La Maternidad

8 Jun

So I know you´re all desperately waiting to find out whether or not I passed out today. I didn´t, but I think that my first glance at La Maternidad, the maternal health hospital in Quito would have given me an adequate excuse.  La Maternidad is awesome because it provides all sorts of healthcare services including cesarean sections, labor and delivery, abortions, sexual health education, contraception, and nutrition education for free! They´re paid for by La Ley de Maternidad Gratuita y Atención a la Infancia, an Ecuadorian law that mandates free health care for women and children under the age of five. Some of these procedures are incredibly controversial, especially abortion and contraception, because Ecuador is a Catholic country. However, the current government supports these services and allows them to be provided.

Anyway, I walked up the stairs to the second floor of La Maternidad to La Sala de Partos, the labor and delivery ward. After being chastised for my scrubs´vibrant shade of green, I was guided to a medium sized room filled with 11 screaming women who were each delivering a child without any pain medications, let alone an epidural. I still can´t figure this out, because I met three male anesthesiologists there who were assisting in abortions and cesarean sections, but they didn´t seem too worried about the poor women who were delivering vaginally. The women were naked from the waist down, legs spread, beds within six inches of each other. Every single one of them was alone, and they were all so young that one woman who was 26 almost seemed too old to have a baby in comparison.  Every once in a while, a nurse would examine them, but generally they were exposed for absolutely anyone to walk by. The room was ridiculously crowded–we had no idea we were going to be fighting with medical students, nursing students, and midwives for our doctor´s attention! Every time he moved, the mass of around 20 people followed.

He then led us all into a small room with only three women in it. He explained that these women all had preeclampsia, and that the only way to cure this life-threatening condition is delivery. Only one woman was close to full term. Apparently the rate of preeclampsia in Ecuador is around 17%, which is shockingly high when comparing it to the rate in the U.S.: 2%-6%. We asked why this was, but the doctor said there wasn´t a real explanation for it–that it maybe has something to do with their diet.

During the four hours I was there this morning, I saw 5 vaginal births. Each time, the woman was completely alone, the doctors were hardly sterilized, and medical students were taking pictures on their cell phones. Not a single room had a door, so anyone could walk in and out as he or she pleased. Doctors outwardly displayed their  frustration with women whose pushing wasn´t satisfactory, and there was only one time that the baby cried immediately after birth. All five of the babies were very blue, and were rushed off to a small room with one table in it: the NICU.  One doctor said their lack of oxygen had something to do with the altitude here in Quito.

We also observed two abortions, both of ectopic pregnancies. Since their pregnancies were relatively early on, it wasn´t too gruesome, but I was shocked by how much the doctors talked to each other about the procedure in front of the patient, cleaning scalpels and speculums as the patient waited for the anesthesia to kick in.

One of the goals of Child Family Health International is to show people the differences between their health care system at home and those abroad. I was talking with a girl in my program yesterday about how surprised I was that I hadn´t experienced any real sort of culture shock here. Now, I can say that it was because I hadn´t worked at La Maternidad yet. Nearly every aspect of my experience shocked me, from the lack of privacy to the lack of cleanliness to the obvious emotional detachment that the doctors had toward the patients. One girl was in so much pain that she thrashed her arms and her IV fell out. The doctors yelled at her, then laughed in front of her and said she was acting childish–she was 14. I´m realizing quickly that any Grey´s Anatomy-planted notion of what a maternity ward should be like is not even close to how it is, especially in third world countries.

Tomorrow, I will walk back up the same stairs, meet the same doctor, be given different colored scrubs (embarrassing!), and walk back into the room filled with women in labor. I´m excited to learn more about medicine, women´s health, and the Ecuadorian health care system, and I´m sure that with a better idea of what to expect, I will be able to look further than the shocking exterior to get a more complete understanding of it all.

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3 Responses to “La Maternidad”

  1. Ray June 8, 2011 at 9:41 pm #

    Wow! That sounds like an interesting and educational day! I hope that you get to have some more impressionable experiences to come. I miss you very much, and I’ll see you soon.

  2. Patricia June 9, 2011 at 2:47 pm #

    WOW! que experiencia en la maternidad! aunque viste las dificultades y las diferencias en el trato de doctores y pacientes es una bendicion que el hospital pueda recibir tantas personas y darles una atencion minima. Hay otros paises como Guatemala que la salud publica es muy limitada, los hospitales generales no tienen medicina y los servicios son muy limitados. Sigue adelante chica! que todo lo que veas te haga una persona mas sensible a las necesidades de otros y puedas ayudar en todo lo posible. I’m proud of you and I thank God for helping you handle all the challenges. God bless you, love

    Patricia

  3. Anita June 27, 2011 at 9:53 pm #

    I am ecuadorian and I have seen La Maternidad through your eyes reading your post. I have only heard the horrible stories that happen there. Just so you know, the very poor women don’t have a choice but to go to La Maternidad because they can’t pay in a private clinic. I think they are humilliated by all those people watching them and doctors that don’t seem to know what they say and do. For example, a blue baby that does not cry is probably related to the altitude. This made me so upset. Anyway, I just want you to know that Ecuador has all levels of care depending on how much money you have. It is not a true free service in my opinion because your life is in risk in those places and with those doctors.
    Also, I didn’t know abortion was legal here in Ecuador!

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