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

[kuldeep kaur]

On 19th April 2005 – 1:55pm Clean Labour room
“Kuldeep we have induced the jhally (psychotic)” as I entered the induction room, came a sharp voice of a senior doctor. I immediately got the image of the mother admitted for induction on previous day with history of psychosis and epilepsy. I replied that I think she should be taken up for caesarian-section. I do not think she can bear the labour pains. 
“Oh! That is true but it is also not advisable to do caesarian-section for such psychosis mother. There are always more complications in caesarian-section than normal vaginal delivery.” The doctor explained further.
“Anyhow, let us pray for the best.”
“Yes, we should try to make her as comfortable as we can.”
Meena (changed name, The mentioned mother) was missing from her bed at the time of over/duty change. I asked Bala, the security person on duty, about the where about patient Meena? It was urgent to bring her inside. She was already induced and it could be risky for her to move here and there. I asked the security person to check in her room. A special room is meant for pre-eclampsia patient, it was allotted to her after many fellow patients from antenatal cabin complained that she was very talkative and arguing with them. She was found eating in her room. She requested the security to wait till she is finished with lunch. While entering in the induction room she greeted, “Hello sister! I think that I should eat as much as I can! It is quite possible that I have to keep fasting till the baby is born. Sister I like samosa/pakoras very much. My mother bought me two samosas and two burgers and I eat till my stomach began to refuse.” I interrupted, “Meena, it is wrong. Anyhow now you will be on liquid diet like soups, juices and plain tea. It will be a ease for you and your stomach and for your baby too- okay!”
“Yes sister, should I go and take some tomato soup right now.”
“ Not at all, kindly stay inside. Our diet worker will bring a soup for you after some time. Till then we want to listen heart –beat of your baby with a machine. You have to lie down straight for some time.”  She obeyed. She was quite pretty with a thick line of sindoor in her hairline and clothes of latest fashion, a kurta-salwar with multi-colored dupatta. From her appearance it was not possible to differentiate her from other mothers.  
In labour room our first introduction with admitted mother starts with advise for removing all ornaments she wears e.g. Chura (a huge set of Red bangles worn at time of marriage) create lots of hindrance. They argue that chura is a symbol of suhag and their mothers and in-laws instruct them not to part away from it till the first baby is born. Then we have to explain them that during intravenous therapy, which is part of induction of labour process, we have to fix a canula. In case this canula displaced or your chura is tight, it can lead to local inflammation or can involve whole arm. So it is advisable to remove all jewelry to avoid such incidences. In some cases, pregnancy induced retention of water in the body makes it impossible to remove chura. It is also a big unconvinced for the mother during labour pains.
The other reason for removing the jewelry is legal. We have to hand over all jewelry/belongings/clothing’s to the attendants of the patient at the time of admission to induction room avoid theft or misplacement of jewellery.
At 4:15pm Meena is again standing beside my chair.
“ Didi, could I have some tea”
“No dear, first we have to assess you for delivery. Bade doctor round par ane wale hai, aap bed par nahin mile to who naraj ho jayenge. Thodi der aur ruk jayo. Wait for some time, senior doctor is about to come if you are not found on bed she will be very angry”.
“Theek hai didi, par main chai zaroor pene hai. Okay sister what I need tea very much.” 
Sometime before this conversation, I was preparing the tray for her I/v (Intravenous) infusion. Our ward attendant Kusam came for help and asked, “Sister ji, have we asked her attendants to get the articles and medicines required for delivery.” 
“They have been given the list in routine. Let us check our stock and see but we can provide. They will return whatever is available here.”
“Try to get all the required things so their purchase could be saved. She is going through bad times.”
“Let us see what are the items available. We will take from their purchase what ever is not available in our stock”
Meena interrupted Kusam and asked’ “Aunty, are you working here.”
Kusum replied, “Look, I am wearing uniform too.”
In between their talk I explained her about I/V (Intravenous) Canula (special needle used for administrating intravenous fluids) insertion. I was apprehensive and nervous by thinking of Meena. During insertion of I/V Canula some mothers scream so much you feel guilty like doing something wrong. If the patient moves at the time of pricking the needle get displaced and thrombose the vein. Then new vein is searched and new Canula is required. More over Meena was on psychiatric drugs. I found it necessary to check her psychiatric consultation records. She was on two regular psychiatric drugs. There were instructions for prepared sedative injections ready at hand in case she gets violent. I immediately check the crush cart (Big trolley with many boxes to keep emergency requisition equipments and drugs) and a refrigerator. No prepared sedation was there. I was astonished at the morning duty nurse who forgets to keep sedation at hand. Anyhow I consult the senior doctor, Dr. Shavnam on duty about the prepared sedative for the patient as prescribed by psychiatric consultant.
“Yes sister kindly read the file and prepare the required dose. It should also be at hand during internal assessment of the patient. As you are going to insert a canula, she may get furious. Be cautious.” The doctor warned. 
“Thanks doctor”
She was hardly 6 feet away from us. She may have listened to our discussion. I was back to insert her canula. There were two patients so I had enough time for making sure that she gets due attention and care. On seeing canula she insisted on eating something.
“Sister Ji, ‘main abhi do minute mein vapis aa jaunge’. I will be back within no time.”
“Look meena, we have to maintain I/V line. It is very very important. We are helping you.” I tried to persuade her.
“No sister, please leave me.”
“Okay, Kusum go with her and bring her inside as soon as possible.” I requested to Kusam with the intention that this favour may make Meena co-operative. 
She was back within 10 minutes. She said on entering, “jahan par bada bura karte hain,  Apni marzi se khane peene bhi kahin dete hain (It is really bad here, you are not allowed to eat at will.)”
Till 8PM, she was eating one or other thing despite having labour pains. When I left the labour room at the end of my duty she was bearing pains very bravely.
Next day while joining my duty in the morning I asked my colleague, “Hello dear, how are you?”
“Quite fine.”
“How was the night?”
“It was quite hectic- one ceasarian-section and four normal deliveries.” 
“Whose caesarian?” I had the curiosity to know about Meena.
“Of Meena.”
“Oh! It was expected. She was not in a state of mind to bear labour pain.”
“No, she was operated due to fetal distress. It was a baby girl, cute like her.”
After taking the over I went straight to her room. I was very anxious to see how she is breast-feeding her child and how she was coping with stress and pain. In normal females operation related stress can be read from their faces — unable to move, bleeding her vagina, pain at operational sites, voiding through urinary catheter. All makes them helpless. They need a sympathetic smile and warm wishes for their babies. Is Meena getting sympathy and a warm love for her baby?
“Hello Meena, How are you?”
“Sister it is good you are here. I remember you. This is my girl-my own baby. Sister can I get up and hold her in my arms.”
“No, no! You have to lie down at least for twelve hours. Then you can sit and hold her tightly.” 
She was looking very thin, pale and tired but she was quite happy with her baby girl. My worries about the newborn baby’s care decreased as a mother was holding her like a mother should. When a started looking towards suddenly I found that my worries as a social being are still haunting — how the society will behave with this jhally mother and her daughter?  I couldn’t stop myself from sharing these worries with her mother. The response of her mother was unlike we are used to in labour room. She was not making unwelcome postures at the arrival of baby-girl and confident of taking care of mother and child.
My worries remained reshaping as it was the mother of Meena not her mother-in-law, where she is supposed to live. She has fulfilled the most desirable duty of women despite being mentally unwelcome. Most of the women live as bodies here Meena have gone through the procedure the body is supposed to. How this rephrasing of slogan sounds, “body thujey salam”?
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