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  Our Experiences

Immediately after passing out from medical college we started practice in a small town named Uran. It is surrounded by many villages where still home deliveries by untrained Dai’s (village midwives) used to attend pregnant women and conduct deliveries mostly. It was a routine practice and custom in spite of being in vicinity of Mumbai where medical infrastructure is of so high standard that people from all over India and even abroad are coming for best quality treatment. In medical college labor duty used to be heavy and labor patients were detailed as 2 fingers or 3 fingers loose or fully dilated. These were heard in all the hustle bustle of labor room.  When patient become fully dilated suddenly the focus was changed and trainee doctors, nurses surround her and a chorus of shouting of patient and nurses to push hard and harder begins. Outside the labor room relatives were pacing up and down in corridor worrying about the outcome- male or female. Inside labor room senior staff nurse will shout on patient to push harder and at times if required she will slap too to make her listen and obey her commands. Atmosphere used to be so charged up and that it looked quite natural at that time. As a trainee doctor we used to wear gloves and get ready in fielding for holding catch. If the process gets delayed then some staff nurse will give fundal pressure to help delivery process. Somehow patient had to be delivered vaginally it was the only motive for us at that time. We were not concerned with patient’s pain. For delivery labor pain is natural thing and every patient has to undergo it, this was a normal thinking. If patient created fuss about it she had to listen why she wants a baby if she can’t bear labor pains. The whole atmosphere was charged up and filled with pain, fear, tension and shout. Excitement and expectation of new arrival in this world and joy of being a part of this whole process was not there. And at least patient delivered after all the trial then is it male child or female child? This used to be the biggest question. If it is male child then everyone is overjoyed and patient also feels relieved and feeling of accomplishment after getting the work done properly comes over. Relatives hand over cash as token of appreciation to nurse/ayah bai and someone is sent immediately to bring sweets for distribution. If by chance it is female child- for the first timer’s hardly the excitement is seen, someone whispers Laxmi has arrived this time next time kanha will definitely come and they reassures themselves. The delivered lady is now tense on in-law’s reaction and she cannot enjoy the excitement and happiness of being mother. She hugs her child with heavy heart knowing very well that next time she has to fulfill their expectation.
If it is 2nd or 3rd rd delivery and the patient delivers female child successively, then the whole atmosphere becomes so gloomy and relatives looks so sad ( specially female relatives) as if someone has just died . Yes, death does occur and it is death of the expectations of having male child this time. No one is concerned about the mother, nobody asks for her well being. More or less this is a common reaction of people in every strata of life right from poor to rich, illiterate to educated, village folks to people from metro cities. Till now we have come across very few exceptions to this reaction.
   This is about the outcome of labor process. Another fixed idea people have about delivery process. When patient is brought in labor room, patient’s relative especially elderly female orders the hospital staff and doctor –patient should deliver normally they don’t want cesarean operation as they have undergone regular treatment for all 9 months under doctor’s supervision. In general people think that doctor’s do cesarean for more money and convenience. This could be true to some extent. Every field has good or bad people and medical field is no exception to it. But everyone can’t be measured by single criteria. In general population, people have got doubt on doctor’s integrity and their intention. Moreover they have some misconception about labor and delivery too. They want to have normal delivery somehow and they expect all this “somehow” should be done by doctor. But in reality all this “somehow” patient has to do. Doctor will definitely help and assist the process but doctor can’t undergo it. For this patient has to be mentally and physically get ready and she gets 9 months for the whole preparation, isn’t it?
Nowadays due to advancement there is less and less amount of physical labor. Our changing life style and dietary habits have caused malnutrition and muscles, bones have become weak. Mind is already occupied with fear, tension, apprehension about delivery process and pain. In spite of these, if someone wants normal delivery, it is like a student who wants to top the exam without studying and preparing for exams. What do you think , is it possible?
    We started delivery preparation classes to overcome all these problems. Here we educated the patients and their relatives about pregnancy and delivery’s does and don’ts, diet, exercise, importance of medication and checkup etc. We prepared them physically by exercise and pranayam and mentally they were prepared to welcome new life by weeding out fear of labor pain, blood loss etc .This help them to feel joy of motherhood and a wonderful feeling which they are going to experience once or twice in their life. This classes help to grow bonds between patient, her relatives and us and they had full trust on us. Meanwhile Mandar did DA so we had facility of administering anesthesia any time so we could safe optimum trial for normal delivery. This all helped us to limit our cesarean section rates to 20-30%only.
    Since last 5 years we have stopped routine obstetrics practice and emergencies. We are working specifically in field of gynaec endocrinology and infertility, so we are doing only elective cesarean section for high risk and precious pregnancies. Still through delivery preparation classes we are sharing our experience to general population and we help to prepare pregnant lady mentally and physically for delivery process. Patient can choose nearly hospital and doctor according to her convenience and go for delivery