It turns out everyone just wants someone to be kind to them...

Another morning spent at Patan hospital. There is some talk that the birthing centre, which is now a postnatal ward, may become a birthing centre again. This would be truly good news as it would be used by a high volume of women. Its not a bad space either with, easily to clean, lots of room to walk around and some degree of privacy within little cubicles. I told Rashmi if it opened up again I would come back and help her teach midwifery care to the nurses :-)

The old birth centre, currently used as a postnatal ward..
...a few mats and some birth balls and it would be grand!

Myself and Sophie then observed another delivery with aspects which were very hard to watch. Strong fundal pressure was used to help deliver the baby with a resulting cervical prolapse. Again, following delivery of syntocinon there was no delay prior to commencing CCT. It is extremely difficult to know how to feedback constructively in these situations because the nurses are so nice and welcoming and it is good of them to let us observe so freely. By coming in from the outside it almost feels slightly offensive to criticise practice and yet that is the only way any hospital anywhere in the world has improved. Of course a longer, more sustained placement at one hospital would allow for a build up of relationship and subsequently would make this easier, as is the case at APS. Now that I know the girls there, it feels much more natural to discuss the birth centre and how it could be improved in a collaborative manner. With these short term observations my conclusion is that it would be best to give feedback to Rashmi who can then dissiminate it as she wishes.

All that aside, what stayed with me from the day was the woman's response following delivery. I had been at her head whispering what I hoped were comforting things into her ear and holding her hand, having no idea whether this was something she appreciated given that we had never met. The first thing she did was turn to me and say 'thank you so much for your support'. I was a bit gobsmacked really, because if I had just been through a horrendous delivery with someone pushing down on my stomach I don't think my immediate thought would be to thank some stranger. But it made me think, as obvious as it sounds, in labour, regardless of culture, people really do just want someone to be nice to them.

We went down to visit her later and she was looking much happier and breastfeeding her baby. Her mum and sister were there bringing her food and massaging her legs. I have to say the culture of postnatal support is something the UK could learn a lot from. Here the ethos is that the woman needs to be protected and looked after with the mother in law generally looking after her for at least a month. I have seen the same practice with my friend Emma - all meals and cleaning are done by the family so that all she has to focus on is feeding her baby and recovering. As a result she does not have the overwrought, tearful and exhausted look I have seen in so many new parents. The alternative is very nice to see.

A baby boy

In the postnatal ward being looked after by her sister...