Thursday, June 05, 2008

The obstetrical history

When newFNP considers the perfect amount of children to have, she generally comes up with one number: two.  However, if newFNP does not get on the stick - so to speak - she will have exactly zero.

NewFNP's patients do not seem to share her values when it comes to parity.  Granted, newFNP has nothing but unfettered access to birth control and is also nursing a semi-paralyzing fear of parenthood.  Be that as it may, she finds the obstetrical history of her elderly patients who grew up in developing countries fascinating.

Today, she asked an 80-something year old lady how many pregnancies she had had.  Fifteen.  Fifteen.  How many births?  Fifteen.  Her vagina must hate her.  As is common with multigravid women in developing countries, some of her children did not survive infanthood.  Seven of her children died during the first year of life.  

It is not uncommon that newFNP's patients are grand-multips.  NewFNP has heard so many 10's and 12's and 14's when she asks about number of pregnancies, she is hardly surprised by the answers anymore.  But these women generally have some type of birth attendant with them.  Sister, mother, nurse, lay midwife, doctor... someone is generally there to assist in the birth.

One seventy-odd year old lady, however, gave birth alone.  Twice.  NewFNP was sure that she had misheard.  Alone?, she asked.  Alone.  No midwife?  No, no midwife.  Twice? Si, si, the patient assured newFNP with an amused smile on her face.

NewFNP's patient went on to tell her that she just had the scissors on hand, birthed the baby, tied off and cut the umbilical cord.  NewFNP's face must have betrayed her amazement.  Her patient explained that there was a woman in her community that gave her something to drink beforehand -- to give her strength.  What in the hell was in that drink and can newFNP get some of it before she goes to work on Saturdays at 7:30?

It's quite a contrast between prenatal care at the fancy hospitals here in the U.S. with ultrasounds at every visit and 3-D ultrasounds and CVS and amnio and EAFPs and episiotomies and forceps and fetal scalp monitoring and NSTs and epidurals and IV morphine and 25% or higher c-section rates.  NewFNP isn't saying that she isn't down for a little picture of the fetus action, but it is nice to remember that pregnancy and birth aren't diseases and that women's bodies are, in fact, designed to support the entire process.  


Anonymous said...

There is actually a number of women in the U.S. who choose to have unassisted childbirth. Well, I think most of them have their partners with them.

Anonymous said...

anonymous #1 beat me to my comment about unassisted childbirth, but I also wanted to say that there are plenty of American women that age who had that many children. My mother is on of 13, and none of her siblings died in childhood. Her mother is still living and well into her 80s. I think it's beautiful. And I wish I could have half as many myself.

BostonFNP said...

Amen, sister, amen. Women got it goin' on.