The Next One...
I enter the Corona Ward and prepare the room for the next arrival. She is having her 7th child and her water has just broken. She is highly suspected for Corona.
I organize everything, gear up, and wait.
They come in with a whirl. Everything happens at once.
"Suspected Corona, asymptomatic, 7th delivery, pushing!"
I greet her. "Hi! My name is Gila! I'm your midwife." She looks at me, "epidural" is all she says.
"OK!" I answer her. I call the midwife outside to get an anesthesiologist. Stat. I move her on to the bed and begin to prepare her for an epidural.
Birth is a primal experience. It is something far beyond the conscious being. When it is time, it is time. The woman moves seamlessly from panting and breathing to the reflex-like guttural push. I look her in the eye, "Its time" I tell her. "Your baby is coming. Lets do this together."
She flat out refuses. "I will not deliver without an epidural".
"Don't be afraid. It will be over in a second. I'm here and I'm not leaving you" I tell her.
These moments of balance between helping the birthing mother accomplish her wishes and her ideal birth experience, while keeping her and her unborn child safe are a constant in the labor and delivery ward. In the Corona Ward I feel an even higher sense of urgency and dedication to her wishes. Nothing has gone the way she planned. The least I can do for her is attempt to achieve even the most basic of her wishes.
Its too late. The head is here. I take her face in my hands and say, "You are almost there. Take a deep breath, give me one final push, and this will all be over." She clings on to me tightly.
In a moment her baby is out. I hold her tiny body up for the mother to see. We look her over, count her finger and toes, cut the cord, and she is handed off to the waiting midwife outside.
I spend the next 2 hours sitting with her and discussing the birth. It is complicated and challenging to have meaningful conversations with only your eyes, but I am learning to communicate as much as I can with my touch, eyes, and tone. Mostly I listen.
One may assume that the mother is relieved to be after the birth and finished with the pain. Studies show the opposite. Mothers who come in with a desire to have the birth go one specific way and are unable to achieve that vision, may experience a sense of mourning or even trauma afterwards. The follow up and debriefing of these women is crucial to minimize the trauma and suffering after the birth. This woman is no different. She is suffering. The lack of an epidural may seem trivial to some, but to her it is anything but.
Each midwife has been through a debriefing training course in order to assist mothers through birth experiences that the birthing mother defines as traumatic. It can be as small as a tear that the mother is having trouble coping with, to a baby that was born with no heartbeat, and everything in between.
Follow up for Corona patients is complicated. They are transferred to a ward that I, as a midwife, am not allowed into. The goal is to minimize risk of infection to all hospital staff so only essential personnel are allowed in.
On a normal day, on my next shift, I would come early to sit with her and help her debrief and unpack the intense birth experience that she went through. If I am unable to do it myself we would send another midwife to do the debriefing instead. Here is has become impossible. Yet another obstacle in the days of Corona. I have developed a phone call system where I call each Corona woman the next day and do an automatic debriefing to make sure that she did not perceive the birth as traumatic in any way.
I take the woman's phone number and she is moved to the Corona Ward.
On this occasion she calls me. She describes a night of intense nightmares and reliving the pushing stage over and over again. She has never delivered without an epidural and she doesn't know quite "where to put this level of pain" in her mind. We talk for a long time.
My next shift is only a few hours later. I arrive at work and immediately check her Corona status. Shes negative! She was moved out of the Corona Ward last night. I immediately run upstairs to the postpartum ward to see how she is.
I stand in her doorway. She is feeding her newborn baby. She looks up at me...
"How are you doing today?" I ask.
"I'm sorry, who are you?" She answers.
She has never seen my face.
"I'm Gila Zarbiv. Your midwife" I answer.