Editor’s Note: Happy Friday! Deepa Upadhyaya is back with another birth story. Here she is:
“Taniqua*, yo hoochi fat.” You could feel her embarrassment, although her teenage face was too black to show blush. I am sure the touch of her cheeks could have started a fire.
The crowd of Taniqua’s so-called friends and family were in the hospital room to stay. I was a young labor and delivery nurse then. I was probably too inexperienced or not bold enough to force people out. Also, my new nurse self was entirely too focused on tasks versus looking at the whole situation. Luckily, sometimes experience gives you wisdom.
So, I tried to shelter her privates as I cleaned her up. Sometimes it looks like a war-zone down there after a delivery. Sometimes a mother’s life has been at war since her own birth. Sometimes both.
For some reason I am drawn to caring for people with chaotic lives. That is probably why I took my first labor and delivery nursing job in the county hospital in downtown Minneapolis, in the high-risk obstetric unit no less.
Later on, my first midwife job serviced a low-income, highly diverse, and high-risk population in Portland. So, naturally it was no shock that my first midwife job in Ireland was at one of the busiest and most famous maternity hospitals in Europe (30 deliveries a day in nine labor rooms, in a 100-year-old building).
I learned a lot about pregnancy, birth, recovery and life while being a nurse at the county hospital. I consider that place the roots of my career. I continue to draw on those experiences, sometimes daily.
Lately, my work in Minneapolis and Portland has been coming up for me right here in Comox. I recently read Push (the movie Precious was based on it). It’s about an illiterate teenager who becomes pregnant for the second time by her father. It reminded me of all the girls and women I had cared for who came from abusive backgrounds.
In Minneapolis I worked nights at County by choice. Why would anyone want that? First, babies come at night! Second, all the wacky stuff happens at night. Third, the coolest and most interesting people are the nocturnal types. And finally, there are way less “white coats” looming about at night and gettin’ in yo bz’ness. If you know what I mean? Of course, I have nothing against doctors (ehem married to one), but like everything else moderation is key!
When you come on shift as a nurse, you get a report for the patients you will care for. In some units you are assigned those patients. We chose our patients at County. The nurse coming off shift would have her clipboard with a chart attached and she would proceed to give us the patient’s report. One of us coming on would put out their hand to accept the patient as theirs for the next eight hours.
I remember one night vividly. The nurse coming off said, “This girl is crazy and out of control. I have never encountered such madness in a delivery room in my whole life. Whoever takes her is in for a hell of a night!”
I stuck out my hand.
Another nurse in the room asked me why I always chose the difficult patients? I simply said, “I don’t know, just a way to keep me awake I guess.”
So, I walked into the room and my eyes bulged out to find this skinny pregnant youngster out of bed and frantically pacing the room (she had an epidural which usually keeps you bedridden). She was swearing left and right and I thought she might grab something and throw it at me. She had pulled out her IV and blood was plentiful.
“This epidural don’t work, f$#king s#@t. Who in charge here? I don’t f$#king care man, I am in pain. Hey you, get over here and get me something for this pain ‘fore the next f$#king contraction comes on!” I took a deep breath and got on with it. Nursing is a lot like motherhood, except you can’t bribe your patients with candy.
I managed to get her back into bed, which was no small feat. I cleaned up the blood and restarted a new IV. I was convinced she was going to hit me, especially when I stuck her with a needle.
I could see the headlines as I sweated through the process of caring for this banshee of a patient…”Young Nurse Dies by Attack from Uncontrollable Patient”.
Okay, now that the task was done, it was time to call the anesthesiologist to replace the epidural. I hadn’t even been able to meet my other patients. I was behind before I even started.
The not-so-happy-to-be-woken-up-again-Anesthesia Resident arrived. I had left the girl alone for five minutes to check on my other laboring patients. We walked into her room together and it was trashed… again! She was pacing again, and had pulled the IV out, again!
We struggled to get another IV going and to get her positioned for an epidural. She had long maxed out on the safe amount of pain medication useable for someone housing a baby. The anesthesiologist was frustrated and I was unsure how to control this situation. There was absolutely no reasoning with her. It was like trying to get a crack addict to do complicated long division.
I popped out and looked for more experienced nurse. Frustrated I said, “I think she needs a C-section!” Another nurse looked at me dumbfounded and said, “Jeez, if Deepa’s saying that it must be bad in there. I’ll get the OB resident.”
The doc arrived, all six-foot five-inches of himself. He was armed with enough morphine to kill a large cat. He said in a loud firm voice, “THAT IS ENOUGH!” He scooped her off the bottom of the bed and dumped her at the top and handed me the morphine to give to her. He stayed long enough for the morphine to kick in, which eased with the replacement of the epidural.
Later on, when I checked on her she looked up at me all glassy-eyed and said, “That doctor really cares for me!”
“This is what history of abuse looks like,” I thought.
She was filled with hatred and trying to off load it on me. The rest of the night I tried my best to reach inside and smother her with kindness. She ended up with a Cesarean Section anyway.
Often pregnancy, labor and delivery is a vulnerable and painful time. One’s history of abuse can surface with a vengeance. There’s no foolproof method of what will work when caring for those that have been abused.
The only thing I could ever come up with was just be present and to show them something they probably were not shown enough of… love.
*No real names were used in this piece.