Wednesday, June 8, 2011

Whooping it up!

She arrived without knocking, barging into my prenatal visit with noise and confusion. Falling to a small, crumpled mass on the floor, she stared up at me pitifully but didn’t speak. She didn’t need to; she was in labor.

Her friend (who later I would learn was her midwife) rambled incessantly. Words! Incomprehensible words!

The noise of it all overlapped and drowned out my own confused questions. No one was listening, except the woman in labor on my floor, and the prenatal mama on my bed. They just looked at each other quietly and waited.

Why does this always happen on a Monday?

I asked her family to wait for me to finish my prenatal visit before they spewed out all their worries and demands. It was hard for them, but they complied.

Turning to my prenatal patient with an apologetic smile, I counseled her on how to take her vitamins, prayed for her and sent her on her way. She didn’t seem the least bit rattled by the intrusion. Frankly, neither was I. The only one struggling to keep up was my translator.

As the prenatal left, Ayen climbed on the bed explaining that her labor had started the night before. Her contractions were good and her vitals were normal, but she was having a hard time handling the pain -- a very hard time.

She was loud.

When I say loud. I mean LOUD.

When she hollered the whole clinic stopped to listen. It wasn’t a fearful high-pitched shriek but a gut wrenching wail of Wooop! Wooooop! WOOOOOPPPP!

Once the contractions stopped, she would quiet down and smile at me sheepishly. She had a crooked smile with a large gap between her front teeth, and even larger expressive eyes.         --Adorable.

But as her contractions started up again, so did the WHOOOOPS! Periodically, she would slap her leg forcefully, making even more noise. I couldn’t help but wonder if those outside listening, thought I was beating her!

Her vaginal exam showed me she was fully, and had probably been fully for quite some time, but she wouldn’t push. She just whooped, slapped and clapped incessantly. My efforts to get her to push were fruitless. She just couldn’t figure out how, or... wouldn’t.

But one thing she did really well, was make noise!

After an hour of refusing to push, an artificial rupture of membranes (AROM), and a number of positional changes, I decided to augment. Perhaps she just needed a little nudge.

Once the IV was in and the oxytocin was flowing, she got serious. Within 5 minutes the whoops had completely disappeared and she was pushing! She arched her back and out came mister Benjamin Button (as we termed him for the day).

He looked a hundred years old! His wrinkles had wrinkles on them! And when he got ready to wail in protest to our teasing, he scrunched up his face like a dried prune, twisted his lips and wailed just like his mother!         --What a hoot!

How could someone so new look so old?

Ayen laughed heartily after the birth and thanked me for helping her do it. When I told her that she was the first woman I have ever seen physically beat herself during labor, she just smiled sheepishly and shrugged.        

Her friend/midwife confessed that she too had never seen a woman react in such a way, and was sure something was wrong; that’s why she brought her in.

Even now as I think back on her birth, I have to laugh. She was truly unforgettable. 

Whatever works, I guess. Right?