Tuesday, December 8, 2009

The Power of a Mother's Intuition

I love to read, and I read almost anything I can get my hands on. Well, within reason. In the last year or so I've finished reading: all the Bronte sisters books, all the Jane Austen books, all books by F. Scott Fitzgerald, most of John Steinbeck's books, quite a few foreign authors (I love biographies), Three Cups of Tea (which is a book I would recommend to anyone wanting to learn more about the conflict in Afghanistan), and quite a few books about midwives, childbirth, pregnancy, and breastfeeding. I truly just love to read!

Last night I finished up yet another book, this one another midwifery book, but this time a biography (ooh, combining two favorite styles, yes!) by Jennifer Worth, simply entitled, "The Midwife." Ms. Worth was a nurse-midwife who practiced in a port city in England in the 1950's; this book is her recounting of some of the individuals she cared for as she attended them in their homebirths, as well as an interesting descriptor of post-WWII England. Right up my alley.

I truly enjoyed the book, and was getting a bit sad last night as I realized I only had one or two chapters left to read. And then I found IT. The story that brought tears to my eyes and made me, once again, want to climb up on my soap box and shout about the power of the amazing bond between mother and child.

The chapter was entitled, " A Premature Baby." Let me bring you up to speed and briefly summarize what had lead up to this particular chapter. The main character, Ms. Worth, who, mind you, was only in her very early twenties and only in her first year as a midwife, had been called in to see a mom who was in premature labor with her 25th child (yes, you've read correctly, 25th child; the Duggars have nothing on this woman!). The woman was roughly 28-weeks into her pregnancy; she fell outside due to ice and poor visual conditions, sustained a rather serious concussion (she was discovered several hours later by her school-aged children who were returning from school) and developed some sort of infectious process, both of which triggered her labor. She was delirious--screaming hysterically, scratching the people around her at her birth (at home, again) to the point of making them bleed, and throwing herself around the bed. The midwife was unable to auscultate any fetal heart tones (assuming that the baby was dead), and focused her care on the clearly very ill mother. The woman's blood pressure was dangerously low, her heart rate dangerously high, and her fever through the roof. A doctor had been called, but could not be reached. Ambulances were unreliable during this time, and also were unable to be reached. The midwife had just about given up hope on being able to save this poor woman's life, when suddenly the woman sat up in the bed, gave an unearthly howl, and in one push delivered baby, bag of waters, placenta, and a truck load of blood.

The midwife quickly checked the baby, found him to be blue, limp, and lifeless, so she simply scooped his teeny body up with the other "debris" of the birth and set it all aside, and again, focused on the mother. A few minutes later, the midwife and one of the woman's older children heard a strange scratching sound, and turned to see the little, teeny, fragile premature baby boy attempting to move around in the dish in which he had been tossed. The midwife was shocked, she grabbed the baby, turned him upside down and gently tapped his back in an attempt to gently clear his airway of mucus, and then wrapped him quickly in a cloth to prevent cold shock.

For those of you who have never seen or held a premature baby of any gestation, let alone one at 28-weeks, let me try to give you an idea of how absolutely tiny they are. Their legs are no wider around than your smallest finger, their arms smaller still. Their tiny heads are only slightly bigger than say, a ping pong ball (which is how this midwife also described the baby in this account), their eyelids are often fused shut, their tiny mouths when open are no bigger than say, a dime (and possibly even smaller), their skin is translucent and truly tissue paper thin, every vein and artery clearly visible, and regardless of race, their skin is very ruddy. Most babies of this gestation weigh roughly 1 lb., some a bit less, and they would be swallowed up if held in my hand (and I have average to even small hands for a woman). But all perfectly formed. Here are a few photos I've snatched off the web to give you an idea of how small of a baby we are talking about (and since I have no idea how to contact the owners of these photos to obtain permission for usage, I have obliterated any kind of potentially identifying info found in the photos; also note, these photos, to my knowledge, are of three different babies at 28-weeks-gestation):

Now for the truly exciting part of the story (as if the first part wasn't exciting enough!). The doctor has finally arrived, an ambulance with a pediatrician and primitive NICU staff and isolette have arrived, the mother is unconscious with the baby on her chest, and the father is about to hand the baby over to the hospital staff for admission to the NICU. It is this part that is amazing to me. The dad leans over his comatose wife, attempts to pick up the baby, and the woman's hand comes up and covers the baby completely to prevent anyone from touching the baby. They try again, not to be deterred. The dad attempts to lift the woman's hand up and off the baby, but she bears down, holding the baby firmly to her chest. She's not even conscious, for crying out loud! Her older daughter attempts to explain to her that if she wants the baby to survive, she must relinquish the baby to the hospital staff. He needs a neonatologist, trained NICU nurses, an isolette, a feeding tube, around-the-clock blood draws, frequent vital signs, a ventilator, the works. The dad tries to explain, the midwife, the pediatrician, you name it, but no one can budge this mother's hands from her fragile baby boy. One last attempt by dad, and this time, without opening her eyes, the mother says, No, if you take him from me he will die. And here's the clincher. She doesn't even speak English. She's from Spain, ignorant, an uneducated peasant girl who was removed from her mother's home at the age of roughly 11 and has never even been able to communicate with her English husband until she bore children who were bilingual.

The dad gives in, tells the hospital staff to leave, that his wife is refusing to relinquish the baby, they will care for the baby at home, and if the baby dies, they will bury him. Can you imagine doing that nowadays? You'd have the police, a judge, a social worker, you name it, all dragging the mother to the hospital by her heels and then locking her up for refusing to accept medical treatment for her child! But in those days, the parents knew best, and so the pediatrician, the ambulance workers, the hospital staff all packed up and left.

And here's the absolute best part of the story. The baby lived. In fact, he thrived. For the next 5 months, this mother never let the baby out of her sight. In fact, here's what she did (and of course, I LOVE this part of the story): she made a rough sling, out of fine silk, ironically, and carried the baby between her breasts 24 hours a day. Every half hour--night and day, so the book says-- she expressed colostrum from her breasts and fed her baby as many drops as his little belly could hold from a pipette (an extremely narrow, very small glass tube). She didn't sterilize anything. She never checked a blood pressure or pulse or probably even his temperature, given her state of poverty, lack of education, and no understanding of any instruction given to her in English). (She did, however, perform a very primitive version of suctioning and chest PT on a regular basis). She didn't chart his progress in volumes of hospital paperwork. She never saw a lactation consultant, a social worker, a lab tech, or even a nurse. And yet the baby thrived.

No one knows how she knew how to do this with her baby-- we now refer to what this mother did as "Kangaroo Care"-- but at the time, no one in England had ever seen such a "crazy" thing done with any infant, let alone a premature infant. And the baby lived. Thrived, even. Makes me wonder if what we do with all of our infants-- let's not even consider the premature infants, let's just talk about the full-term, healthy ones that are induced into this world a few weeks before their "due date," roughly suctioned, removed from mom and placed on an isolette for a "necessary" examination to determine their state of health, then rubbed down, given a bath, a heel stick, and footprinted all before mom ever gets a chance to barely lay eyes on him. And then he's put on a feeding schedule, a pacifier is shoved into his mouth every time he opens it and mom is cautioned not to let him "use her as a pacifier." Mom is instructed not to "spoil" the baby by too much holding, he's forced to sleep by himself in his own bed (often in his own room), and then when it is determined that he does "need" holding, oftentimes it's by someone other than mom or he's "held" in a bouncy seat, a swing, or my absolute favorite, the car seat "carrier." (They're not carriers, BTW, they're simply carseats and belong in the car-- save your back and nurture your baby!). I often wonder how different our society would be if we practiced a more simple, more nurturing method of infant care.

Could wearing your baby change the world? It did for the little guy in this story, and I believe it could for all of our children as well.

"The Midwife,"
by Jennifer Worth.

1 comment:

Anonymous said...

What a wonderful story. I am 28 weeks pregnant and I teach child psychology and I will share this story with my class.