showing me the size of a big bass he had just caught. He rolled his eyes and emphasized it again... big fish. We had a big fish. I rushed down and stood on the thresh hold to the waiting area, next to the gestapo ladies at the front desk, yelling at everyone that he was here. The gestapo said something to me... I decided to interpret it as congratulations and headed back upstairs before I could be thrown out for breaking a rule I didn't know about.

Rachel was laying in the hall on a gurney, all by herself. She said she was glad I was there, like I wouldn't have fought to be, and asked where the baby was. Good question. I assumed the nursery had him. She told me to look between her legs and sure enough there was a baby in there all wrapped in sheets and stuffed between her deadened legs... worked. He was warm and she wasn't going anywhere. The orderly came out and we moved down the hall to her room. Rachel had me fish the baby clothes out of her bag, that had been stored under the gurney, and on the way past the nurses desk a nurses came out and took Luka and the clothing. It was late so the room she was rolled into was dark. She was given the bed by the door and I tried to help Rachel slide into it. The orderly held the gurney and a nurse held the IV bottle and I carried her dead legs. Rachel was responsible for the top half of her body. We settled in... alone. Several minutes later they rolled an ancient bassinet  in with Luka curled up inside and deposited it next to the bed. I noticed the little hat we had brought for him didn't fit but they had gotten it on as much of his head as they could anyway. He was a big fish with a large head. We had to bring our own diapers, sheets for the babies bed, blankets and clothing. One other patient had her mother staying with her and I watched her change her grandchild's diaper so I figured out that they provided cotton balls and a squirt bottle, that we filled at a sink in the room, to clean the babies bottom. Rachel was exhausted and laying flat, afraid to roll to her side to nurse the baby... she didn't have a pillow (they took ours at the door... should have fought for it) so we figured out how to latch him on with his little head in her armpit. I found a chair and pulled it up by the bed as quietly as I could and sat down for the night. When I leaned back the back of the chair fell off... I propped it against the wall and sat staring at Rachel, changed Luka's diapers, helped her nurse, jiggled him when he fussed and watched her IV run out... no one came in. I had the feeling that we had been locked in and left alone to fend for ourselves.

The IV was going dry and she hadn't had any pain medication. Her epidural hadn't worn off yet so I knew she was ok for now. I had been checking her for bleeding through the night and wondered who I would tell if I saw she was having a problem. The other ladies in the room or Luka... seemed my only choice. I wandered the halls looking for someone... anyone. What I would say when I found them I hadn't figured out yet. I headed up the stairs to another floor... no one. Finally I stood in the stairwell and cried... took a deep breath and headed back to Rachel. I went to the nurses station again to see if I could get someone in to check the IV and ran into an hysterical new mother holding her newborn. An older woman with her was telling me that the baby had choked... they handed him to me. Blonde, blue eyes and in flip flops but i guess I looked like authority. I patted the baby, he seemed fine, and pointed at the empty nurses desk. The older woman went into the depths and came out with a half sleeping nurse, her hair in bobbie pins and a hairnet. She took the baby from me and looked into it's face then handed it back to the mom and sent her back to her room. I was not going to let her escape. I grabbed her elbow and pulled her down the hall... telling her she needed to look at Rachel's IV. She fought, but I won. When I pointed out the empty bottle to her she shut the IV off, pulled the tubbing out wound it up and taped it to Rachel's arm... I could have done that... and stomped out. Rachel looked panicked. I told her it was all good, checked her dressings again, changed the baby, helped her nurse him and propped myself up in my broken chair for the remainder of the night. Towards morning the old air conditioning unit in the wall huffed, wheezed and quit. Perfect.


  1. While that could all be looked at as very dramatic, I just read it and laughed my ass off! I remember trying to figure out how we were going to clean his toosh with no wipies but cotton... And when your chair broke! Omg, that was so sad it was funny. Your legs were so swollen. And then the air conditioning. All of us moms batting away mosquitos from the babies. LOL. It was the craziest experience. I think those 3 days could be made into one of those comedies where everything goes wrong.

  2. it was fun.... is that the right word?

  3. it made me cry. What would be of us without our moms and this desperate and imeasurable love? And how overwhelming it is to think that we are that one and only person in the world who will love our babies no matter what. still weeping here. maybe it's the pregnancy hormones... nervermind me.

  4. Rachel - all the more reason countries like Brazil and Spain need good doulas and midwifes, more home births and natural birthing centers. Your experience has inspired me further to try to help in this arena. Spain is also stuck in the 1950s and though the quality of care here is quite good, the "services" and sympathetic nature of doctors and nurses really need to improve.

    I hope my mom never reads your mom's post! Ha ha.

    Congrats for your two gorgeous boys. And I will think good thoughts for the women that lost her twins. That is so sad...


  5. They do need more doulas and midwifes. They also need a more open mind about home births. Of course the 10 min wait for emergency care does make a difference in that case. At least you can say Gisele Bündchen brought the whole idea up down here...

  6. Thais - A mother's love is amazing. Amazing how Mom chose to cry in the hall and managed to tell me everything would be ok. She didn't even show one moment of doubt if front of me.

    In defense of the public hospital, I have a friend who was left in the birthing room of a private hospital here. I guess it can happen anywhere. They just forget about us poor moms. ;)

  7. Nossa senhora. Getting a "plano da saude" like yesterday. I am sure it was a fun/interesting experience but from what it looks like this wasn't your first birth. I would have freaked out. My husband has a 4 year old daughter who was born in a private hospital, what a difference, it was like a hotel with a private side waiting room for guests next to the mother's private room, which has a husband bed and a crib.

  8. Actually, it was my first birth. My second was in a private hospital! Talk about a difference!