Birth A La Mode; No Cherry On Top
I miss the good old days. I admit, it’s hard to miss something you never actually witnessed, although that’s how things were when I was an infant.
No one who had a baby in the early sixties remembers giving birth. When women arrived in labor, their husbands were promptly dispatched to the waiting room, and the mothers were taken to a labor room.
They would not have signed a consent to give birth. The lawyers had not yet mucked up the entire medical system. What a laughable thing, signing a consent to give birth. What the hell happens if you refuse to sign the consent? That thing is coming out anyway; I can assure you of that.
On admission, they were administered a cocktail of at least two medicines: Demerol, a powerful painkiller, in doses calculated to make one gutter drunk, and scopolamine, also called the zombie drug, because if you give enough of it to someone, they are in a trance-like state and will almost certainly be suggestible and compliant with any orders. Scopolamine also has a powerful amnestic effect: given in sufficient doses, the recipient will remember virtually nothing from the time the drug was given.
Doctors back in the day tell me that those women were still awake; they still felt pain and yelled, but they did as they were told and didn’t remember a BIT of it. My mother remembers nothing about giving birth to me. And she doesn’t seem to regret that one bit. She told me, “Well, I had some contractions, so I did the laundry and vacuumed the house, and went in to the hospital. When I woke up 2 days later, I had a baby.”
That would be AWESOME. And I say this not because I am a narrow-minded misogynistic control freak, but because the pendulum has swung WAY too far in the other direction. The change began in the late 1960’s when the hippies decided that childbirth was a beautiful and natural experience and they wanted to live every bit of it. Grudgingly, the physicians agreed to allow the husbands to be present at the delivery. That meant no more doping the patient, so now they were dealing with a wide-awake very scared little person in massive pain, because they didn’t really do epidurals back then. And then they had to deal with the baby’s FATHER (I don’t say husband, because that was around the time of free love and marriage while procreating was optional at best).
I can just imagine the ambiance. The physicians at that time would still be all male, serious as all get out, and doing things the way they were done in the 1950’s: clinical and sterile and blue gowns and drapes and sterile instruments and obedient nurses all doing things very, very seriously.
And in the middle of all this would be the father of the baby (which we heretofore will refer to as the FOB, which is what we call the biological paternal unit, even on the chart, because it gets rid of all need to establish whether or not the patient is married, or if the guy in the room is indeed even the one who donated the DNA, or just some new guy). The FOB would be intoning things like, “Just stay groovy, baby. We want the little dude to have a peaced out aura. Like, so, you probably shouldn’t be screaming and stuff.” At which point, the woman in labor would probably do what all women in labor do at this point, and scream, “Shut the hell up, and get this damn thing out of me!” Hispanic women in labor scream this in Spanish. It is universal.
And then IT happened. After the major adjustment made by the obstetrical community, and the drastic move of allowing fathers in the birthing room, the slippery slope began. The logic being, well, if my FOB can’t be here, can my mom be in here? Which then extended to, well, if my husband or my mom can be in here, can they BOTH be in here?
And that is when stuff just fell all apart. It became anarchy. Allow me to describe a common scene when I enter a labor room: the patient is in the bed, hanging out comfortably with her epidural. Her boyfriend is in the bed with her. The mom and the mother-in-law are both there, because if HER mom can be there, then why can’t mine? Grandma is there too, over in the corner, reeking of gin. There is some young girl with low rise jeans and her thong hanging out sprawled in the recliner meant for the FOB, and her boyfriend is sitting on the armrest. We are not sure who she is but we think she might be the patient’s half-sister. It is explained with some giggling that the boyfriend in the bed is, well, not the FOB, because the FOB is in jail right now, but he didn’t do anything. There is someone’s toddler on the floor. No one is watching him; his diaper is dirty, and he is fondling the patient’s foley catheter bag.
When I enter the room, there are cries of, “Who’s that?” from the imbeciles who arrived late, and from those in the know, cries of “Hey doc, has she done dilated yet? Can we have this baby now? We done waited a long time!” I announce that I am going to examine the patient. Nobody moves. I pointedly say to the patient, “I am going to uncover you and check your cervix. Would you like anyone to step out?” The patient shakes her head. Over from the corner, where it emerges that the patient’s own father is lying on a sleeping bag on the floor, the father yells, “Naw, I done seen it before! Done changed her diapers all these years!” Again, no one steps out. There is a mass craning of necks (from the ones NOT passed out) and they all wait eagerly for the verdict. This is better than reality TV for them. We get more visitors yet on days when there is nothing good on cable, and they’ve already seen that episode of Duck Dynasty.
Now you may ask, why do you put up with this? The answers are multiple. First, this is now part of the birth culture. These people have already attended multiple other labors and would not understand why they were not allowed to hang out for this one too. Second, most of the time, they aren’t really hurting anything; they are just being picturesque and inappropriate. If they are really in the way. I will boot them out. If they are upsetting the patient in any way, we will boot them out, with the help of Security (or the police, if need be), and yes, I cannot begin to enumerate the number of times cops have been called to drag out feuding potential FOBs or belligerent family members.
The other reason for the tolerance is this. All these clowns seem to reduce the anxiety level of the patient and FOB by distracting them, and they are not staring at the baby monitors and pushing the nurse call button multiple times and yelling down the hall, “Hey, the baby’s heart beat done went down!”
Also, we are not nearly as tolerant at the births. After all, birth requires focus. And there can be complications of a birth, certainly, and you don’t want a room full of panicky bystanders with camcorders getting down every second of it. Most hospitals allow two guests at pushing time, usually the FOB and one of the moms. If the patient and family are well behaved, I may allow one more, so we have, say, the FOB, his mom, and the patient’s mom. I reserve the right, at any time to boot everyone out.
Everyone who has been shooed out into the hall for the pushing phase now gathers in the hall. Despite multiple warnings from the nurses, they ooze back out of the waiting room and materialize right outside the door. From out in the hall, we hear audible speculation on what is happening with each scream that is heard. Usually, there is a pool for the weight of the baby or the time of birth. Wagers are cast. I have literally exited the labor room to get something during the pushing process and had people who were pressed up against the door actually fall halfway into the room.
The plague of locusts is rousted one more time, hopefully timed so that the poor girl gets some privacy during the birth and her creative swearing and screaming may not be heard. I hand over the baby, give my congratulations, and head out to the desk to do the paperwork.
After the paperwork is done, I usually swing by the room to make sure everything is stable and mother and baby are well. At this point, all the starlings have come back to roost and are perched on every available semi-horizontal surface and playing Pass the Baby. The TV is blaring. Multiple cell phones are in use. Pictures of the baby and the bleary-eyed mother are being uploaded to every single social media site known to man. I can barely see or speak with my patient because the room is so full of family, friends, and random acquaintances who may have just wandered in.
So this is where we are. It is a far cry from the calm, controlled circumstances in the 1960’s, and all dignity pretty much seems gone from the process of birth. So, I feel I can hardly blamed for being nostalgic for the good old days, where the dads were out pacing the waiting room with cigars, and the moms were pliant and drugged to the gills. There is a happy medium somewhere between where we are now and where we were then. But since when does mob mentality settle for happy medium? We’re just another reality show.