Sunday, July 29, 2012

Giving birth at Hadassah Ein Kerem

After Mordechai was born, I wrote birth story parts one and two, and didn't get to three. I've been putting it off, but I do want to write it, and not really just for me. I want to write it because I wish I'd known beforehand that such things were liable to happen--if I had, I would have done some things differently.

Even though I think what happened to me is not the norm, it really could happen to anyone. So. For the record, and for anyone else who is planning on having a baby in Jerusalem soon, this is what happened.


Where were we? The baby had been born, my friend went home, Mr. Bigfoot went home to get a few hours of sleep before getting the kids off to school in the morning. It was around 1:30 am, a little over an hour later. And the nurse came in and said, "I have some bad news." Fortunately, before I had the chance to react to that as one might, she went on and said, "We don't have a room for you." I didn't really process this. She said that they had a bed for me (okay) and that there should be a room by about 11 AM. I kind of thought that this meant they'd put me back in an L & D cubicle, one of the partitioned areas with a bed and a curtain, for a few hours.

But before I could go anywhere I needed a lot of stitches. I had given birth to a 9-lb baby who was face down, and it was pretty unpleasant. In addition to the horrible-ness of it in general, was the additional horrible-ness of the OB who told me I needed stitches insisting, right after I gave birth, that it was now or never. I said, I need a few minutes to recover from this. She said--and I cringe just remembering it, but she is the one who should be ashamed and not me-- "I know how to deal with Americans. I worked in America. Let me tell you, if you do not get stitches, you are acting against medical advice. It is your responsibility. You take full responsibility. Don't think you can sue me later."


I said, I just had a really horrible delivery and I need half an hour to recover. I know I need stitches but I can't deal with it right this second. Please come back in half an hour to give me a chance to gather myself together before there is more pain. And that was the response. She said, she might be busy in half an hour and no she would not come back. And I said,  I cannot do this now, and she shrugged and said, "Your decision." Then she walked out the door without looking at me, tossing a nasty "Mazal tov," behind her as the door slammed shut.

The very nice American nurse who had been there when I arrived ran some kind of interference, I am pretty sure, and at some point a different and much nicer doctor came in and did the stitches. It really was awful, although not his fault, and almost as soon as he was out the door the nurse suggested I go take a shower. I was completely confused by this and said I couldn't stand up long enough to do that. She said, do you want me to help you? Because you might not get another chance for a long time.

She was right.

I changed into clean clothes, washed my face and hands, picked up the baby. She got a wheelchair and brought me and the baby upstairs, along with all of our stuff (bag of my stuff, bag of baby stuff, bag of clothes I'd worn during labor). In one elevator, up a few flights, out another elevator to Yoldot Bet (postpartum ward #2).

Okay, so, for those of you who have had babies, let's imagine this scenario. I have just had a baby after about a week of early labor, and the baby was almost 9 pounds and face down. I have had a lot of tearing and a lot of stitches. I have had no drugs, not even Tylenol. It's around 2 am, and not only have I not slept yet tonight, I didn't sleep at all the night before, and I've barely slept most of the week. I'm sticky with sweat and shaking with hormones and covered in blood. I'm still in that very early stage where just moving can make me bleed enough to soak completely through a pad and soak my skirt. Which is exactly what happened when I sat down in the wheelchair.

When the elevator door opened, there was my bed, which was sitting in the hall next to the elevator. No curtain. No screen. Nothing. Just a normal high hospital bed (which isn't easy to get into, by the way, postpartum), sitting there in the hall next to the elevator. Everyone and their brother--patients, families, staff, anyone and everyone--is walking right past. This is my bed, where I am supposed to wait until I get a room.

The L&D nurse piled my bags and paperwork on the bed and we brought the baby to the nursery to be checked in.  As I stood there, swaying a little, waiting for the nurses to look at him, the L&D whose who'd come up with me said, well, mazal tov! And she left.

And I sat down on a plastic chair near the little plastic bassinet the baby was in. Then after a few minutes, I pulled him and his little bassinet into the nursing room, to the side of the nursery, and sat down.

I stayed there for 12 hours.

I don't want to be overly dramatic about this but I do want to be honest. I was no one's job. No one looked at me. No one offered me a drink of water, anything to eat, or asked how I was doing. There was a water dispenser, but no cups. I did not have a cup, and I couldn't stand up to get to the water, so I didn't get anything to drink. At one point I asked for a cup and was given a disposable plastic cup that held about two ounces of water; I got up to fill it and soaked my skirt with blood just moving. One of my most vivid memories of that day was sitting in the chair, thirsty, nursing, just staring at the water dispenser, wondering if it was worth the risk.

The only attention I got was when I started to fall asleep holding the baby, at which point I was suddenly surrounded by angry nurses telling me not to fall asleep because I might drop the baby. They could not have made it more clear to me that I was not their job; I should be out in the hall, in that bed, and not there in the nursery where I had no business being. They really just wanted me to go away. But I couldn't, because I needed to keep nursing the baby so that he wouldn't get newborn jaundice just like all three of my other boys had. And I couldn't nurse the baby out in the hall. And frankly, the idea of lying in that bed, on public display, in the state I was in, was not anything I could consider. So I stayed in my chair in the nursing room.

There was no bathroom. I needed a bathroom and asked where the bathroom was and was told there wasn't one. So what do I do? I asked. Go into any woman's room and use hers. As in, just walk straight into another room and say hi, I'm using your bathroom. I had no choice, so I did, and of course--of course! I bled all over the floor, and it was while I was trying to mop up blood from the floor with wet paper towels four hours after having a baby I began to think, something here is really not right.

At around 8 AM I started wondering about breakfast. I knew that the way it's done in Israeli hospitals is that all the new mothers are expected to go down the hall to the dining room, but I didn't know where or when. At that point, foolishly, I sort of expected someone might tell me. By 9, I was really, really hungry, and I asked one of the other mothers who were coming in and out to nurse their babies (this was not a rooming-in unit) where breakfast was. She told me that I'd already missed it.

At 12, I started trying to get a nurse's attention to ask about lunch But it was lunchtime for them too, I guess, and no one was around or interested in looking at me. By the time I found someone to ask,  I was told, with obvious irritation, that lunch was over. And then she said something about how I should read the sign. By the door. OK, the sign by the door? There was an entire bulletin board covered with paper, all of it in Hebrew, some of it packets of multiple pages or brochures stapled to the board, some of it copies of copies. I could not even have told you at a glance which pertained to the hospital and which to postpartum care and which to... anything. I certainly could not have told you which had to do with dining hours and policies. I couldn't have stood long enough to figure it out, and just walking that far would have been a challenge.

I haven't eaten, I said. She pointed me alllll the way down a very long hall. Lunch is there, maybe you'll still get something. I started walking and again, not to be dramatic, but I was so dizzy I'm amazed I made it. I was hanging on the rail and taking two steps and resting. And then I finally got all the way down there and there was no food left. So I walked back.

The same nurse was there behind the desk and saw me come in and looked back at what she ws doing.  I said, there was no food. No reaction. I said, look, I haven't eaten since yesterday. I just had a baby. Could you help me out here? There was a lot of eye rolling and exasperated sighing but she did, after a few minute, beckon me into the hall and down--all the way down--that long hall again, somehow expecting me to match her pace. When she realized I could barely walk, she did slow down. And she found me some chicken and rice from the staff dining room and I ate it alone at a table in the empty dining room. And then I walked back.

The baby cried, and I sat there shivering and sweating and feeling the blood seep through my clothes. I tried to nurse and he didn't seem to be getting anything. I tried so hard not to fall asleep. I remember dreaming while awake, seeing things move that weren't there. Everything hurt, and the longer I sat, the worse the pain from the stitches and the swelling. I was there holding the baby, watching people move past at not quite the right speed--too fast, too slow--talking too loudly or seeming not to make any noise at all. I wondered sometimes if I was dreaming, but the crying of the baby and the pain in my body were all real.

Don't fall asleep. Don't drop the baby. Don't fall asleep. And watching the hands of the clock which seemed not to move at all.

At some point in the afternoon I remember them calling my name from the other room and telling me someone was ready to look at my baby. I got up and pushed him into the other room, where there was nowhere to sit, and just stood there waiting. For half an hour. While no one looked at my baby. Is anyone going to look at him? I asked. It's not so easy to just stand here. So go back in the other room, I was told. But then I wouldn't be HERE when the doctor does show up and I really don't trust you to explain to him about my children's history with jaundice. So I stood. There weren't, by the way, lockable brakes on the bassinet, so I couldn't even lean on it. It would have rolled away.

Every so often, I'd get up and walk to the desk and ask when I was going to have a room. The answer was always, not yet. But I always had to stand there for what seemed like forever before anyone looked at me, and if I dared an "excuse me" I got that Israeli Hand of Wait--if you live here, you know it.

Why didn't I kick and scream and pick a fight? I just didn't have it in me.

At around 1:30, finally, I heard my named yelled from the other room. "You have a room." I got up, I got my stuff together, I put the baby in the bassinet and rolled and dragged everything to the front desk. Where I was ignored. For twenty minutes, by the clock. At which point I finally, finally, lost it. I started to cry, and it was the kind of crying where you just can't stop.

The nurses stopped talking and all the heads swiveled in my direction. They stared. And then one of them said, in honest confusion,

?למה את בוכה

Why are you crying?

They really had no idea.

It did get their attention, and the nurse (or whatever she was) who brought me to Yoldot Gimel (Postpartum Unit 3) did at least carry some of my stuff for me. By the elevators, we ran into Mr. Bigfoot, who had scrounged a single guy to watch the kids while he brought me Shabbos supplies. "It's a good thing you came when you did," she said to him, shooting a meaningful glance in my direction, implying that I was not quite stable. We got up to my new room, and put my stuff down and she had the gall to say to my husband something along the lines--I can't remember now--of how I was very worked up and needed something something.

I don't remember now what I said in response, but I do remember the look on her face when I was done. It was shame.


So. If you're going to have a baby in Jerusalem, would I say, don't go to HEK? No. There are good reasons to go there. I think the L & D care I got was excellent. My postpartum care once I was in a room was also excellent. It's the only hospital in the city that allows rooming-in, and that was a very big deal to me; it is the only hospital that had a lab onsite that could do CMV testing for the baby, which also was relevant.

What I would say is, do not be there alone. This is of course easier said than done; if someone had said that to me before Mordechai was born, I would have shrugged and said, well, I don't really have a choice. But if I'd known what could happen, I would have taken someone up on an offer even if I wasn't sure she meant it. I would have hired someone. I would also have read more carefully the list of things to bring to the hospital. Bring your own water bottle, because no one is going to bring you anything to drink. Bring snacks, because there's no such thing as meals in your room.

I knew I needed someone to advocate for me before and during birth. It just never occurred to me that I would also need an advocate afterward. I thought I was covered. I didn't know it wouldn't be enough.


In the end, it's only a blip. I didn't hemorrhage like I did with Marika; if I had, things might be different. After two days in Yoldot Gimel, I was discharged and spent three days at Hadassah Baby, where I ignored the newborn care they provided completely and spent my days in bed, nursing the baby and watching the National Geographic channel. In the hospital, for the first time ever, I had not had enough milk for the baby. He cried incessantly and I had to give him formula--I really had no choice. At Hadassah Baby, I had milk. I took four hot showers a day and ate food I had not shopped for or cooked, and by the time I went home I was OK.

The baby was fine. He did not have CMV and he did not have jaundice.

Now, that otherworldly interlude in the tinokia feels like a bad dream. The baby I brought home is real.


Anonymous said...

What you have experienced is a nightmare. The only redeeming factor is you went home with a healthy baby. You should definitely send this post to the head of Haddasah Ein Kerem. I'm not sure if it will help change anything, but I know from personal experience, the venting is very helpful. Mazel Tov to you and the entire family.

Adrienne D

OneTiredEma said...

Agree--someone in HEK needs to see this. If only that this NEVER EVER happens to someone else.

Ima2seven said...

What a nightmare! When I had my daughter in Jerusalem, I chose a homebirth. My circumstances were completely different from yours, but there were so many things I feared; like a bed in the hallway. The idea of being home simply scared me less. I had a super-qualified midwife from Misgav Ledach (back in the day) and a doula.

I know that when there are medical risks like you had, it is a very bad idea to be home. It is just stories like yours that make me think that if I have another baby in Israel, will choose to do so at home again.

Anonymous said...

As a physician I am appalled by the behavior of the medical and nursing staff. When I had my youngest via a scheduled C-section, there was no bed or room for me either. So, they put me on a stretcher in the private room of some Xerox executive who spent the entire day barking commands at her co-workers and complaining about my presence! I hope you are safely ensconced in the new house.

Deborah said...

Yikes! No wonder you did not want to think about it.

But I agree that you should print off a copy and send it to someone in charge at the hospital.

Anonymous said...

If you don't want to send this to someone in HEK then I'm sure any (or all) of us would be more than happy to do so.



Anonymous said...

what you're saying in the end is true not just for birth situations: never leave anyone alone in a hospital. even if nurses have good intention, they are drastically overworked and understaffed and your loved one will not get the care they need. period.