Burden for Brazil

YAY!!  He’s finally here — just like this post!!

Mishael (mee-shy-L’) Lundberg Rodrigues celebrated his first “birth-day” on 6/20 @ 6:20 am, weighing 6.25 pounds and measuring ~ 20 inches. And yes, it’s only taken me four months to officially announce it!

Before I continue , I would like to state for the record that I actually started this post on June 23; however, we had no internet at the apartment, then we moved and school started and…well, oh well.  Better late than never, right?  At least, that’s what Fred and I said about my obstetrician’s presence during Mishael’s delivery!

Mishael’s first due date was June 19, meaning it was the due date given by Dr. Marinaldo, my obstetrician.  ( For those of you who were counting, we had to change doctors three times, the last time at 33 weeks.)  On that morning I woke up with contractions, although it took me a while to recognize them as such.

I had felt contractions before, of course; but after a time I realized that these were much more regular and lower in my abdomen than the typical Braxton-Hicks.  At some point, I decided to time them and, sure enough, they measured at twenty minutes apart; so I called my local medical expert Carol Dennis.  She agreed that it could be the onset of labor, so per “the doctor’s” orders, I put my laptop in my backpack and went to spend the day resting up for the big event at the Dennis house.

It was a rather uneventful wait.  Although the contractions weren’t necessarily painful, they were regular, so it was hard to ignore them.  I had a little diversion when some friends stopped by around lunch time to discuss church business, but throughout and after the meeting, my contractions continued at a steady twenty.

After lunch, Carol suggested I take a nap.  Obediently, I laid down on the couch but to no avail; I couldn’t sleep, more because of anticipation than pain.  When I had rested enough to please Carol, she suggested a walk in an attempt to speed up the process.  The physical activity did cut the time down to fifteen minutes apart, but it was a small improvement; and the moment I stopped moving, so did the 15-minute contractions, rebounding back up to 20-minute intervals.

I had a doctor’s appointment scheduled for that evening, and Carol advised me to pack the car for the hospital just in case the contractions sped up during the predicted hours-long wait for our notoriously tardy doctor.  (Remember that because it’s going to be significant later on.)  While we waited, we walked, visiting a nearby grocery store to kill time and quicken the contractions.  By the time we finally got in to see Dr. Gervasio that night (two hours later than our scheduled time), the contractions were about 10 minutes apart; however, we were disappointed to discover that after an entire day of labor, I was only dilated one centimeter.  Dr. Gervasio told us to go home, suggesting that if I did not open up to three centimeters by Sunday, he would induce labor.

We returned home where I again worked diligently to put the contractions out of my mind, especially since Dr. Gervasio had predicted such a long wait; but the contractions proved more willful than my mind, and I had difficulty sleeping.  Around 2:00 AM (when I was up for the umpteenth time), I decided to measure the contractions to see if there had been any progress and was surprised to discover that they were  now only five minutes apart — no wonder I had had trouble sleeping!

I woke Fred up, then hurriedly went to get ready in the bathroom.  When I returned a few minutes later, I discovered that Sleeping Beauty hadn’t budged, so I woke him up again, this time emphasizing the timing of my contractions.  That got his attention.

As Fred loaded the car, I called and alerted Carol, who was to accompany us to the hospital.  When we picked her up a short time later, Fred took the passenger seat, too nervous to drive.  The drive was relatively simple as there were no other cars on the road (That’s the first and only time I’ve seen Washington Suares empty!), and I was “maintaining” in the backseat until we reached a section of cobblestone road.  Wowzers!!  Nothing like a few jolts here and there to encourage a baby’s arrival!  It’s just too bad I hadn’t thought of that earlier.

The hospital was dark when we arrived, including the reception area where we had previously been instructed to register.  The night guard, watching over the few cars parked out front, was kind enough to find me a wheelchair.  Since the reception area was closed, we went up to the maternity ward to see who we could find there.  (Thankfully I knew where it was from a previous visit.)

You need to understand that Brazilian hospitals function very differently from those in the U.S. (something to keep in mind as socialized medicine is encouraged more and more in the States).  They are often understaffed and, I would argue, under-trained.  In the maternity ward, there is no perpetual doctor on duty because a woman’s obstetrician is always the same one who delivers the baby.  They are alerted – or, in the case of the majority, scheduled – and meet their patient at the hospital.  That’s why you don’t hear any stories about a Brazilian woman suffering through an extended labor.  It just doesn’t happen because the doctor, weary of waiting, opts to deliver the baby by c-section.  (There are also some external factors, like the absence of a reliable internal heart rate monitor, etc.)  I had discussed these issues various times  with my own obstetrician who, due to my strong wish and disposition to have a natural birth, was willing to wait up to ten hours for the delivery; but at this point, considering the proximity of my contractions along with the fact that neither he nor any other doctor was present, that point was moot.

In the maternity ward, we encountered “Nurse Fatima” who was apparently in charge of the very few on night duty. She seemed disgruntled at being disturbed and when she measured me at only 2 centimeters apart, she deemed that I was not yet far enough along and ordered me back home. Both Carol and Fred, however, appealed on the basis of my five-minute contractions and asked Fatima to call my doctor. She did so reluctantly.  Much to her chagrin, Dr. Gervasio insisted that I be admitted into the hospital (I had told him about my mom’s quick labors.) and ordered Fatima to perform a second touch-test in one hour’s time. It was 3:30 AM.

Our room was basic but nice with an extra bed for a caregiver (explained in following paragraph), a small “closet,” a dorm fridge and, of course, hammock hooks!  It was very different from the U.S. experience, but also different from the Brazilian experience in a public hospital, God’s gracious provision through Fred’s company insurance.

Once we were settled into the room, Fatima and her assistant left.  In Brazil, as in other countries, family is expected to take care of the patient.  There is no labor nurse to give instruction (we never did find a place that taught Lamaze!), take blood pressure readings regularly or monitor the health of the baby.  We were left to ourselves while the contractions progressed.

Poor Fred, being new to the whole experience, wasn’t sure what to do!  Carol wanted him to take part as much as possible, but she (and others!) had warned him that I might not be in the best mood.  As predicted by my mother, the contractions naturally started coming more quickly and soon were down to every two minutes and very intense.  Nurse Fatima, however, failed to return.

Upon Carol’s insistence, I was struggling not to bear down and had heard plenty of “Don’t push!  Breathe, breathe!”  Finally, at 5:00 AM, Carol urged Fred to fetch Fatima. (Say that five times fast.)  Fred returned quickly but was only later (twenty minutes?) followed by Fatima who sauntered in, unaffected by my state of being.  She casually measured, then said, “Well, it appears that somebody’s going to have a baby tonight.” Thank you, Captain Obvious. (It’s just as well that I had to focus all my energies on resisting the contractions at that moment!!)

Fatima left to go call Dr. Gervasio and we continued with the wait game.  I later learned that when Fatima talked with Dr. Gervasio, he asked if he had time to take a shower. Fatima’s response? “A half-of-a-shower.” (I kid you not!)

During this time, my water broke, and a short time later, I felt Mishael’s head begin to crown. When I bellowed, “He’s out! He’s coming out!” the quick-thinking Carol clamped my legs shut and pushed me onto my side, which is how Dr. Gervasio found me when he finally arrived at 5:40 AM.

Bobbling into the room in his Santa-Claus style, Dr. Gervasio grinned upon seeing me and asked me to roll over so he could examine me. I answered, “Doctor, if I roll over, this baby is going to come out!” At that point, Dr. Gervasio took a peek, and that was sufficient for him. He asked the nurse to bring down the delivery equipment from the Surgical Center (deliveries are not done in individual rooms here in Brazil). The nurse quickly left to comply with the order.  A short time later, the door opened, however, it was Fatima who appeared – a little cup of coffee in hand! – and began to reason with Dr. Gervasio about the impossibility of transporting all the equipment.  For whatever reason, Dr. Gervasio agreed.

At this point,the nurses wheeled a gurney into the room and asked me to move over on to it. Once again, I said, “If I move, this baby is coming out!” Not to be outdone, Fatima told Fred to grab the top corners of my sheet while she grabbed the bottom lower corners; then the two lifted me onto the gurney.

All this time, Carol was talking to me, reminding me to use my energies for breathing and not pushing! She continued with me down the hall.  Somewhere along the line, we paused for some reason or other (I was a little preoccupied with other things to pay much attention).  At that moment, a strong contraction hit.  As I began to give in and push, Carol’s face suddenly popped out from behind the nurse standing beside me. “Don’t push! Not yet!!”  I will never forget that moment.  Had I not been wanting to push so badly, I would have laughed.  What a trooper and friend!!  I can honestly say that were it not for calm, cool, collected Carol, the morning’s events would have gone very differently! Such a wonderful provision from God – truly!!

With that said, Carol was left behind as I was wheeled into the Surgical Center.  It is rare for a Brazilian dad to watch the birth of his child, let alone someone else.  Fred, too, was absent as he was getting dressed in hospital garb.  As for the nurses present, they seemed a bit unorganized, probably because they so rarely perform natural births and were unfamiliar with routine.

As the gurney was wheeled alongside the surgery table, a nurse worked frantically at removing the leg stirrup.  With the way I was feeling, I was about ready to push her out of the way and say, “Let me do it!”  But finally Dr. Gervasio stepped in and detached it.  He then asked me, once again, to change tables.  I gave him the same answer as before, but he encouragingly insisted, “Try”; so I did.  I grabbed the surgery table with my hands and dragged my lower half behind as the nurses tried to hold back the damp sheet while getting a clean one under me.

Once on the surgery table, the doctor said, “Okay, turn over onto your back.”  I simply answered, for the last time, “Doctor, if I move, this baby is going to come out!”  Watching him through the reflection in an above lamp, I saw Dr. Gervasio secure Mishael’s crowning head with his hands, then he said, “Okay. Turn now!”  I flipped, waiting for the inevitable.  As soon as I was turned over, Dr. Gervasio gave me the go-ahead to push.  I asked only once, “You’re sure you’re ready?”  He nodded, and I pushed. Twice. And no, they were not long, drawn out pushes. It was more like two grunts, and POOF! A brand new baby!!  (I never did get my legs in the stirrups, which was just as well considering they never returned the one the nurse worked so hard to take off!)

All in all, I was in the Surgical Center a whopping five minutes before Mishael was born. At that moment, Fred walked in. “No, no, no!” he said. “Put that boy back in!” but it was too late.  Better late than never, right?

Now, aren’t you glad you stuck with me to the end!  Well, that wasn’t actually the end of our adventures in the maternity ward, but that’s where I’m going to stop for today!