Ovo je razgovor sa ženom imena Zamira koja se porodila u Zagrebu, maja 2011, u Petrovoj bolnici. Dijelom zbog činjenice da joj je vodenjak pukao prije početka trudova, imala je vrlo medikalizirano iskustvo. U mnogim bolnicama uobičajena je praksa izazvati porod ukoliko on ne krene sam u roku određenog broja sati od trenutka pucanja vodenjaka, i često se administriraju antibiotici. To je zbog malog rizika od infekcije. Međutim, postoji neka rasprava o tome da li je to stvarno potrebno (pogledajte ovaj članak). Zamira je vrlo dobro podnijela iskustvo indukcije, kao i neke trenutke, gdje njena želja da izbjegne carski rez nije bila podržana, ali je izvukla snagu iz ovog iskustva.
Recite mi o svojoj trudnoći
Bila sam malo zabrinuta, jer sam doživjela spontani pobačaj prije ove trudnoće. Ali, inače, bila sam sretna i zdrava. Zapravo, mnogo sam uživala u trudnoći. Pokušala sam razvijati odnos sa svojim sinom razgovarajući s njim i moleći se za njega svaki dan. Jela sam pažljivo. Redovno sam posjećivala ginekologa radi pregleda i ultrazvuka. Bila sam vrlo sretna kad bih vidjela svoje dijete na ultrazvuku. Jednom je izgledalo kao da nam maše!
Bila sam iznenađena stavovima ljudi u Hrvatskoj prema trudnoći. U mojoj domovini, Kirgistan, trudnice bi samo nastavljale s normalnim životom. One kuhaju, čiste i zabavljaju goste. Ponekad se možda i previše očekuje od njih, ali to je druga krajnost u Hrvatskoj. Željela sam puno hodati i biti aktivna, ali ljudi su mi uporno govorili sve vrijeme da idem i da legnem da spavam!
Kakve su bile Vaše posjete ginekologu?
Bio je vrlo služben. Uvijek je pitao da je li sve u redu, pregledao bi krv i urin, ali nije bilo puno vremena i nisam se osjećala ugodno razgovarati s njim. Pobrinula sam se da mu kažem da želim dojiti, i tako sam ga na kraju trudnoće, pitala da provjeri da li je sve u redu s mojim grudima. Dojenje je bilo normalna stvar za mene, jer moja majka dojila desetero njene djece. No, nisam dobila puno informacija o dojenju i vjerojatno je da on ne bi ni provjerio moje grudi da ja to nisam tražila. Međutim, čula sam da se u bolnici održavaju časovi dojenja, ali ja sam smatrala da meni to nije bilo potrebno.
Kada ste bili trudni, kakva su bila Vaša očekivanja poroda?
Moj doktor mi nije rekao ništa o tome šta možete očekivati u bolnici niti čak o tome kada treba da idem u bolnicu. Sve što sam znala o porodu je iz mog djetinjstva u Kirgistanu. Moja majka je imala desetero djece, svi su bili “normalni”, pa sam bila uvjerna da bi i ja mogla imati jedno. Znala sam da je moje tijelo izgrađeno za porod, i da to mogu učiniti bez potrebe za carskim rezom. Hrabrila sam samu sebe da ja to mogu, ali i bebu.. “Mi ćemo to učiniti zajedno”, rekla sam mu. Inače, nisam znala mnogo o tome šta mogu očekivati. Kao stranac, samo sam se pokušavala prilagoditi na način na koji su se stvari radile u Hrvatskoj i molila se da sve prođe kako treba.
Šta se desilo kad je došlo vrijeme da se porodite?
15. maja (dva dana prije mog izračunatog termina), pukao mi je vodenjak, oko 23:00 h ili tako nešto. To nije bilo šikljanje, samo malo. Nisam bila u bolovima (bez kontrakcija), ali sam bila zabrinuta, pa smo oko 01:00 h, otišli u bolnicu. Kad sam stigla, doktor je uradio vaginalni pregled i ustanovio da još uvijek nisam dovoljno otvorena. Rekao je: “U redu, moramo te pripremiti”. Oni su mi dali klistir, obrijali su moje stidno područje i očistili me tu. Također su provjerili moj krvni pritisak i dali mi drip. Mislila sam da to mora da je drip glukoze, jer neću ništa jesti do nakon poroda. U nekom trenutku također su mi stavili u kateter, pa nisam imala potrebu za mokrenjem. Također su me stavili na kontinuirani elektronski fetalni monitoring, tako da nisam mogao ustati iz kreveta sve vrijeme. Nakon toga, doktori su mi rekli da ćemo sačekati trudove da počnu i otišli.
Sljedećeg jutra, oko 9.30 ili 10:00 sati, drugi doktor je došao. Vodio je neke studente sa sobom. On je uradio još jedan vaginalni pregled. Nije bilo ‘poboljšanja’ kod moje dilatacije, pa mi je stavio vaginaletu prostaglandin gela da pomogne sazrijevanje i otvaranje vrata maternice. On je otišaom a ja sam čekala. Još uvijek nije bilo kontrakcija. Doktor je dolazio opet dva puta provjeriti moju dilataciju i staviti još gela, ali još uvijek nisam imala trudove. Pitala sam da li moj muž može biti tamo. Njima obično nisu dopuštali. Ponekad, očito, muževi moraju ićo na kratki kurs u bolnici kako bi bili u mogućnosti da dođu. No, u našem slučaju, on bi mogao biti sa mnom, jer je on doktor. Jako mi je laknulo kad je došao.
Oko 4 ili 5 sati popodne, gel je počeo djelovati, a ja sam osjećala blage kontrakcije. Bojala sam se toga što se događa. Bilo je teško ne biti u mogućnosti otići u krevet, ili hodati. Čak ni ići na WC. Činilo se kao da sam bila bolesna. Ipak, čvrsto sam vjerovala da ćemo beba i ja bi biti u redu. Znala sam da je porod normalna stvar.
U 7 ili 8 sati poslijepodne, trudovi su postali puno jači, tako da sam tražila epiduralnu. Rekli su mi u redu i dali mi, ali nisam sigurna da je funkcionisalo, jer sam još uvijek mogla osjetiti sve. U nekom trenutku, sestra je došla i rekla: “Tvoja beba je jako velika, vjerojatno će trebati carski rez.” Bila sam vrlo tužna jer je ovo rekla. Srećom, kasnije, došao je drugi doktor, protrljao mi stopalo i uvjeravao me da mogu roditi normalno!
Ubrzo nakon toga, moj suprug je sugerirao da je možda vrijeme da počnem tiskati, pa sam pokušala gurati. Premjestili su me u drugu sobu da rodim bebu. Rekli su mi, naravno, da ležim ravno na leđima na stolu i da, kako budem tiskala, držim svoja bedra. Nisam znala da li sam to radila ispravno. Nitko nije razgovarao sa mnom. Jedna medicinska sestra je pritiskala moj stomak prema dolje kad bih ja gurnula, a da me nije ni pogledala. Osjećala sam se izvan kontrole, pa sam se neprestano molila. Srećom, moj muž je bio tamo, pa mi je rekao kad se glava počela pojavljivati i ohrabrivao me da guram. Da on nije bio tu, ja ne bih imala pojma šta se događa. Zamolila sam supruga da im kaže da me ne režu (izvođenje epiziotomije). Zamolio ih je da me ne sijeku “, ako je to moguće”, ali oni su mislili da je to najbolje učiniti u svakom slučaju, pa su me razrezali dva ili tri puta. Vjerojatno su to uradili zato što su mislili da je beba velika, i da ću, u suprotnom, zaplakati. Bila sam jako nesretan zbog toga. Na kraju, saznali smo da je beba teška 3.8Kg, što i nije bilo puno.
Nakon poroda, prerezali su pupčanu vrpcu, umotali dijete i omogućili nam da se slikamo s njim. Zatim su, ostatak noći, uzeli bebu. Izbacila sam posteljicu i preselili su me na drugi krevet. Bilo mi je teško biti odvojena od bebe. Sve što sam mogla učiniti bilo je moliti se za njega. Nisam ustala iz kreveta cijelu noć, a oni su mi ujutro u 6 sati, opet donijeli dijete. U tom trenutku, sljedeći dan, prvi put sam ga dojila. Niko mi nije pokazao šta trebam učiniti, ali sam vidjela moje sestre kako doje, pa sam znala šta učiniti, i on je jednostavno bio pričvršćen i dobro se hranio. Mislim da su ga izvagali i okupali dok je bio tamo. Ja ne znam da li su ga hranili. Sljedećih nekoliko dana, dok nisam izašla iz bolnice, dijete je bilo sa mnom tokom dana do 21:00h, a onda bi ga tokom noći odnijeli. Međutim, jednom sam ih pitala da uzmu dijete na neko vrijeme da se malo odmorim. Ponekad mi je bilo teško dojiti, jer nisam mogla sjediti uspravno zbog bolova od od epiziotomije.
Kako je bilo kad ste se vratili kući iz bolnice?
Ponekad je bilo teško znati šta činiti. Nisam imala puno podrške u dojenju, samo sam to morala sama shvatiti.
Bio sam malo razočarana što je sve bilo tako tiho kad sam došla kući. U mojoj domovini je veliko slavlja kad se dijete rodi. Djed pozdravlja dijete prilikom povratka kući iz bolnice i šapuće njihova imena na njegovo / njeno uho tri puta. Šestog dana nakon poroda, porodica obično poziva cijelu ulicu da dođu i upoznaju bebu. Posebno slatko jelo se priprema da bi se služilo samo za tu prigodu. Međutim, ništa od toga se nije dogodilo, jer se moja porodica vratila ponovo u Kirgistan, a u Hrvatskoj postoji tradicija držanja dijete u kući 40 dana.
Kako se osjećate zbog svog iskustva u bolnici?
Pa, osjećanja su mi pomiješana. S jedne strane, osjećam da se ne mogu žaliti. Učinili su sve što sam tražila od njih, dali su mi epiduralnu i brinuli o bebi poslije. Međutim, bilo je trenutaka kada sam se osjećala jako usamljeno, i to je teško, jer ponekad nisam razumjela šta se događa. Također je teško biti u takvom kliničkom okruženju, zakovan za krevet. Osjećala sam kao da nešto nije u redu, kad znam da je porod normalna stvar.
Pošto ste već ovdje… …mi smo Udruženje koje opstaje zahvaljujući neumornom radu mama, najčešće u sitne sate nakon svakodnevnog posla i porodice, i to sve volonterski! Da bi naši projekti bili značajniji i veći ipak su potrebna neka sredstva. Ukoliko Vam se svidio ovaj članak te ukoliko podržavate naš rad, kliknite ovdje da nam donirate kako bismo proširili svoje djelovanje i pomogli i drugim mamama onako kako smo, nadamo se, pomogli i vama! Kada bi svako na pročitani članak donirao barem 1KM naš rad bi bio finansijski osiguran. Potrebna je samo minuta. Hvala vam što činite da porodi budu bolji u BiH.
In English
This is an interview with a woman called Zamira who gave birth in Zagreb, May 2011 at Petrova Hospital. Due partly to the fact that her waters broke prior to contractions starting, she had a very medicalized experience. In many hospitals, it is standard practice to induce labour if it doesn’t start within a certain number of hours of waters breaking and, often, to administer antibiotics. This is because of a small risk of infection. However, there is some debate about whether this is really necessary (see this article). Zamira handled very well the experience of the induction as well as some moments where the staff were unsupportive of her desire to have avoid cesarian section and drew strength from the experience.
Tell me about your pregnancy
I was a bit anxious because I had experienced a miscarriage prior to this pregnancy. But, otherwise, I was happy and healthy. In fact, I enjoyed my pregnancy very much. I tried to develop my relationship with my son by talking to him and by praying for him every day. I ate carefully. I went to see a gynecologist for regular check-ups and ultrasounds. I was very happy to see my child on the ultrasound. One time, it looked like he was waving at us!
I was surprised by people’s attitudes in Croatia towards pregnancy. In my home country, Kyrgyzstan, pregnant women just go on with normal life. They cook, clean and entertain guests. Sometimes maybe too much is expected of them, but it’s the other extreme in Croatia. I wanted to walk a lot and be active, but people kept telling me all the time to go and lie down and sleep!
What were your visits at the Gynecologist’s office like?
He was very official. He always asked is everything okay, checked my blood and urine, but there wasn’t much time and I didn’t feel comfortable to talk with him. I made sure to tell him that I wanted to breastfeed, and so at the end of the pregnancy, I asked him to check that everything was okay with my breasts. Breastfeeding was normal to me because my mother breastfed all ten of her children. But, he didn’t give me much information about breastfeeding and probably wouldn’t have checked my breasts, except that I asked. However, I did hear of a breastfeeding class run at the hospital, but I didn’t think I needed this.
What were expectations about the birth, when you were pregnant?
My doctor didn’t tell me anything about what to expect at the hospital or even about when I should go to the hospital. Everything I knew about birth was from my childhood in Kyrgyzstan. My mother had ten children, all ‘normally’, so I was confident I could have one. I knew my body was designed to give birth and I could do it without needing a cesarean section. I encouraged myself that I could do it and also encouraged my baby that he could do it. “We will do it together”, I told him. Otherwise, I didn’t know much about what to expect. As a foreigner, I just tried to adapt myself to the way things were done in Croatia and prayed that everything would go well.
What happened when it came time to have your baby?
On the 15th of May (two days before my estimated due date), my waters broke at 11pm or so. It wasn’t a gush, just a little bit. I wasn’t in pain (no contractions) but was concerned, so at 1am, we went to the hospital. When I arrived, the Dr. performed a vaginal exam and saw that there wasn’t any dilation yet. He said, “Okay, we need to prepare you”. They gave me an enema, shaved my pubic area and cleaned there. They also checked my blood pressure and put in a drip. I think it must have been a glucose drip, because I didn’t eat anything until after the birth. At some point they also put in a catheter, so I didn’t need to urinate. They also strapped me to a continuous electronic fetal monitor, so I couldn’t get out of bed the whole time. After this, the doctors said we will wait for your contractions to start and left.
The next morning, at about 9.30 or 10am, another doctor came. He had some students with him. He did another vaginal examination. There was no ‘improvement’ in my dilation, so he put in a pessary of prostaglandin gel to help ripen and open the cervix. He went away and I waited. Still no contractions. The doctor came again twice to check my dilation and put in more gel, but still no contractions. I asked if my husband could be there. They are not usually allowed. Sometimes, apparently, husbands have to do a short course at the hospital to be allowed to come. But, in our case, he could be with me because he is a doctor. I was very relieved when he came.
By 4 or 5pm, the gel started to work and I was feeling mild contractions. I was afraid about what was going on. It was hard not being able to leave the bed, or walk. Not even to go to the toilet. It made it seem like I was sick. Still, I had a strong belief the baby and I would be fine. I knew birth is normal.
At 7 or 8pm, the contractions intensified a lot and so I asked for an epidural. They said okay and put it in, but I’m not sure it worked because I could still feel everything. At some point, a nurse came in and said “You’re baby is very big, you will probably need a cesarean section.” I was very distressed that she was saying this. Fortunately, later, another doctor came in, rubbed my foot and reassured me that I could give birth normally!
Soon afterwards, my husband suggested maybe it was time to push, so I tried to push. They moved me to another room to deliver the baby. They told me to lie flat on my back on the table and hold my thighs as I pushed. I didn’t know if I was doing it right. No one was talking to me. One nurse was pushing down on the top of my belly as I pushed, and not even looking at me. I felt out of control, so I just kept praying. Fortunately, my husband was there and he told me when the head started to emerge and encouraged me to push. If he wasn’t there, I’d have no idea what was going on. I asked my husband to tell them not to cut me (perform an episiotomy). He said he asked them to do this “if they could”, but they thought it was best to do it anyway, so they cut me two or three times. Probably this was because they thought he was a big baby and I might tear otherwise. I was unhappy about this. In the end, we found out that he weighed 3.8Kg, which is not incredibly big.
After the birth, they cut the cord, wrapped the baby up and allowed us to hold him for a photo. Then, they took the baby away for the rest of the night. I delivered the placenta and they moved me to another bed. It was difficult being separated from the baby. All I could do was pray for him. I didn’t leave that bed all night and the next morning at 6am, they brought me the baby again. It was at that point, the next day, that I first breastfed him. No one showed me what to do, but I had seen my sisters breastfeed, so I knew what to do and he easily latched on and fed well. I think that they weighed him and bathed him while he was away. I don’t know if they fed him. For the next few days, until I left the hospital, I had the baby with me during the day until about 9pm, and then they kept the baby in the nursery overnight. However, one time, I asked them to take the baby for a while so I could rest. It was difficult breastfeeding sometimes because I couldn’t sit properly because of the pain of the episiotomy.
What was it like when you got home from the hospital
It was sometimes difficult to know what to do. I didn’t have much support for breastfeeding, I just had to figure it out by myself.
I was a bit disappointed that everything was so quiet when I got home. In my home country, there is a lot of celebration when a baby is born. The grandfather welcomes the child when returning home from the hospital and whispers in his/her ear their name three times. On the sixth day after birth, the family normally invites the whole street to come and meet the baby. A special sweet dish is prepared that is only served for that occasion. However, none of this happened because my family is back in Kyrgyzstan and in Croatia, there is the tradition of keeping the baby home for 40 days.
How do you feel about your experience at the hospital?
Well, I have mixed feelings. On the one hand, I feel that I can’t complain. They did everything I asked of them, such as giving me an epidural and taking care of the baby afterwards. However, there were times when I felt very alone, and it was difficult because sometimes I didn’t understand what was going on. It was also difficult being in such a clinical environment, stuck in bed. It made me feel like something was wrong, when I know birth is normal.
