More than a decade ago I read an article of the same title in the Hindu Newspaper. I was a little girl then and an avid collector of interesting articles. I would cut out things from the newspaper and stick them in my scrapbook; everything from Harry Potter trivia to Calvin and Hobbes cartoons. This particular article spoke about an old widow who’d worked as a domestic help all her life laying alone in a hospital bed. ‘She did not how old she was,’ it said. This was very hard for my young mind to comprehend, it was almost silly to me – how could one not know when they were born? How could one not know their age?! How on earth would you celebrate your birthday? How would you know how many candles to stick on a birthday cake? Where did such ladies live? Did the maid at my home also not know her age? I decided that this lady needed my prayers and instead of sticking the article in my scrap book I folded it and slipped it in my Bible. Someday if when I met such ladies I would try to help them. And with that I tucked her away in one corner of my mind.
I’ve passed through years of school and college since then. Recently I started working at a rural hospital and I meet her often these days.
On Monday I met, Ruby Devi.
‘Aap ki umar kya hai?’
‘Yahin kuch bis, pachees.’
‘Kitne bacche?’
‘Teen ladki.
She had three girl children. She had gotten married at the age of fourteen and had her first child about seven years after that and that child is now 12 years old. She claimed she was 20/25 years old, and yet she looked like she was at least 35.
‘I hadn’t even started getting my period when I got married,’ she giggled, tugging the edge of her sari pallu across her face and nervously chewing on the edge as I not-so-subtly gawked in surprise. ‘You see I’m one of six sisters and two brothers, my mother had no choice but to marry me off. My father died when I was twelve and I was just a liability.’
On Tuesday I met, Jhuniya.
She was pregnant for the eighth time. She fit the textbook description of bad obstetric history, having had six recurrent abortions in the first three to four months of each pregnancy. Only her first baby had made it to full term – ironically, a girl, who is now 7 years old. Five of these aborted babies had been boys, and every aborted boy had been a blow to the family. Each year she conceived and each year she aborted. She lived in one room with her mother in law, brother in law and his wife, who had already borne three boys making her the jewel of the family. Along the way she had visited several pandits, witch doctors, expensive private clinics, contracted Hepatitis B and received numerous blood tranfusions on account of anemia. Finally she came to us. We told her that we would put a stitch at opening of her uterus to prevent the baby from aborting, we warned her it may or may not work, but it’s the best we could do. A few weeks later, she came to us frantic, ‘I can’t feel the baby moving!’ Fearing the worst, we did a scan to find that this time too, the foetus has not made it. She lashed out in anger and then she broke down and cried. A tiny gold nose ring adorned her tear streaked face, with two mis-matched earrings. The chain around her neck held six lockets with a little child depicted on each to keep away the bad luck of the children she had lost. Her hair was in disarray and her eyes pleaded to hear a different diagnosis. Through her sobs she said her husband was going to leave her if she didn’t produce a boy child. ‘He’s already chosen another bride for himself.’ On her left stood her little 7 year old, ignored. And on her right, her sister in law with her boys, a constant reminder of what she failed to achieve.
On Wednesday I met Bina Devi.
She arrived at 2am, in labour, her belly was funnily shaped with two symmetrical bumps as though a heart. On per vaginal examination where I had expected to feel the comfort of a solid foetal skull, I felt something soft and squishy pulsating against my finger, surely not – the cord! Although not very well versed in obstetrics my sleep hazed mind was jerked awake as it shouted – CORD PROLAPSE PREETI! In simple words, it’s the mother of all obstetric emergencies, most babies don’t survive it – it’s like slowly but surely tightening a noose. We rushed her to OT, and prepared for an emergency Caesarean. We separated the rectus muscle (popularly known as abs) and were looking straight at a very weird uterus. It was heart shaped, with two horns instead of one. ‘It’s uterus bicornuous unicollis,’ said Bina ma’am calmly. And visions of my first year anatomy class came flying back, as she asked, ‘Remember the paramesonephric ducts?’ It struck me as odd that I should be surprised at encountering a uterine anomaly in a lady from a village, as though deviation from normal anatomy is something that happens only in embryology textbooks. Her baby did not survive, but she did. She recovered phenomenally well, was very thankful for it and to this day does not understand why I felt the need to repeated explain to her that, ‘Aapke bachadani ka aakar alag hai.’ (The shape of your uterus is different.)
On Thursday, Baby of Laxmi was born.
This was Laxmi’s third pregnancy, she had two girls previously, both by Caesarean section. This was the third and last time she would be able to carry a child, because further pregnancy in someone who has undergone so many Caesareans is dangerous. The third baby was born at 4am, a healthy pink cute baby girl. Her face fell when we showed her. At 6am we got called by the sister in ward, ‘Ma’am, Laxmi’s baby is turning blue and is not able to breathe.’ Her mother had tried to smother her to death, and had been caught just in time. The baby was rushed to the Neonatal ICU, given Oxygen, resuscitated and slowly regained colour. Her small chest was heaving, she was breathing too fast, and there was a slight depression on her chest when it had been pressed. For days she hung by a thread like this, while I tried desperately to figure out what kind of pressures could push a mother to take such an extreme measures in a moment of weakness. The parents agreed to put her up for adoption. Baby of Laxmi stayed with us a long time, she got better, started feeding and breathing alright. She became an instant favourite with all the hospital staff. A real fighter, just like her mother, who returned a week later to take her home, determined to provide her a safe future.
On Friday I met, Nilam Devi.
Referred from the government hospital, she was pregnant, past the nine months, and her baby had been dead for the past 2 days. She startled easily every time we came close to examine or speak to her. Her husband didn’t know what to do. He stood with his hands splayed open facing the ceiling and just asked us to do something, anything. He had been all the way to Patna to get a scan worth Rs 4000 to determine the sex of the baby. They had told them it was a boy, elated to have a boy at last they returned to Madhepura. When it was past her due date, she was taken to a government hospital where she was administered Oxytocin to initiate pains; when that didn’t help, four-five nurses pushed down on her pregnant belly to force the baby out (the infamous ‘fundal’). After all this pushing and pulling, the baby ceased to move and with the baby jammed in her pelvis she was sent to us. She hadn’t passed urine in 2 days as it was obstructed labour. She delivered a still born baby boy weighing 4 kilos. She was dehydrated, exhausted and mentally traumatised by the experience. She got better after a few weeks of hospital stay and she returns often, just to chat.
On Saturday, I met Sukhmayar.
It was dramatic, it was scary, it was such a shame. She had been in labour for 2 days, the pains had once more been induced with Oxytocin artificially. She’d gotten many scans and investigations done in the past, but had not been able to deliver the baby. Somewhere during that time the baby had died, and she had started bleeding profusely. As I moved my hand to touch her abdomen she screamed even before I got within a few centimeters of her. Ultrasound showed a ruptured uterus, and a baby with a very larger than normal head full of fluid. I snatched back the scans they’d shown, read and re-read them. Not one scan mentioned the fact that the baby had an anomalous head - that it was too big to deliver normally. Not one of those scans was signed by doctor. Each said boldly, ‘Not valid for medicolegal purposes.’ It was a crime, murder in broad daylight, to not detect so obvious and significant a finding. She was taken up for surgery, and stayed many days in the ICU. She left early and never came back for follow up.
On Sunday, I’m off duty and I sit around scrolling down my Facebook newsfeed, to see what everyone else has been up to. It tells me loudly about what a celebrity wore on the red carpet at Cannes, or who the next feminist face of India is, or that we are progressing by leaps and bounds. Yes, urban India is changing, but what of the other rural 70% that knows, cares and profits nothing of this ‘progress’?
This is the original Hindu Article from which the title is derived.
I’ve passed through years of school and college since then. Recently I started working at a rural hospital and I meet her often these days.
On Monday I met, Ruby Devi.
‘Aap ki umar kya hai?’
‘Yahin kuch bis, pachees.’
‘Kitne bacche?’
‘Teen ladki.
She had three girl children. She had gotten married at the age of fourteen and had her first child about seven years after that and that child is now 12 years old. She claimed she was 20/25 years old, and yet she looked like she was at least 35.
‘I hadn’t even started getting my period when I got married,’ she giggled, tugging the edge of her sari pallu across her face and nervously chewing on the edge as I not-so-subtly gawked in surprise. ‘You see I’m one of six sisters and two brothers, my mother had no choice but to marry me off. My father died when I was twelve and I was just a liability.’
On Tuesday I met, Jhuniya.
She was pregnant for the eighth time. She fit the textbook description of bad obstetric history, having had six recurrent abortions in the first three to four months of each pregnancy. Only her first baby had made it to full term – ironically, a girl, who is now 7 years old. Five of these aborted babies had been boys, and every aborted boy had been a blow to the family. Each year she conceived and each year she aborted. She lived in one room with her mother in law, brother in law and his wife, who had already borne three boys making her the jewel of the family. Along the way she had visited several pandits, witch doctors, expensive private clinics, contracted Hepatitis B and received numerous blood tranfusions on account of anemia. Finally she came to us. We told her that we would put a stitch at opening of her uterus to prevent the baby from aborting, we warned her it may or may not work, but it’s the best we could do. A few weeks later, she came to us frantic, ‘I can’t feel the baby moving!’ Fearing the worst, we did a scan to find that this time too, the foetus has not made it. She lashed out in anger and then she broke down and cried. A tiny gold nose ring adorned her tear streaked face, with two mis-matched earrings. The chain around her neck held six lockets with a little child depicted on each to keep away the bad luck of the children she had lost. Her hair was in disarray and her eyes pleaded to hear a different diagnosis. Through her sobs she said her husband was going to leave her if she didn’t produce a boy child. ‘He’s already chosen another bride for himself.’ On her left stood her little 7 year old, ignored. And on her right, her sister in law with her boys, a constant reminder of what she failed to achieve.
On Wednesday I met Bina Devi.
She arrived at 2am, in labour, her belly was funnily shaped with two symmetrical bumps as though a heart. On per vaginal examination where I had expected to feel the comfort of a solid foetal skull, I felt something soft and squishy pulsating against my finger, surely not – the cord! Although not very well versed in obstetrics my sleep hazed mind was jerked awake as it shouted – CORD PROLAPSE PREETI! In simple words, it’s the mother of all obstetric emergencies, most babies don’t survive it – it’s like slowly but surely tightening a noose. We rushed her to OT, and prepared for an emergency Caesarean. We separated the rectus muscle (popularly known as abs) and were looking straight at a very weird uterus. It was heart shaped, with two horns instead of one. ‘It’s uterus bicornuous unicollis,’ said Bina ma’am calmly. And visions of my first year anatomy class came flying back, as she asked, ‘Remember the paramesonephric ducts?’ It struck me as odd that I should be surprised at encountering a uterine anomaly in a lady from a village, as though deviation from normal anatomy is something that happens only in embryology textbooks. Her baby did not survive, but she did. She recovered phenomenally well, was very thankful for it and to this day does not understand why I felt the need to repeated explain to her that, ‘Aapke bachadani ka aakar alag hai.’ (The shape of your uterus is different.)
On Thursday, Baby of Laxmi was born.
This was Laxmi’s third pregnancy, she had two girls previously, both by Caesarean section. This was the third and last time she would be able to carry a child, because further pregnancy in someone who has undergone so many Caesareans is dangerous. The third baby was born at 4am, a healthy pink cute baby girl. Her face fell when we showed her. At 6am we got called by the sister in ward, ‘Ma’am, Laxmi’s baby is turning blue and is not able to breathe.’ Her mother had tried to smother her to death, and had been caught just in time. The baby was rushed to the Neonatal ICU, given Oxygen, resuscitated and slowly regained colour. Her small chest was heaving, she was breathing too fast, and there was a slight depression on her chest when it had been pressed. For days she hung by a thread like this, while I tried desperately to figure out what kind of pressures could push a mother to take such an extreme measures in a moment of weakness. The parents agreed to put her up for adoption. Baby of Laxmi stayed with us a long time, she got better, started feeding and breathing alright. She became an instant favourite with all the hospital staff. A real fighter, just like her mother, who returned a week later to take her home, determined to provide her a safe future.
On Friday I met, Nilam Devi.
Referred from the government hospital, she was pregnant, past the nine months, and her baby had been dead for the past 2 days. She startled easily every time we came close to examine or speak to her. Her husband didn’t know what to do. He stood with his hands splayed open facing the ceiling and just asked us to do something, anything. He had been all the way to Patna to get a scan worth Rs 4000 to determine the sex of the baby. They had told them it was a boy, elated to have a boy at last they returned to Madhepura. When it was past her due date, she was taken to a government hospital where she was administered Oxytocin to initiate pains; when that didn’t help, four-five nurses pushed down on her pregnant belly to force the baby out (the infamous ‘fundal’). After all this pushing and pulling, the baby ceased to move and with the baby jammed in her pelvis she was sent to us. She hadn’t passed urine in 2 days as it was obstructed labour. She delivered a still born baby boy weighing 4 kilos. She was dehydrated, exhausted and mentally traumatised by the experience. She got better after a few weeks of hospital stay and she returns often, just to chat.
On Saturday, I met Sukhmayar.
It was dramatic, it was scary, it was such a shame. She had been in labour for 2 days, the pains had once more been induced with Oxytocin artificially. She’d gotten many scans and investigations done in the past, but had not been able to deliver the baby. Somewhere during that time the baby had died, and she had started bleeding profusely. As I moved my hand to touch her abdomen she screamed even before I got within a few centimeters of her. Ultrasound showed a ruptured uterus, and a baby with a very larger than normal head full of fluid. I snatched back the scans they’d shown, read and re-read them. Not one scan mentioned the fact that the baby had an anomalous head - that it was too big to deliver normally. Not one of those scans was signed by doctor. Each said boldly, ‘Not valid for medicolegal purposes.’ It was a crime, murder in broad daylight, to not detect so obvious and significant a finding. She was taken up for surgery, and stayed many days in the ICU. She left early and never came back for follow up.
On Sunday, I’m off duty and I sit around scrolling down my Facebook newsfeed, to see what everyone else has been up to. It tells me loudly about what a celebrity wore on the red carpet at Cannes, or who the next feminist face of India is, or that we are progressing by leaps and bounds. Yes, urban India is changing, but what of the other rural 70% that knows, cares and profits nothing of this ‘progress’?
This is the original Hindu Article from which the title is derived.
7 comments:
Thanks for this Preeti. It saddens me so much to hear of beautiful sisters who don't have the care and opportunities they deserve. But heartened that there are those who care deeply, like you! God bless you richly. Xx Amanda
Well written & so true! It appears as though there's been no change in this area since independence!
Prreti keep writing - these stories need to be heard shared today in the context of the much hype of India becoming the next superpower...The reality of rural life and contexts need to be shared widely. Keep it up...Yes in the midst of all your challenges
Well written mam!
Mam
Really appreciate the efforts you put in to put all your experiences into an article so it gives us a first hand experience of rural life and your experience as a doctor in such a setting.
Thanks Mam
Hi Preeti
Well done dearie
Hope you are doing well in all health mind n spirit
Loved your experience n your viewpoint on it
Thanks for publishing it ,that too so much vividly!
Conditions of woman in a country a sun continent like India is pathetic in simple words not only rural but even so the much urban. I mean I can't really get this thing past my gut that a woman smothered her OWN dear child a few hour old one!!! Help them Lord
Honestly you can't really expect much to change,but having said that I do wanna say we all live on hope the eternal binding force.
So,yup tragically so but do reach to them
Am happy you doing it n that too with much strength n caliber!
May Lord be with you n give your enough strength n power to bear this n may you help them in this in all possible ways.
God Bless You always
Take Care
Keep Up The Good work
I love your easy style and depiction of reality .Shobana aunty
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