Hyderabad: Twenty-three per cent of the 1.5 lakh women interviewed stated that they want dignity and respect during childbirth, according to a survey. Nurses in the labour room are often rude and sometimes inexperienced, which does not lead to a happy birthing.
Safe motherhood is not only about safety from infections and good surgical care, but also requires that the childbirth experience not be traumatic for the mother.
Ninety per cent of women according to the survey in India walk into the labour room without having any idea about what is going to happen to them. Neither does the family. The healthcare system does not prepare them for the labour pain, help them deal with the fear, or explain the changes that the body undergoes during birthing. The coping mechanism is solely the strength and mental make-up of the mother.
Traditionally, when women gave birth at home, the mother, grandmother, or aunt, along with the mid-wife, would prepare the woman for childbirth. Within the family, the women would talk about it and explain the process. During child birth, the mother or grandmother would be beside the mother. Most mothers continued to do housework until the labour contractions got very strong and the birth was imminent.
Dr Neena Desai, a senior gynaecologist, says that women did not rush to the hospital once the labour pains started.
“They endured pain at home and continued with their normal life. This gave them enough mobility and only when the labour contractions became very strong did the woman come to the clinic. But now, if there is the slightest pain, the woman is rushed to the hospital. Many times they get tired lying on the bed and have no energy when it is actually required. The body does not support them and they are rushed in for a C-section.”
The biggest drawback is that nurses are not trained, says Dr Desai. “To get a well-trained nurse to assist at childbirth is an asset. But we have new nurses who are young and not trained. This makes young mothers and even middle-aged first-time mothers very nervous. They do not find the comfort they need. They are already not able to deal with the changes in their body and to top it all, there are so many different people in a hospital who keep visiting them to check blood pressure, pulse, and heart rate. They are not able to cope and concentrate on the pain and childbirth.”
In one instance, a woman’s ultrasound scan showed that the child’s head was not turned down. Labour pains were very slow so medication was given to induce labour, but that didn’t help. The doctors got the nurses to apply external pressure, but that too was not helpful. The husband was made to sit beside his wife but he did not understand what was going on. It was only when the woman’s mother was called in that the delivery went smoothly.
Gynaecologist Dr Manjula A. explained, “In most of these cases, the husband is confused and not able to cope with the stress. They are found to be more stressed than the women. Hence as a support system, we allow the mother or mother-in-law to come inside the labour room and support the mother. This often works as they cajole, soothe and also support the expectant mother to bear the pain and push the child out. Of course, the number of people in the labour room has to be limited and specified. The ante-natal classes which are held during the pregnancy show the labour and childbirth processes, allowing the mother to understand. But at the time of delivery, she needs the support of her mother or those whom she is close to.”
A few private hospitals have begun to understand this, but most small nursing homes and government hospitals do not.
Modern methods: In an institutional delivery in the modern set-up, the expectant mother is alone in the labour room with a host of unknown nursing staff who ask her to push and who are unwilling to put up with her screaming and kicking when she is in severe pain.
“Some women are very scared and the pain often drives them mad. In the present set up, an epidural for painless delivery is given, but it finally boils down to the energy the mother has to push the baby out. Many get so tired that they are not willing to try further and the doctor rushes them straight for a C-section, afraid of complications that may lead to the loss of the baby. But in earlier times, 80 per cent of deliveries were normal and the children survived. Presently, late and planned pregnancies are resulting in larger number of C-sections,” says gynaecologist Geeta S. Laxmi.
Institutional deliveries are safer in that they can provide immediate medical assistance if it is required, but an atmosphere conducive to the care of the mother and child must also be incorporated. Having two experienced family members around at the time of delivery will allay the mother’s psychological fears at least partially.
Young mothers are now asking for more than just medical care. They want their dignity and respect to be maintained while giving birth.
No familiar Face in the crowd
- Traditionally, when women gave birth at home, her mother and close kin along with the mid-wife, would prepare her for childbirth.
- The mother or mother-in-law admitted into the labour room support the woman. This often works as they are able to cajole, soothe and support the expectant mother to bear the pain and to push the child out.
- Having two experienced family members around at the time of delivery will allay the mother’s psychological fears at least partially.
- If there is the slightest pain, the woman is rushed to hospital. Many times they get tired lying on the bed and have no energy when it is actually required.
- Many are not willing to try as a result of fatigue and the doctor rushes them for a C-section, afraid of complications and harm to the baby.
- Unwarranted advice or demands from relatives often pushes the doctor to opt for a C-section.
