Labour Ward antics

Pregnant ladies have for some reason become my very-cliched-but-true "calling". I have worked with them in 3 different provinces, namely the Western Cape, Kwa-Zulu Natal and last but not least Mpumalanga. There is one common factor that all these women share, besides a growing fetus, and that is the primal utterances of "Aaaawema" during labour. To those of you who have never stepped into a labour ward, this might sound very weird, but I will try my utmost to set the scene for you. For those of you who have had the unfortunate privilege of working in labour ward, you will know exactly what I'm alluding to.

A labour ward usually consists of beds either in one room with dividing curtains or smaller separate rooms. In these beds will be the birthing mothers. They lie on their backs, after being repeatedly told not to, and with their arms raised to the ceiling, fingers opening and closing rapidly, scream (or rather shriek) the word "aaaaawema". It can be heard from the corridor proceeding the labour ward and is commonly alternated with a equally high pitched "hey jesu". The labour ward staff seem to be immune to this noise, while they sit behind their desks chewing the cartilage off their left over fried chicken (also commonly know as shikken). This is a national phenomenon.

The sad thing is that many of the patients are under the age of 18. They are scared, usually alone and are in no way prepared for what is about to happen to them. As the labour progresses, these frightened girls transform into shrieking beings and the chorus of "aaawema" crescendos. I have no idea how they know to scream that, it's as if it's been programmed into their DNA, something from their forefathers.

You will often hear the word "difficult" being used to describe pregnant patients. That is because often, at the very end of labour, when one final push is required, they give up and refuse to deliver the baby. This is extremely dangerous to the newborn, as the umbilical cord is squashed and it receives no oxygen until it takes its first breath. Literally a few minutes and the baby will be brain damaged. The nursing staff in Mpumalanga have discovered a nifty trick to avoid this from happening. I call it the "umlungu phenomenon". An umlungu is a white person and the nursing staff have used a type of torture tactic to get them to push the baby out. The first time I was called for a delayed second stage (where the head is about to be born), as I walked in the door, the patient gave one final push and the baby was delivered. I was ecstatic as it was 4pm and time to go home and, had the baby not been delivered, it would mean I would have to do an emergency caesar. This happened a few more times and I realised that it was not luck but that the birth was linked to my arrival. I asked one of favourite senior sisters what the reason was. She took me into the injection room and closed the door. In a hushed tone she explained that they told the patients that if they did not push that baby out, then the white doctor would come. This hardly seemed scary. As I probed further, she admitted that she had added her own little tactic, which involved threatening the patients that when the doctor came, he/she would cut off their labia. At first I was horrified, but later it proved to be quite an effective method. I then found out that if a white doctor was not available, or if the doctor was not around, they would call a white nurse from another ward and she would arrive posing as the "umlungu".