May be it was dead before seeing the world.

by | Dec 8, 2011 | Blog, Urban Health Action

It is more than, two months since, I had an opportunity to stay overnight in a tertiary government hospital in Bangalore.  This is the storey of what I observed that night at a labor ward. It was a night of the August 23, 2011. If the nurses and doctors had listened to the crying would-be mother that night they might have prevented the death of a child.

I arrived at the hospital around 10 pm. Dr.Upen and myself were there to play the role of family for Juliet, a young lady (rather a girl) from KG halli with risk pregnancy brought to this hospital for delivery. She had no support from her in-laws.  Our worry about her risk delivery flew away as doctors assured that she would deliver normally.

As the Juliet was taken inside the labour ward, we were waiting eagerly thinking what will happen, and when will they break the news.  We waited for almost three hours. Later at 12.30am a staff nurse called over mike,” who are the Juliet’s relatives? Get the cloth to wrap the child”. Upen and I ran towards labour ward with the cloth and gave it to the helper.  She asked me to accompany her to sign on the form before handing over the child to us. I had never come across such situation in my life before, holding and caring the child. I happily transferred this responsibility to Upen, who accompanied the helper, singed the form, and came out with the child, I saw a male baby in his hands.

The people around us were very cooperative. Some of the women sympathized with Upen and helped him in wrapping the new born properly. The baby was very quiet and slept till morning without disturbing us. The baby was separated temporarily from the mother since the mother was given drips inside the ward that had no facility like cradle, for the baby.  Beds were arranged on the either side of the ward entrance so that mothers can be put temporarily on these beds before shifting them to the post natal ward.

There are enough places for the family members to stay near the labour ward. Only women were allowed to stay near the labour ward. Every now and then helpers would chase the men away from there. But my colleague Dr. Upen was excused as the baby was happily resting on his lap.

I had nothing to do but wait till morning to ensure that both mother and the baby get shifted safely to the ward.  I was observing what all was happening there. I felt I was in crowded and noisy place. Staff nurse was calling the name over the mike “who are Geetha’s relatives?”, “who are the relatives of Nagamma? “etc. Family members were running fast with the cloth to sign the paper and get the baby.

The pregnant women who were waiting to deliver were walking from one end of the hospital corridor to the other end. Some of them were inside the labour ward. Some of them were screaming loudly due to pain. In the midst of all these a pregnant woman caught my attention. I was watching her from the time I have entered the hospital.  She suddenly used to come out from the labour ward, would ask for water to drink, would walk the corridor and would again go inside the labour ward. She was repeating it continuously.

I could understand her behaviour that she was trying to control crying from labour pain. She was very anxiously asking her husband, mother-in-law and mother, “Ma why I am not yet delivering? For how long I need to bear this pain? Why don’t you tell the doctor to do cesarean? I think I may die due to the pain, ma please…………………. tell the doctor”. Her mother-in-law went inside to tell the staff nurse about her daughter-in-law’s wish. But she shouted at her and asked her to go out. The helpless lady came out with unhappy face. Her situation was difficult as she was neither able to console her daughter-in-law nor convince the doctor.

Around 5.30 am this lady burst out with loud cry, as she could not tolerate the pain. One can see blood stain on her dress and she was repeatedly telling her mother-in-law about blood spot, in turn; her mother-in-law was reporting it to the nurse. But it seems to be a futile exercise by the family members as the nurse did not care to take this incidence to notice.

Meanwhile Juliet was shifted to the ward with the baby. We both (Upendra and myself) were waiting to hand over the responsibility to Nagrathna, our colleague working in KG halli. While leaving hospital by around 8.30am, I met the same family and noticed no progress in the situation I saw at night. They were so helpless and asked for help, I was thinking how to help them. Suddenly I remembered the names and phone numbers of doctor in-charge displayed on the board near labor ward. I told them that they can talk to an authority and get the work done.

Afternoon I went to meet Juliet and her family members to motivate them to stay with her on that night in the ward. At that time, I met the husband of the lady whom I was observing since last night crying out in pain. As soon as he saw me tears started rolling down from his eyes. He said – “Madam as you suggested I called the doctor. Doctor asked the duty doctor to attend immediately, they did it, and they took our signature saying there is some problem with the baby. After five minutes, doctor came out to say that we have lost the baby. If they would have listened to us, and lent an ear to my wife’s cry we would have gone back home with the live baby”.  Gentleman said “I do not think the child died after five minute; maybe it was dead before seeing the world”.

How to justify the behaviour of the nurse/doctor?

Is it the power of knowledge that makes them to refuse the request made from the women or family members?  It is like “I know what do, you do not know anything”?

– By Amrutha

A night at the labor ward

by | Aug 27, 2011 | Latest Updates, Research, Urban Health Action

This blog is about what I observed and experienced as being one of the many, but the only male, attendants at a labor ward of the tertiary maternity hospital in Bangalore. This is in context of a minor (girl) with risk pregnancy  who was admitted to and looked after by urban health project team after she was found to be in labor for 24 hours by our community health assistants at her in-law’s home. There was no support from family.

Roopa, my senior colleague, managed to assist in admission and investigations, following which the expecting mother was in what is called ‘clean’ labor ward (yes that’s how it is officially called). I took over duty as patient’s attendant from Roopa to be over night at hospital along with my other colleague, Amrutha (who joined me little later in night) so that I can do run around that may be needed in case of emergency.

For me, it was a first experience of being at labor ward. It was a very busy scene there due to sheer number of cases to be handled by a few (post graduate medical student, an intern, a couple of Aayas) staff available. We witnessed some 15 deliveries that night. No attendant was allowed to accompany women in labor ward so we all were crowding near its entrance in the lobby where we were frequently shouted at by Aaya requesting us to be away. So only thing we can do is to sit in the lobby, hear screams of women from labor ward and wait till name of the woman who delivered is announced. It must be scary for women inside as they were lined up inside the ward and I suspect they were able to see other woman delivering.

Among all these, suddenly just past the midnight, a spiritual leader from the near by Mosque started praying in a loud tone just at the entrance of labor room for a new born baby just delivered by a muslin woman. To my surprise, staff did not interfere and did not pay much attention. But it took many women waiting outside the ward with surprise. Later, from long conversation with this gentleman who taught me meanings of prayers that I used to hear a lot in KG halli, I understood that this was a normal happening and he used to visit the ward often. Things were just back to normal and a doctor (all of whom happened to be women) came walking from another end of the ward with a blood covered new born in her hands. This stunned every one of us waiting in that corridor, with our eyes fixed to the baby and I heard many asking each other,  “is that a live or dead baby?”
Few hours passed by and I realized that this was not the place for a man to be. Every half an hour, a security guy or Aaya will walk the corridor and drive out attendants especially men (as only one female attendant is expected to be there). I had to repeatedly explain that I needed to be there, being the only attendant. To qualify as sole attendant, I sat apart from Amrutha as if we did not know each other. Also I came to know to my surprise that there is no toilet for men in this hospital. I got familial with all the corners of the hospital in search of this sought after place and was finally directed by security guy to go out in the dark.

By 12.45 am, o
ur young mother delivered a male baby through normal delivery.  What a happy news! Then came a challenge of keeping the baby with me till morning. Attendant has to sign the form taking responsibility of the baby as baby kidnapping incidents have been reported in past.  This is where completely unrelated women in the corridor showered empathy and help. They helped me wrap baby with available cloths and taught me to handle the baby well, while explaining what they were doing in Tamil/Kannada – though they knew I do not know these languages. Most women who passed by asked one question “yenu magu”, and I soon learned to answer “gandu magu (male child)”. Some one asked “nimda?” (yours?). In fact some imagined me as driver of Amrutha’s car!

Finally by around 4.30 am when mother was shifted out from the labor ward, some strange guy with camera appeared from the dark end of the corridor asking to unwrap the baby and adjusting mother in a specific pose! I later understood he takes photos so that by the time of discharge, a computerized birth certificate can be handed over with photo and other details.

It was a night that made me wiser. I leant about maternity services; how to handle a newborn; few things about Islam; challenges of huge work load that few health staff somehow manages; and humanity of a common man. By early morning, I located a Sulabh Shouchalaya (public toilet) in the campus of the nearby hospital only to find me in a queue  waiting for a manager to complete ‘Aggarbattis and routine chores’ before he can open the facility for us.