Birth

26.09.2010 – Celebrating Birth: A Rite of Passage

emilyrgeorge5 Comments

It was late September and it was almost time.  My body burgeoned with new life.  Sheets were washed in hypo-allergenic detergent and carefully placed in the bassinette.  The freezer was stocked with meals that the village had made.  I had comprehensively prepared for the new arrival, knowing deep down that birthing had no dress rehearsals.

The morning the contractions started, the man whose sperm met my egg on a cold morning in December walked with me for over 6 miles.  Meandering through the Emerald Necklace, reading aloud from Jonathan Safran Foer’s Extremely Loud and Incredibly Close, we laughed and dreamed and reminded the other to be brave.

Dusk brought more silence, more focus, and more pain.  I paced and moaned.  My baby’s spine grinded against my own as he eased down into the birth canal.  His father pushed on my back with enough force to break bricks.  My mother kept time.

We knew it was a boy; a son.  Jude August George Payne would be his name.  Two middle names because his Daddy wanted something with cadence when announced at graduations, after book titles, in newspaper articles, and as head-of-state.  We kept his name a secret, but I whispered it over and over under my breath as my body writhed.  Finally, my mother signaled that we needed to leave for the hospital.

Once we arrived, I immediately stepped out of my clothes and into the shower.   My arms, free from tubes holding drugs, pressed against the cold tiles.  Scalding water poured down over my swollen breasts and protruding uterus.  My skin burned bright red.  The steam enveloped me.   The soon-to-be Daddy stood, fully clothed, inside the shower with me.  His tired eyes closed.  His head leaned against the door.

An hour passed and the nurse told me it was time.  Time for what?

Time for unquantifiable and unimaginable pain to course through my entire body.

Time to experience more vulnerability than I have ever felt in my life.

Time to fully embrace my rite of passage into the mystery and essence of womanhood.

“I can’t do it,” I screamed.  I was standing on the bed.  “I have to get out of here.  Saw my body in half!  Let me leave!”*

I was quickly brought back down to my hands and knees by an animalistic desire to push.  “You can do this,” the almost-Daddy whispered.  “He’s almost here.  I can see the top of his head.  He has beautiful hair.”

I had to cross over to another planet to make him come; a planet void of inhibitions, glamour and time.  There was no past or future.  Only the moment, the actual second, the millisecond…breathing in and out of every contraction as it tore through my insides.  Feeling my naked body contort, strain, bear down.  Hearing the wildness of my voice as I screamed, “Oh, God!  Oh, Jesus, help me.”  My mind flooded with images of Joan of Arc burning at the stake, Perpetua being ripped apart by wild beasts, Jesus dying on the Cross, and I found courage on the faces of my fellow sufferers.

My son was brought into this world with the piercing shriek of a wild animal and he echoed my greeting with a wail of his own.  My exhausted body fell back on the sheets soaked with sweat and blood.  The new daddy came close to my face, “Look into my eyes.  Look at me.  We have a son.  You did it.  He’s perfect.”  I looked over to where Jude was being weighed and saw my mother leaning over the side of the scale, whispering into his ear, greeting the new generation of life that came forth from my body.

After a few moments, Jude was placed on my chest, his bare skin touching mine, his whimpers quieting instantly as he recognized the familiar drumming of my heart.  I stared down at him, overwhelmed with wonder, unaware that I had crossed over into a foreign land that would soon become more intimately known than the world I was leaving.  Both of us finally surrendered to sleep, our poignant journey dually embraced, capturing the very pathos of motherhood.

*These quotes were taken from statements my dear sisters made while they were in labor and were too amazing to not include in my own story.

Nursing, Maternity Care, and Cultural Sensitivity

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I was asked by The Maternal Health Task Force to guest-write an article in honor of International Nurses Day on May 12.  The following post was what I submitted.

One of the most wonderful things about being a nurse is the unique role we have with our patients.  This role automatically encourages vulnerability and transparency from patients to express things that they may not express to their physician.  Furthermore, it is a role that comes with immense responsibilities to be both compassionate caregiver and attentive advocate. Part of that responsibility means acknowledging the disparities in access and quality of care that many minorities face—an often overlooked and underlying factor that can contribute to poor maternal health. Increasingly, studies are showing that patients who face cultural and language barriers have worse maternal and infant health outcomes.

Generally, research has demonstrated that patients report high levels of satisfaction with their nurses.  However, a recent study by Wikberg, et al released in 2010, explored approximately 1160 female patient perspectives from over 50 countries on the provision of intercultural maternal care in the Nordic countries and found that this area of care had been extremely neglected by nurses. These results seem especially disturbing given that pregnancy, labor and delivery are some of the most sensitive, unguarded times for any woman and should be handled with the utmost respect by clinicians.

Similar to Alice in Wonderland…

The researchers compared the women in the study to Alice from Alice in Wonderland.  Like Alice, these pregnant women find themselves caught up in the wonder of a foreign land – not knowing where to go or whom to trust, experiencing communication problems, and meeting strange or unkind people – all the while desperately needing medical and emotional attention.  The common feeling these women described was powerlessness: not knowing what was happening to them, not being listened to, and not being able to influence the situation.  Consequently, these women became silent, passive, and avoided or interrupted the care being provided to them.

A few nursing considerations…

Education of different cultures is not enough because there is a risk for stereotyping when differences are focused upon.  Nurses need to not only learn more about the specific cultures of their patients; they must learn what their patients need, want, and expect on an individual basis.  During the initial visit, the nurse must inquire after the patient’s personal wishes and concerns surrounding her care.

Secondly, professional interpreters of the same sex need to be available for the patient.  When this is absent, true communication that promotes the relationship between nurse and patient cannot occur.  Educational materials in other languages must be available, as well, so the patient has a variety of resources to ensure complete understanding of what is to be expected during pregnancy, birth, labor, and the postpartum period.

Finally, a culturally diverse staff of nurses is also important so that when situations arise like a patient who has undergone the trauma of female circumcision, culturally and medically competent clinicians are available to provide optimal care.

In conclusion…

Walking through pregnancy, labor and birth with a woman is a privilege and an honor for any person, especially one who is responsible for providing medical attention and care.  As nurses, we must strive to protect this vulnerable and beautiful time for every woman by honoring her personal wishes and providing her with the highest quality care despite language or cultural barriers; thus preserving every woman’s dignity – and even our own.