Labor and delivery is a most powerful path of surrender. No matter how the baby eventually arrives. *Angela’s first experience of surrender was in 2017 when her husband *Bob pushed her through the glass doors of a private hospital. She sat somewhat slumped on the wheelchair, a hissing sound spilling out of her, uncontrolled. The more she hissed, the more he found himself running along the corridors, bags on his shoulder, with the screeching sound of his sneakers accompanying every turn.
Two hours prior, she had been fast asleep when she felt a distinct pop deep in between her legs. When she rose from the bed, a gush of clear fluid soaked the floor.
“Babe,” she shook Bob’s shoulder, “I think my water has broken.”
“Mmmh.” He snatched back his shoulder and disappeared deeper in bed.
She shook him again; this time more forcefully. “Heeey. Wake up! My water has broken.”
“What!” He jumped out of bed and ran out of the room. He was back in a split second — with a mop!
Angela rolled her eyes and waddled to the shower as he followed her cleaning up the mess. It was while dressing up that the first contraction hit. It was a brilliant pain that felt like someone was breaking her bones limb by limb. “Whoa! With that look on your face you might end up giving birth in the house. Let’s go.” Bob told her. At the hospital the nurse took one look at her and sprang into action.
“Take this and change.” She gave her an orange frock. And in the interval between the contractions, she was able to ask her a few questions and have someone prepare a bed for her. “Before you are moved to the ward, I will need to examine you to check your dilation.” The nurse smiled reassuringly and spoke the lie for which every medic should be immediately jailed, “This will not hurt.”
“Ok.” Being her first time, Angela did not know what to expect. She figured they had a special measuring tape that they would use to know how many centimetres she was. She watched oblivious as the midwife put on her gloves, cleaned her up and then slid her fingers inside her.
“The sensation I felt, has no name. But it had a direct connection to my buttocks, thighs and eyes. They all went into spasm.” Even as the nurse asked her to relax and place her buttocks back on the examining couch, she couldn’t. Her thighs had invariably locked the nurse’s hand in between her legs. Every instruction to breathe was met by a resistance so strong, one probably needed to meditate to come out of that state. She struggled. The examination was as brief as the life of a fly yet the nurse’s face was opaque, her tone flat.
“Angela. You are just a tip of a finger! You are a long way away from the end. You need to get to 10cm.”
Angela looked at her own fingers to estimate how wide a tip was. “Tip?? I can’t be a tip! If the pain I am in is that of a tip I may not live to see 10cm!”
And she was serious. She knew then that what she was experiencing was a preamble of the horror to come — and it came.
Soon after she settled in the ward, the breaking of bones went into a crescendo. She began to feel like the seasons had changed. It was summer and someone was holding a flame to her body. The cute orange frock felt prickly and heavy on her skin. Thank God for the curtains that gave her and her husband privacy. Soon, she was on her hands and knees on the cold tiled floor. She began to beat the ceramic tiles hard with her palms as if they were responsible for impregnating her.
Initially she was hissing because you know, decorum. But there is something about the 6cm mark and the loss of sanity. When the midwife came to check her, she still had that smile on her face. Angela wished she could open her mouth and fluidly tell the woman off. What was she smiling about! By this time, hissing was for the weak. Angela felt herself receding; her mind unfurling rolling back on it’s own. She was now composing songs and making unintelligible sounds. Soon she was driven to shouting, “I want an epidural pleeeease. Someone please.”
“Just breathe babe,” Bob felt brittle, “remember how we had practised earli…” His words were cut off by the look on her face. She was flinging stones at him with her eyes. A wise man knows when to shut up. He did.
“Call them. Tell them to check me now.” Angela begged.
“But the nurse just left here not too long ago.”
She ignored him and rang the bell next to her bed. She rang it as if it would raise the dead. And each time the nurse came Angela behaved like a spoiled toddler who was being resistant to bedtime. “Please give me water. Just water.” After a few minutes she rang the bell again, “Aki hii nguo inanichomaaa. You don’t have other dresses?” And again, “Wueh. Please show my husband how to rub my back. I think he is making the pain worse.” But the best was when it was time for the next check and she said, “Ngoja kidogo uchungu iisheeee.” All the while groaning and bobbing about as the pretty nurse in white granted her latest request.
It’s harrowing. Labor. It’s like digging through rocky ground using a spoon. It ends eventually. But you never know when. It takes you into a world of such despair and disinhibition and no one but God and time can get you out. Well, an epidural helps. Yet for most, it’s a state of helplessness and vulnerability and you have no choice but to surrender. In the end when the bundle of joy comes, you suffer temporary amnesia. You smile, take photos and the people around you believe you have multiple personality disorder. How can you be dying one minute and smiling the next.
You leave Bob holding the baby and walk to the shower for a hot bath.
Across the road from that private hospital, women are labouring too. Same anatomy, same physiology, same pain receptors yet, worlds apart.
There, when *Jane arrived in labor ward, she said goodbye to her support system at the door. She didn’t have a birth partner. There was just no room. She waddled in to the ward, carrying her baby bag, her basin and other personal effects.
She was welcomed, triaged and assigned a bed among the women who have no complications. There was no orange frock. “You are lucky if you find the bed unoccupied. Most of the time there is someone just like you already lying there.” And now during the industrial action there were definitely more.
Three pregnant women couldn’t all lie in one bed and fit. So she sat with her back against the wall. When she got tired, she stood. Then the contractions began. Here, there was no one to rub her back. Her left or right hand was her only companion. That, and the room that was filled with other women screaming, pacing and huffing like her. There was no social distancing. No breathing or cough etiquette.
The worst was when either she or her comrade (because they were now like soldiers at war) needed to be examined. There were no curtains separating the beds. Besides the room intended for two was now at four then five then six. “We are asked to lie on our backs and depending on how many times you have delivered here before, some were used to it. Used to strangers staring at their private parts.”
Here, there were no bells to ring. Jane’s bell was her voice. One she used when she felt she was on the edge and couldn’t take it anymore. “If not your voice, then your feet will be your ally. At some point I ran out, grabbed the nearest nurse I saw and said, “Mtoto anakujaaa!” The nurse looked exhausted. She was carrying a tray that was wrapped in blue linen stained with blood and I figured she has just delivered someone else.”
“The scariest is when it’s your first time and you are given a front row seat to watch your comrade deliver.” She didn’t have a smart phone to have watched you tube videos on the process of delivery. “I gawked as I saw my bedmate huff and puff and push her baby out and knew that in a few hours, I was next.” After she delivered, our shared bed was soiled. We had to wait for it to be cleaned to even sit on it. “Now we were four. Three women and a baby. The labouring continues.”
Eventually Jane got to 10cm and delivered her bundle of joy. The worst was over and she wanted to wash away any residual pain in the single bathroom that was shared by all the patients in the ward. “But who would I leave my baby with as I took a minute to clean up? My other comrades were still on their journey.” The ones who had just delivered were spent and had their own babies to hold. So she sat in her sweat and struggle and waited to be transferred to the ward hoping for a warm cup of tea or porridge.
The temporary amnesia will happen to Jane too. In time she will forget and come back. She still smiles at her bundle and because she hasn’t experienced what it feels like to deliver across the road, she accepts this as normal.
But it is not normal. To have citizens living in the same country have such a wide disparity in care during labor and delivery.
As Narrated to me by Angela and Jane who wish to remain anonymous
WHO says every human has a right to quality and timely access to healthcare. We want women to give birth in a safe environment with skilled birth attendants in well-equipped facilities. And to have a positive pregnancy and delivery experience. If you are reading this and you didn’t know what happens across the road in public facilites, now you know. Happy New Year guys. Your Tuesday fix is back.