I am trying to teach the midwifery students to ask questions and discover each woman' story as an important part of collecting information important to her care. I tell that a stethoscope and lab can only tell us part of the story and we must learn more if we are to help.
We go to a woman's bedside in the postpartum room. We can see there is no baby and she is very swollen. She has no IV ad has a catheter in but the bag is not full. She stares out into space and is breathing fast. Her chart says she is anemic and is getting iron pills. That is all it says. I can see that there is much, much more to this story. For six days nurses and midwives had taken her bllod pressure, pulse and temperature. There were no notes, in the chart, about a baby.
The sister tells us she has not spoken since she was fifteen. Her mother died when she was young. She tells us that when the father went to work, the men of the village came and raped her day after day for many years. No one knew she was pregnant. When the baby was born she refused to nurse and let the baby die. She refused to eat and refused to go to the toilet. She had not had any water in two days and has not had any food. I can see that she is breathing very fast and her pule is racing.
The sister's one hope is that they will give her a tubal ligation. I ask who will protect her from further abuse but I can see that this does not seem possible. We get her water and a light broth. The students give her a sponge bath and she smiles a soft, far away smile.
I ask the sister if it is possible that she stopped talking because of the rape but the sister seems to think she was raped because she was not talking. She says the father knows that they are there but does not send anyone to help and does not send any money. They have no way to get home.
I am going to try and see if the Mother Terressa House will take her but we know that beyond this one woman that taking away the causes of such brutal anger towards women is an essential element of any healthy society.
In the last United States election, a candidate said that a woman could not get pregnant when she was raped and that if she got pregnant it wasn't really rape. Most people were outraged at his statement and he was forced to re-design his statement. I think of this as I sit beside a young woman, just nineteen, who has slipped into a world of mental illness rather than face her reality. She does not seem to be aware that she had a baby, at all.
There is no plan for her. She can not have a tubal because she is anemic. Her sister has three children in a village hours from the hospital and needs to go home.