Indian Talent, Global Content
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Indian Talent, Global Content |
Giving Birth in Bangalore: Three Expats’ Perspectives
Research comparing women’s short-term and long-term memories of their birth experiences reveals that we have vivid, accurate, and deeply felt memories of the events and our feelings during childbirth, for as long as 20 years. While most women in India, unfortunately, give birth in overcrowded government hospitals with little support, most expats here have the luxury of accessing private institutions that provide care that might be more in line with your expectations. Following are three stories of expat experiences in major health care institutions in Bangalore. Remember, every birth is unique, so use these accounts to help yourself get informed and prepared for your own special experience. Know what is most important to you: The Cradle
Tonie and her son Ellis Tonie, a British mother of two who moved to Bangalore from France last March, was initially discouraged about giving birth here. Concerned about the distances and the city’s infamous traffic situation, she visited Manipal Hospital, as it is relatively close to her home in Whitefield. Her first impression of Manipal was that it was loud, busy, and “a bit dirty.” After meeting a doctor who she describes as “very bossy, very overpowering, not warm or empathetic at all,” she decided to switch to the Cradle in Jayanagar, having heard positive things about it. “The facility was new, it was clean, it was modern and it just made me feel very comfortable and relaxed,” she recalls. Tonie immediately connected with the doctor she saw, feeling reassured by her friendliness, the fact that she had children, had worked in England, and emphasized the importance of the baby’s well-being. Induced at 39 weeks due to low amniotic fluid, Tonie had a slow start but once the contractions got going (as a result of Pitocin adminstration), she gave birth to her son in one hour and 49 minutes, and is “more than satisfied” with her birth experience. The staff went out of their way to make her feel comfortable, making sure she had fresh juice and water, encouraging her husband to stay the night, and not pushing any unnecessary tests or amenities. She says there are three things she tells people who ask her about the Cradle, knowing that some people might have a problem with these practices: 1) shaving of pubic hair is routine; 2) the baby is whisked away immediately; and 3) the staff insists on bathing the mother soon after the birth. Tonie describes the nursing staff as “competent and efficient,” and found the facilities at the Cradle to be better than the English hospital in which she gave birth to her daughter four years ago. Her advice to other expats planning a birth in Bangalore? Research, ask questions, don’t take anything for granted, and know what is most important to you. Take your time and shop around for the right doctor and hospital: Sagar Apollo For Priya, a health researcher and mother of two from the US, having her husband by her side during the birth was of utmost importance. She was also concerned about having to do a lot of self-advocacy, a task she wasn’t exactly up for during pregnancy, let alone labor. After a couple of disheartening visits with condescending doctors at Manipal Hospital, which Priya says resembles a bus terminal, she decided to switch to Sagar Apollo, as she was emphatically guaranteed a private birthing suite there. Aside from the “underqualified” nursing staff (“I could’ve probably done a better job,” she reflects), she felt her prenatal care was fine (albeit self-driven), with the exception of being prescribed — for preventative purposes — an anti-contraction medication that is banned in the US. While she very much liked her OB, she describes the hospital experience as “abysmal,” and feels lucky that it was her second child and therefore had an idea of what to expect of birth and breastfeeding. Receiving no assistance with breastfeeding, she “can see how someone who was on the fence about it would get pretty deflated. I lucked out because she’s been a pretty easy baby, but I think it would be really hard for a first-time mom.” Upon arrival to the hospital, while in labor, she was told that there were no birthing suites available, and was led to a room where she was checked by a junior doctor, who found that she was in transition, i.e., close to delivery. Her husband was not allowed in the room, and the doctor had not arrived. Meanwhile, “there was a mad rush to get an IV in me, nurses tripping on each other, it was kind of chaotic… and I’m frantic because my husband isn’t there, my doctor isn’t there.” After arguing with nurses and other staff who tried to give her an enema and shave her pubic hair against her will and without consent, her OB finally arrived and let her husband join her. Priya had a natural birth (with no episiotomy), which she thinks was the reason for having a stronger and easier postpartum period than with her previous birth. As soon as the baby was born, they asked her husband to leave and ushered in another laboring woman. Sadly, he wasn’t allowed to accompany the baby for her newborn check-up. Soon after the birth, the nurses insisted that Priya take a shower. Barely able to stand up, she noticed blood clots in the drain (not her own) and tried to refuse the shower but to no avail. The baby developed a fever, so they had to stay an extra three days in the hospital. What followed was a series of extremely frustrating events, from having to remind the nurses to take the baby’s temperature (and ultimately having to buy their own thermometer!) to having the baby taken away without any explanation. Her advice to other expats planning a birth in Bangalore? “Just really shop around for a good OB and from the get-go lay out what your expectations are, be it by asking a lot of questions or telling them pointblank. I think there are some things you just can’t do anything about, like the quality of the nursing staff,” which she considers to be pretty ubiquitous, from accounts she has heard about other hospitals. Expect the unexpected: Columbia Asia
Joanie and Isabel Joanie, a former Labor and Delivery nurse from the US, moved to Bangalore seven and a half months pregnant with her first child. Having attended so many births, she had a very clear vision of how she wanted her own birth to go, and chose a doctor at Columbia Asia who agreed to honor her preferences. She soon found that prenatal care was very basic and even inaccurate. Since the nurses didn’t know how to properly take blood pressure (BP) and getting an accurate read was important because of her swelling (a potential sign of hypertension), Joanie took matters into her own hands and began taking her own BP at each prenatal visit. She also became concerned when her OB told her that the baby was really small because she didn’t have stretch marks, even though Joanie knew the measurements of her belly indicated a normal-sized baby. (She also knew, of course, that there is no correlation between presence or lack of stretch marks and size of baby.) The OB came up with a reason for extra testing at every visit, Joanie recalls. “I had three growth scans and two tracings for 30 minutes — and I was only with her for eight weeks!” Among the most important things to Joanie during her first birth experience were having trust in the doctor, being in control (i.e., able to use the birth ball and walk around, and to make informed decisions), and having her husband and mother in the room. Having written, submitted and discussed a birth plan at the request of her OB, Joanie says that “at the birth it all went out the window.” Like Priya, Joanie was guaranteed a private birthing room, but when she arrived for induction (due to low amniotic index and an insufficient placenta) on her due date, there were no private rooms and Joanie was admitted to a shared room. At three centimeters dilation, the OB insisted on breaking her bag of waters. “I didn’t want my waters broken, but she talked to me like I was a three year-old child. I felt like that more and more with all of my interactions with her; you feel like you have to do what the doctor says.” The nurses, similar to Priya’s experience, tried “about ten times” to give her an enema, even though it was in her birth plan that she didn’t want one. “I had to insist on using the birth ball and walking around,” she recalls. Every ten minutes the doctor or nurses would come in and say that she had to lie down. “They kept coming in and offering me pain meds, and I kept saying that’s not what I wanted.” The OB, she says, relentlessly guilt-tripped her for refusing the epidural. Since there was no bathroom in the labor room, Joanie says she had to sneak out when the nurses weren’t looking to relieve herself. Finding that she was only four centimeters dilated and in so much pain, she decided to get the epidural. After a heparin lock was placed, the OB decided to check once more, and discovered that the head was right there and Joanie was ready to push. (The four centimeters conclusion a few minutes earlier was clearly a major mistake.) Joanie was encouraged to lie flat on her back and had her feet put in stirrups, a pushing position she had tried to negotiate against but her OB did not agree. “She promised she wouldn’t, but as soon as I lay down she whipped out the scissors and cut a huge episiotomy.” Being an L & D nurse, Joanie was constantly watching the baby’s heart rate to ensure that it was in the normal range, which it was. Nevertheless, the OB insisted that the baby was in distress and needed to be born fast; she reached for the forceps. “My animal instinct took over,” she says, “and I pushed her out!” Joanie’s husband was with her, and her mother had come into the room when she was pushing and insisted on staying, despite being asked to leave. As Joanie requested, the baby was immediately placed on her chest, but instead of letting the placenta be born naturally, the OB pulled on the cord and as a result it detached from the placenta. This can be very dangerous, so she decided to manually remove the placenta from Joanie’s uterus. She remembers:
At that point, Joanie was begging for pain medication, to which the OB responded, “‘If you don’t just be quiet and let me do this, I’ll have to take you to the operating room,’” which is exactly what happened. Joanie was supposed to be there for 15 minutes but she was in the operating room for three hours; she was never told why. The next morning, the doctor came in to ask how she was doing, and when Joanie replied that she was very tired, the doctor said, “‘Because of all that yelling you did yesterday?’” While in recovery, the nurses were very warm, helpful and sensitive to what Joanie wanted and didn’t want. However, the OB continued to be extremely condescending and inaccurate in what little information she gave Joanie. “I kept asking her, ‘How many stitches do I have?’ and she kept laughing and saying, ‘Why do you keep asking me that?’” She never found out. About performing the episiotomy against her will, the OB said that it was because of her blood type, and because her mother was getting nervous; reasons that had no relevance and thus made no sense to Joanie. Because of the manual placenta removal operation, Joanie was given medication to prevent infection and instructed to take it. Upon further investigation, she found that it was all contraindicated for breastfeeding. Her OB had assured her repeatedly that it was fine. What’s her advice to expats planning a birth in Bangalore? “Don’t rush into a doctor or a hospital. Expect the unexpected and do your research. Listen to the good stories and the bad ones.” Do your research – Don’t be afraid to ask questions! More than anything, these stories highlight the importance of having a good relationship with your doctor and choosing a hospital that feels comfortable. Learn as much as you can about all of your choices, and remember that there are many different ways of caring for mothers and babies. Find a good childbirth class that will empower you to make informed choices in health care, to assume responsibility for your health, and to trust yourself and your body. Such courses are best if they are a 12-hour series over a period of six weeks giving you and your partner time to explore your preferences and practice useful techniques for assisting labor. Try to avoid classes that focus on preparing women for the possibility of complications, and on the inevitability of routine interventions. Penny Simkin, an American childbirth educator, doula, lecturer and writer reminds us that
If you’re feeling stuck or unsure of how to approach an interview with an OB, here’s a list of questions to ask. The birth process is an incredible gift, and one that women have been successful at for millions of years. Taking the necessary steps to ensure that you are supported and well cared for by everyone involved can seem overwhelming, especially in Bangalore, but you’re worth it!
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