[Reader-list] Hospital's labour room as a space for unheard voices

[kuldeep kaur]

Better sense may prevail as I don’ t have any other reason to continue



Kalapna was screaming with pain as I entered the induction room. At least five-six gynae doctors were there on her bedside. A senior resident of surgery was trying to insert I/V canula to maintain body fluid volume. All of them were busy. I requested the evening duty nurse to give over the charge. She said, “Didi you will have to count down the instruments, articles by yourself. I cannot leave this patient.”
“Oh! Then we can start right with this patient only.” I replied.
“ Yes, it is must. She is Kalpana, a mother with 8th month pregnancy with severe anemia (Hb=4gm) with severe pregnancy induced hypertension (BP was 220/130 mm/hg). She is semi-conscious, not responding to verbal commands. She is about to deliver the baby.”
In between our conversation we were assisting the doctors in handling the patient for her internal assessment as well as to avoid displacement of I/V lines. She was on anti-eclamptic drug, which is emergency drug to avoid possibility of sudden fit.
	Suddenly our senior resident shouted, “come fast, she is delivering the baby” she was on bed. Bobby and I (evening duty nurse) have to run for normal delivery set and required medicines. In the mean time pediatric nurse was also called in. She immediately received the baby and rushed to the Nursery (a small neo-natal unit attached with induction room). I left the evening duty staff nurse with the patient and decided to help pediatric Nurse for resuscitating the baby. Pediatric senior resident was also informed by through intercom. After ensuring that baby was normal and stable I joined evening duty nurse for further management of my patient.
	We helped Kalpana to get out of the bed. Placenta was yet inside and a through internal examination was required. Evening duty was over at 8:00 PM but Bobby (evening duty nurse) was still there for the patient.
	Pediatric Nurse came to show the baby’s sex to the mother after sometime. Kalapna was looking surprised. She immediately shouted in furious voice, “This is not my child, I can never give birth to a girl-child. This is not my child, show me my baby. I give birth to a male baby. He is my baby. Give me my baby.”
	It was a shock for all of us. We tried to convince her but she was not listening to anyone. “Dr Mona, I think she is not in her senses although her Blood Pressure is stable now. She is not able to cope-up with the process of labour.” I tried to break the silence.
	“Blood pressure is normal. She is arguing. No major complication now. She can easily recognize her baby”. We planned to call her mother. The pediatric nurse decided to show the baby to her husband and brothers and to get their signatures on respective files to avoid further confusion. She persuaded her, “ Kalpana, this is your first baby, your own baby. Why you are not accepting her? She is so cute and sweet you are a mother now. You can not ignore your baby.”
	“ Par yeh mera bacha he nahi hai (But this is not my child) Tum police le ke ayo, hum sabat kar ke dikhange. (Call the police, I will prove).” She insisted.
	Till that time I took the over from evening duty nurse and she left for her hostel. We were at least eight medical personnel in the induction room, trying to convince her but she was screaming and trying to remove all her canulas, I/V lines and catheter. We decided to call her mother inside so that she can make her co-operate. Her mother entered the induction room in furious mood and shouted at us.
“Aap log samajate kauon nahin? (Why don’t you understand?)” She looked around at all of us and continued, “is ke ladki ho he nahi sakti. Humne iska ultrasound karwaaia hai, doctor ne bataya hai ke ladka he hoga. Pura ek hazar rupaya laga hai hamara ultrasound pe. Aab ladki kaise ho sakti hai. (She can never give birth to a girl child. We have got her Ultrasound, The doctor has told us about the male fetus. We have paid one thousand for that check-up. How can it be girl?”
	We were stunned. Condition of Kalpana was not improving. She was not allowing us to keep up the efforts to check the bleeding. She was bleeding profusely. She could go in shock once again. Despite all our efforts she was not ready to listen. She was not allowing us to pursue with episiotomy suturing. A junior resident ran to blood bank to get blood for her. I was trying to give her I/V fluids. Senior resident was assisting with another junior resident in Episiotomy suturing. Kalpana tried to run outside in delivery gown with all tubing. It was already 9:30 PM. During this time we could not take care of the other patients. Her mother and relatives were arguing with night duty staff out side the induction room and were using abusive language. Then we informed emergency medical officer and Nursing Supervisor. Consultant was also called from home. 
All patients admitted in ward and their relatives were listening each and everything with keen interest. This whole atmosphere was working out to create an imagery fear in rest of the patients and attendants. We were seen as suspects with no reason to substantiate the claims of Kalpana and her family members. I was feeling very upset to realize that how we will be to re-establish their faith in us? The social pressure to give birth to sons was turning to be an extra burden on us. We discussed that have the doctor who did the ultrasound would have told them about girl fetus and they would have got the male baby what would have been their reaction. What could we do about the doctor who did the ultrasound and told them the sex of baby despite much talked about campaign against such practices? 
The family was ready to accept the baby girl half mindedly. They cursed us saying that god will see to all and everyone will get the justice. Here my thoughts were with the newborn and the behavior she will encounter as an unwelcome sudden guest. One of my colleagues said that with the passage of time they will find the similarities of features of newborn with her parents. I found it wishful thinking and became a bit philosophical that better sense may prevail. 


regards

kuldeep
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