Midwife: I would like to check to see if you have dilated.
#Vietnamese interpreter: Tôi muốn xem tử cung bạn đã giãn chưa?
Midwife: Is that OK?
Interpreter: Có được không?
My client only spoke Vietnamese, a beautiful first time mom whose
water broke 2 days ago and who only this evening called me.
Midwife: Now, put your heels together and let your knees fall
back…
Interpreter: Bây
giờ, đặt gót chân của bạn với nhau và để hãy thả lỏng đầu gối
Midwife: You can relax ... that's better.
Interpreter: Đừng lo….. đúng rồi.
Midwife: Now you will feel my touch.
Interpreter: Bây giờ bạn sẽ cảm thấy tay tôi. I can only guess that she was either expecting labor to be
contractions first, or a huge gush. A small tear high up in the bag of water
can drip like a leaky faucet and was obviously not noteworthy to this mama. As
soon as she called me I insisted on meeting her at the hospital and asked her
to let her midwife know before she left the house.
Midwife: Now I want to put this speculum inside to look (holding
the thing up).
Interpreter: Bây
giờ tôi muốn đặt mỏ vịt này bên trong để xem.
Midwife: Sorry it’s cold.
Interpreter: Sẽ
lạnh một chút.
Midwife: I will first test and see if this is amniotic fluid; this
won’t hurt.
Interpreter: Đầu tiên tôi sẽ xem đây có phải nước ối không; nó sẽ không đau đâu.
This little exchange would all be fine and dandy except for the
fact that the interpreter agency sent a male interpreter to labor and delivery
that night. I can’t believe what I am hearing.
Midwife: All done.
Interpreter: Xong rồi!
Midwife: But your water has broken. It seems that it started 2
days ago.
Interpreter: Nhưng bạn đã vỡ nước ối. Có vẻ như nó bắt
đầu từ 2 ngày trước.
Midwife: There is some concern that labor hasn’t started and we
want to avoid an infection….
Interpreter: Tôi lo rằng bạn chưa lâm bồn và chúng tôi
muốn phòng ngừa nhiễm trùng ....
When he walked into the room I had leaped off of my perch on a
little exam stool by Khou’s bed, looked straight at him and said, “You and I
will go BEHIND that curtain by the door and you can translate from there!” as I
ushered him away from the bedside.
Midwife: So would it be OK if we started labor with something that
will soften the cervix tonight?
Interpreter: Chúng ta có thể bắt đầu chuẩn bị sinh với
cái gì đó làm cho tử cung mềm hơn tối nay có được không?.
Midwife: And hopefully get things going in the morning?
Interpreter: Và hy vọng có thể bắt đầu vào buổi sáng?
There was no way I would have him gawking at Khou lying there. I
can’t believe they sent him!
Midwife: Yes? OK. I am going to put some medicine into your vagina
and into the cervix.
Interpreter: Có?
OK. Tôi sẽ đặt một số thuốc vào âm đạo của bạn và vào cổ tử cung.
That’s IT! I am about ready to stomp out to the nurses’ station
and demand a woman interpreter. How can they do this? I am furious!
Midwife: You will need to stay flat for 2 hours then. Do you need
to go to the bathroom first?
Interpreter: Bạn
sẽ cần phải ở lại căn hộ cho 2 giờ sau đó. Bạn cần phải đi vào nhà vệ sinh trước không?
Why should you come to a foreign country and have to put up with
this? I would feel so ashamed!
Midwife: Can you put your fists under your bottom so I can reach
your cervix a little better?
Interpreter: Bạn có thể đặt nắm tay của bạn dưới mông của
bạn để tôi có thể tiếp cận cổ tử cung của bạn tốt hơn một chút được không?
This is awful! He acts as if he does this every
day. He does do this every day. She must be feeling sooooo embarrassed. The last time I had to
throw someone out during a birth was when I worked at a free-standing birthing
clinic and found both sides of the family of the couple in the kitchen smoking
up a storm and setting up a bar. They were going to party until their baby was
born! I tried to nicely explain that we weren't set up like a hospital
exactly...we didn't have a waiting room and we would need the run of the whole
floor so she could walk around during labor (much less any other clients who
might show up that night to fill the remaining 2 birthing suites.) I suggested
a motel down the road -- some of them had driven from more than an hour away --
so they reluctantly packed up and camped out in our parking lot for awhile,
serving drinks from the car's boot until it started raining around midnight. We
assured them we would have the couple call them when the baby arrived. BYOB to
a birth. Really, now!
Midwife: Just breathe slowly. You will feel my touch now….
Interprer: Hãy thở chậm lại. Bây giờ bạn sẽ cảm thấy
tay tôi ....
How humiliating! “You will feel my touch now…” his deep smooth
voice coming from behind a flimsy curtain. This is like something out of a
horror movie! I couldn’t do this! It’s awful!
Midwife: Just breathe slowly. Great. Thank you.
Interpreter: Thở
chậm lại. Tuyệt vời. Cảm ơn
bạn.
Midwife: I hope you can get some sleep now.
Interpreter: Tôi
hy vọng bạn có thể ngủ một lúc bây giờ.
Midwife: I’ll check back in the morning.
Interpreter: Tôi sẽ kiểm tra lại vào buổi sáng.
One Friday night I brought my baby doll named Tofiq (toe-FEEK, an
Ethiopian boy’s name,) a life-like 7 lb. African-American demo doll that was
donated by an educational catalog company for my work with African refugee
families in Minneapolis) to a women's shelter where
one of my clients lives. The shelter is just for Ethnic women; there is that
much domestic violence here in Minnesota to necessitate a culturally-specific shelter
all their own!
We had been meeting for the past 3 months discussing her birth
plan, and seeing videos together on birth and the stages of labor and
breastfeeding , and going to classes about interventions and options. She asked
if I had a camera and begged me to bring it to her birth. I promised I would.
Khou* though barely 18, had asked at our last appointment who was
going to teach her how to bathe her baby when s/he is born, so baby doll and I
arranged for a translator and we all crammed into her tiny bathroom that
evening: Khou, me, Tofiq, the interpreter and the shelter director, a young social worker who had never
bathed a baby before either, so she had asked to come, too. (See The best baby
video yet! At this blog in the March posts.)
So I filled the tub, lined up the soap, shampoo, towel, and
washcloth, and gave Tofiq a real bath,
showing Khou how to first test the temperature of the water by dipping in an
elbow and then how to support him in the water (he is even anatomically correct
which sent her into giggles!) Then I had her do it all over again by herself.
She did a great job until she laid him on the towel on the floor. I suggested
at that point that her baby looked pretty cold to me. She quickly dried him off
and wrapped him up in the towel and held him close, looking up at me for
approval. I said he looked better, but, see his mouth is open (it really is)
and that he is probably hungry. I didn't need the interpreter to repeat what
she said then: “OH, NO!” as in, ‘what do I do now?' a look of panic spreading
across her face. So we had a mini class there on the bathroom floor about how
to get him in the best position for nursing: “Belly to belly, chest to chest…
nose and chin should touch the breast!” Then she reminded me for the umpteenth
time to be sure to bring a camera to the birth. I promised again that I would.
I had to laugh seeing this teeny Oriental lady hugging a big Black baby doll to
her breast.
Midwife: Now, put your heels together and let your knees fall
back…
Interpreter: Bây giờ, đặt gót chân của bạn với nhau và hãy thả lỏng đầu gối
Midwife: You can relax ... that's better .
Interpreter: Bạn
hãy thoải mái người…. đúng rồi
Midwife: Now you will feel my touch....
Interpreter: Bây
giờ bạn sẽ cảm nhận được tay tôi....
YUCK! I am never letting this happen to one of MY ladies ever again! I hate this! Mental
note: see nursing supervisor after this birth.
Midwife: Well, you have dilated to 5 centimeters! That’s great
news!
Interpreter: Ồ,
bạn đã giãn ra đến 5 cm! Thật tuyệt!
I rummage
through the cupboards in the room until I find a dilation chart. I get the
interpreter to explain what dilation is and what 5 looks like. Finally I can
say, “You can GO NOW!” I point to the door and thank him. At last he is gone.
It isn’t his fault. But couldn’t he protest? She could have been his daughter,
for heaven’s sake!
Ok, breathe
deeply. Relax. Doulas need reminding to breath slowly too sometimes, I guess.
ARGH! I will
explain myself in pantomime from now on if I have to and show her how she will
open up the rest of the way until she can push her baby out.
The nurse
wheeled in some kind of a Lazy Boy lounge chair and to my utter surprise made
it up with clean sheets and pillows for me. Gosh! I could have done that. We
finished the last of the snacks I had brought along and I went down to the
nutrition room and got us hot drinks. Most hospitals will even give us doulas
the door combinations to the kitchen or linen closet so we can help ourselves
and take care of our moms without having to get a nurse every time. Warm
blankets? No problem. Just dial 1532 on the door’s lock pad.
The rushes
kept up for another two hours but eventually settled down so that Khou was
sound asleep by about 3 a.m. I lay down and didn’t hear anything until she
called me at 8:00 a.m. In her
limited English she sheepishly said, “Stephy-ah, me hungry.” I stretched, got
out of my little bed and fumbled around the bedside stand until I found the folder
with the menu options and the extension to call to order meals. She knew the words
for bread, eggs, tea and meat, so I ordered it. She again asked while we waited for her
breakfast if I had the camera ready. I pointed to it right there on the
counter. When the food tray arrived she dove into it. They had also
included a blueberry muffin which is now her favorite food. She tried to order
just blueberry muffins for lunch but we were told they are only a breakfast
option. Later that day I let the secretary at the ward’s front desk know so she
could make sure Khou got 2 blueberry muffins on her tray every morning while she was in the
hospital.
No sooner
than she had finished eating, the rushes started up again in full force
(it is amazing what a little food and sleep will do!) and breakfast suddenly made a
surprise appearance once again. I told her not to worry about it and helped her
clean up and rinse her mouth. I told her what Ina May Gaskin says about this:
that you actually dilate one centimeter every time you vomit during labor. It
works this way because you can’t totally relax your throat and mouth without
also relaxing the sphincter muscles down below. There is a connection: Wet your
lips. Now just try to pooch your lips out and blow – we call it ‘horse lips’.
Now, try to do a Kegel by contracting or pulling up on your bottom and the
floor muscles of your perineum … hold it … and blow out through your lips again. It
can’t be done at the same time. (Kegel
exercises are used for
strengthening your pelvic floor muscles.) You have to relax those muscles when
you throw up and there isn’t anything that can’t be cleaned up in a few
minutes. As a doula it is funny how fast you get used to these things. In spite
of having just lost her breakfast, Khou cleaned up the last crumbs of the
blueberry muffin and got up to brush her teeth and go to the bathroom.
Before long her
labor was picking up speed beautifully. We stood, we walked, we sat on the birth
ball (Khou did – I didn’t). She asked
for pain medicine at one point and asked about an epidural (and in the same
breath asked if I still had the camera handy). The midwife said that she could
get an epidural if she wanted it, but that she had other options too and
suggested some fentanyl which would take the edge off the pain but still allow
her to be up and moving around. She explained that it worked for an hour or two
at the most. Khou said she wanted something and agreed to try it. She was very
happy with the results and was able to rest. She asked again if I had the
camera ready and I assured her I did as I pointed to it on the bedside stand.
She closed her eyes and was able to manage the rushes better now.
She asked the
midwife the next time she was in the room if Mary, the midwife she had been
seeing in clinic was going to be at her birth. She was able to assure her Mary
had been called. Khou again closed her eyes. We breathed through each rush and
then rested. We were in a pattern now: breathe, slowly… blow it away… rest;
breathe… slowly…blow it away….
Suddenly Khou’s
eyes opened wide and she said, “I go toilet. NOW!” I knew this was the urge to
push without even knowing if she was at 10 centimeters. The midwife with us did
too and didn’t even check her cervix. Then Khou asked, “Where is Mary? I want Mary!”
just as she walked in. She checked Khou and said, “Well, she’s complete. Can we
get the room ready?” The nurses spun into action. The warmer was turned on.
They checked the equipment, unfolded baby blankets and stacked up towels as
Mary robed up and I tied the strings at the back of her gown.
We helped Khou
lean forward from her sitting position and put a squatting bar in place while I
stacked pillows behind her with one hand, the camera ready in my other hand.
The nurse lowered the end of the bed slightly before the next rush. Khou
flashed Mary a panicked glance which we recognized as the classic
‘tell-me-what-I-am supposed-to-do-next look.’ Mary smiled and told Khou that
she was doing just great. She waited for the next rush and nodding her head
said quietly, “You can push a little now.” It took a few more rushes for Khou
to get the hang of it but very quickly the little head was crowning. Then baby
literally dropped out onto the end of the bed during the next push, completely
surprising Khou. If looks could talk I would swear she said, “Where did THAT
come from?!” And I did get pictures – lots of them.
I voiced my complaint about the male
interpreter as civilly as I could manage on my next trip for coffee as I passed
the nurses’ desk and was able to get a woman interpreter for my postpartum
visit the following day. I had waiting at my bus stop in the snow earlier that
morning in front of a florist shop. It occurred to me that no one would be
bringing Khou flowers after all her hard work. If I had the money, I pondered,
I would have loved to have bought her a huge bouquet but I had just spent the last of
my savings unexpectedly the weekend before in order to attend a funeral in
Seattle. Friends of mine had lost their 19 year old daughter in a tragic
accident while she was visiting friends in Taiwan. It was a sad trip and I
couldn’t say anything that would take away their pain, but I hope just being
there with the hundreds of others who came would give them strength for the
days and weeks and months ahead.
I thought of my friends in Seattle once
more as I walked into the room. A young nurse was just arranging a beautiful little
arrangement of pink tea roses on Khou’s bedside table. It was this nurse’s
birthday and someone (special, I could imagine) had flowers delivered to her at
work but she said she wanted Khou to have them. I had never seen such an act of
kindness as that in a hospital before.
I asked Khou if anyone had explained
how or what they had done to fix her tear after her birth. She shook her head.
I know she had been quite mystified by everything at the time and knew she
could not take in one more thing, so I postponed this discussion until now. At
the time her midwife had simply explained that she was going to repair a tear
though I doubt any of this registered with Khou then. I brought along my sketch pad and drew
a picture of her anatomy at the time of birth, explaining how the baby’s head
was stretching her vagina as she crowned:
Then I drew a picture of what it looked
like after birth with the tear along the vagina’s back wall. I explained that Mary had used a round
needle to first pull together the underlying muscle, pushing everything back
into place there and then closed the tear with small stitches along both edges
of the torn skin. I told her that the string is a
self-dissolving material so the stitches won’t need to be removed later. Then I
told her that her midwife is a real artist and that she looked absolutely
beautiful down there. She questioned the interpreter if she had heard that
last comment right and I assured her that she had and that I had seen lots of
women so I should know!
Another thought on the bus on my way
home: what if we had gotten a male midwife? Or if the only resident on the
floor was an African American and I knew that my Asian lady was not assimilated
enough yet to be OK with that because no one in the jungle village of Phongsali where she comes from had ever seen a Black
person? Should I just chalk it up to her American education or make her as
comfortable with each member of her team as I am humanly able? Would they
understand? I am not sure yet what is the better course. More to ponder…. I
will throw this one out at our next doula meeting.
*All names, places and other identifying characteristics have
been changed to protect privacy
** Heartfelt thanks to Vu Nguyen, University of Minnesota, Minneapolis for his excellent translations for this article!
COMING SOON: This and other stories
will be appearing in either Call The
Doula! a diary© or Stone Age Babies
in a Space Age World: Babies and Bonding in the 21st Century©
pending by Stephanie Sorensen
When you were born, you cried and the world rejoiced. Live your
life so that when you die, the world cries and you rejoice. - Cherokee
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