Years ago, I used to work at a hospital which had both medical and psychiatric divisions. I was the only social worker for the entire medical side of the hospital, so I got to work with every kind of situation which brings a person into a hospital: trauma, oncology, addictions, HIV, but also OB/GYNE, which was a great balance to the rest of it – and also had its own types of crisis. One memorable day I was called to Labor & Delivery, to help the staff with a patient who they were feeling a little overwhelmed with. A teenage girl, probably 14 or 15, was in labor. This wasn’t unusual for our hospital; the complicating factor here was that this particular girl had been brought over from the Behavioral Health side of the hospital, where she had been receiving psychiatric care until she went into labor. Her psych nurses were at her bedside, nervous about her labor and trying to get her to cooperate with the standard procedures; her L&D nurses were also at her bedside, not knowing how to deal with her behavior; the girl herself was writhing and screaming. The entire room was chaotic and the anxiety level was sky-high.
 
 
I stood in the doorway, watching the scene, and wondering what in the world they expected me to do to help. The small room was full of staff already. The L&D nurses were saying to the girl, Lay back and lift up your gown, we have to put this monitor on your belly. The psych nurses were saying to the girl, Listen to the delivery nurses, you need to lay back and pull up your gown. The girl was screaming and crying and writhing. I mean, she was really carrying on, and crying out No, No, No, I want to go, Let me go, I have to get out of here. Also, she was laying back and pulling up her gown. Except nobody noticed that, because they were focused on her face, which was shouting No and screaming and crying and tossing and turning.
 
 
I was still standing in the doorway, several feet away, so I could see her whole body. A room full of skilled and trained nurses, trying to get her to cooperate. One terrified and panicked girl, in labor, doing everything she could to express her fear and pain, but even so, doing what she was being asked to do. She WAS laying back, she WAS lifting her gown, and no one saw it, and no one was there to reassure her, meet her where she was, tell her she was doing the right thing despite her fear. A room full of nurses, trying to engage rationally with a frightened psychiatrically disordered teenager in labor.
 
 
If we look only for outward and verbal agreement, for those around us to say calmly out loud, Yes, Yes, You’re right, you’re so right, I will do as you ask; we may very well miss what is actually happening despite all the fear and noisy protest. Messy, wild, loud, groaning: birth.
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