November 18, 2008

At some point between completing nursing school and beginning work, I read an article that drastically changed my practice as a labor and delivery nurse.  This article submitted that a woman’s self image is dramatically influenced by her birth experience.  Citing personal experiences and statistics, research has shown that how a woman feels about herself both during and after her labor and birth experience directly relates to how she views her self worth and self image.  

If a woman feels like she was inadequate or didn’t “do a good job” for any number of reasons (the natural vs. medicated delivery, c-section or vaginal delivery, negative comments from medical personnel or family, etc) then she carries that image of herself (as inadequate) throughout her life, into her relationships.  Interestingly, the positive or negative self-image a woman comes away from her birth experience with does not correlate with a positive or negative outcome.  Women who have delivered still-born babies have come away feeling positive about their role and women who have delivered perfect and healthy babies have, in the end, felt like failures.  

And even more interesting, the labor nurse has the most influence over this perception, more than the doctor or the family.  I wish I could find and reference that article now.  I’d give it to every labor nurse I know.  

It is weighty.

Some days I’m overwhelmed by the weight of it.  Everyone’s story is different and spending my days in some of the most meaningful, dramatic, life-altering moments of people’s entire lives makes the ordinary seem less so.  The second I step in the hospital room, I am immediately a part of their family.  I have the ability to shape who they are and that responsibility is both magnificent and terrifying.  

A few weeks ago I cared for a mother pregnant with twins who went into labor earlier than expected.  Weeks before her medically necessary, scheduled c-section.  From the moment she arrived in painful, active labor, she progressed more quickly than we expected and the doctor and I frantically delivered her first premature baby as I held her hand and coached her through and the doctor sat on the end of the bed to catch.  The bed, coincidentally, was positioned half-in and half-out of the doorway of the operating room where we were rushing her for the c-section.  A few minutes later as I struggled to find baby 2’s fading heartbeat, the doctor urgently cut open the mothers belly to delivery baby 2 by c-section.  This mom now had two premature babies and was forced to recover from both a vaginal delivery and c-section.   She was brave and amazing.

Some days up to half of our patient population is Spanish-speaking only.  And I can hold my own in Spanish as my OB-GYN Spanish vocabulary has expanded exponentially.  Although I still find it strange to tell a mother that I need to check her “boca de la matriz” (cervix) because it translates directly “mouth of the womb”.  I can communicate in Spanish labor progess, pushing, caring the the baby and breastfeeding but sometimes I’m forced to rely on my carefully crafted arsenal of OB-GYN charades.  Which are much more universal than one might assume.  (Don’t you wish you had a video of those?).  

Because of my relatively advanced ability to speak Spanish, I am occasionally asked to stand-in as translator in the times that we can’t find one soon enough. A few weeks ago I was in on a delivery with a co-worker to translate and coach the mother through pushing.  Most of my co-workers know enough Spanish to be dangerous.  At least they think so. 

Apparently oblivious to my calm coaching of the mother as the baby’s head begins to crown, this particularly excitable co-worker began to enthusiastically encourage the young mother to Push! Push! Push! by saying, emphatically, “Puta! Puta! Puta!”.  Much to the dismay of all in the room (most of all the co-worker), “Puta!” does not mean “Push!” in Spanish. 

Not at all actually.

It means “Whore!”.  So the father has stormed out of the room, the co-worker is bewildered, the doctor is trying not to laugh while attempting to catch this baby and the mother is crying and confused.  I use my best, most compassionate and eloquent Spanish to explain, apologize, console and coach this mother.

So I can do Spanish.

This week I cared for a patient who only spoke Arabic.  She had the most intricate and beautiful henna tattoos covering her hands and feet and had been in the United States a matter of months.  She had a benign tumor in her placenta which forced us to induce her labor earlier than expected.  Two nights in a row I cared for her during the long and trying process of inducing a baby that’s not ready to be born.  And by the second night we were familiar with each others facial expression, short phrases and charades enough that our bond began that slow, breath-taking crawl beyond language barriers.  

Her delivery was a comedic and beautiful dance of me animatedly coaching her by using a translator phone where I speak into one phone and the off-site translator relays the message to the patient through another.  It’s a strange and amazing experience to talking someone through their birth experience both over the telephone and face-to-face.  But eventually the phone was set down.  She was only reading my expression and listening to the tone of my voice, following my cues.  We didn’t need the words.  She delivered the most beautiful baby girl while looking me in the eyes and that expression has the power to stop time.  It is nearly other-worldly.    

And there are other mothers.  Ones who I have to cry with as we hand them their carefully swaddled, lifeless baby.  Ones who arrive high or drunk and delivery babies who go through detox along side their mothers.  Slowly and painfully.

But every day, every patient, every birth, I share the joy and the tears, sometimes the deep sadness of loss and usually the celebration of a new baby and a new mother.  And with each one I am forever repeating the words of encouragement.  In English, in Spanish, with my words, eyes and actions. You are doing such a good job.  You are a strong mother.  You can do this.  I am so proud of you.


6 Responses to “”

  1. emma said

    thank you for sharing this.

  2. Aw Amber what a wonderful nurse you are. And I am so proud of you.

  3. schmanda said

    why do you always give me chills when you write? =) i love you and miss you!

  4. emma said

    i sent this to a friend of mine that is currently going to school to be a midwife in vancouver, she said she really appreciated it. i knew she would, is why i sent her the link. but thought i’d let you know you are appreciated more than just by me. by someone that doesn’t even know you. ha.

  5. Amy said

    Late March/early April, your date with me….niece #2 😉

  6. JonBlack said

    ¡Puta! ¡Puta! Bwahahahaha!

    I know… leave it to me to fixate on the crass, hilarious part.

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