Womanhood: Stories from the Hospital, as told by a medical student
It was a rainy Saturday morning and Lily (pseudonym), irritated and betrayed by every sensation in her body, flung the blankets off her writhing torso. She took yet another drag of the gas that was supposed to take her pain away – but it never worked. When later she goes into labour she would have cursed this faulty gas. But all throughout she would keep the gas mask plastered to her face. Her hair was damp in this cool, dim-lit room, and her face puffed, from drifting in and out of consciousness on this birthing bed since 5am this morning. She was transferred to the labour ward a few hours ago because her membrane ruptured, which was to say this 9-month infant inside her womb was finally ready to meet the world. Lily had given birth before. She expected things to go smoothly.
When I first spoke to Lily she had her eyes glued shut, and she couldn’t speak properly. I could not tell if it was because of the pain, or the analgesics mask she had cemented to her face, from which she was strenuously inhaling. I stepped away to give her a moment, then returned to take her consent for my assistance in the birth process. This involved monitoring her and her baby’s vitals every 30 minutes, performing vaginal examinations to check if her cervix was dilated enough for the baby to pass through, and finally, the moment I am most excited to be a part of – the birthing process. All the times I have witnessed vaginal deliveries I had been a mere observer, standing in a corner with my jaw dropped, watching in awe as midwives caught newborns emerging from frazzled, sweat-soaked mothers. This time, I thought to myself, I’ll finally get the opportunity to guide the baby into the world, helping it take its first breath and emit their first piercing cry.
Neither Lily nor I had our expectations met.
By mid-afternoon it was clear something was wrong. Her cervical dilatation had remained static, which was to say that the baby’s head was too big to descend. The head was trapped by the pelvic bone, so the cervix remained stuck at 8 centimetres for over five hours. In a frenzy, 3 doctors entered, hovering by the charts and encouraging Lily to push. When that failed, they informed her that an emergency Caesarean section was necessary to safely deliver her baby.
Lily couldn’t take it any longer. In anguish she cried “I don’t want surgery!”, as she stomped her feet on the bed, kicking and grabbing wildly at the air. When the doctors left she clutched my arm, knuckles paled. “I don’t want surgery. I ate as much as I could during my pregnancy, I thought it’d be nutritious for the baby, I didn’t know this would happen,” she proclaimed in one strained breath. I couldn’t tell sweat from tears as beads ran down her forehead, eyes, and cheeks. I felt my own vision blur as I whispered, “This isn’t your fault”.
Childbirth is a process that has existed for millions of years, yet has evolved tremendously since. Humans, with our upright stance and larger brains, have developed a far more challenging head-to-pelvis ratio than our ape cousins. Babies must twist, rotate, and sometimes require tools like forceps or vacuums to navigate their mothers’ narrow pelvises. If Lily knew all this in the throes of labour, she might well have wished to be born an ape rather than endure this ordeal!
Fortunately, Lily consented to the surgery, and in no time, she was in the operating room. As the obstetricians performed the procedure, I stood by, retracting the bladder and snipping stitches, eager to assist in any way. Soon after, Lily held her baby boy, exhausted but beaming. I watched in awe, struck by the efficiency of the surgeons, the professionalism of the midwives, and the abundant support Lily had throughout her gruelling journey. In many countries, maternal and infant mortality rates remain high, and inequalities are stark. I couldn’t help but wonder how differently Lily’s story might have unfolded in a less well-endowed facility.
There is so much that I’ve witnessed as a medical student – intimate moments playing out in front of my eyes that I feel privileged to have been a part of. Some were dramatic, like when amniotic fluid splashed all over my gloved hand as the amniotic sac ruptured right when I was about to examine for cervical dilatation. Others were painfully vulnerable, like watching Lily in agony, where at times I felt my presence was intrusive. What I’ve come to realize, is that childbirth – the whole process, from conception, to birthing, to rearing and parenting, is far more challenging than I’d ever imagined.
I will never forget Desiree (pseudonym) and her dead twins. She walked into the clinic, 14 weeks pregnant, for a routine appointment. She climbed agilely onto the bed, eyes wide and eager to see her babies on the monitor. The lights dimmed. Doctor Leung marched over and with a shrill rattle of eyelet hooks against cold railings, the curtains closed behind him. With a vigorous shake and a loud squirt the ultrasound gel was seated comfortably on the probe, then squished onto Desiree’s belly. The black-and-white screen connected to the device flashed to life, and from it I could make out two tiny figures, curled and resting with a strange calmness next to each other. The image was zoomed in. Desiree lay still on the bed. Her babies even stiller inside her tummy. I froze as well, straining to search for the flickering heartbeats that were missing on the screen. Surely I must be wrong – I’m just a student. The hum of the air conditioner stretched eternally as I held my breath.
“There’s no heartbeat.” My chest tightened as the doctor confirmed my dreaded suspicions. “I’m so sorry, I’ve searched for quite a while. I would not say this lightly,” Doctor Leung added as he turned the screen towards Desiree, revealing the silent, lifeless figures. She clenched her fists, and without uttering a word, turned her head towards the grey screen that would steal away her hopes of mothering these new lives.
Desiree stepped out of the bed and back into her chair as the doctor returned to his seat. The flick of the light switch did little to expunge the somberness of the room. I hardly knew how to act. I wanted to hold her clenched fists and tell her I’m sorry, that it was going to be okay. Just a minute ago I was palpating her abdomen, feeling for her enlarged womb . Before that we were scheduling follow-up consultations for her twins and chatting about vitamins and supplements. At present, I caught a glimpse of the bright computer screen at the corner of my eye, and watched with a clenched heart as the doctor cancelled all her future pregnancy appointments. All I managed to whisper to her was, “Are you okay?”
Motherhood is arduous, and though it does not define a woman, it is still a journey that many women experience. What I did not know was that the path towards motherhood could be so painful. Grief and motherhood never seemed so entwined. Grief for getting a permanent scar on your body for a caesarean section you did not want, for the sudden loss of children you were hopeful for, even grief for the woman you were before you were a mother. As a woman and a witness, I share in their pain. I feel guilt for not understanding, for not being there for women in my life who endured similar traumatic events. My own mother had a miscarriage, but I was too young to understand her loss.
So many women around us—those with the strength to bear children, those who choose not to, those who adopt, those who struggle and go through agonising procedures to conceive, those who are not eligible for healthcare and give birth “illegally” — carry stories that deserve to be heard.
Throughout my rotation, I’ve encountered profound insights into womanhood and its diverse challenges. Yet I’ve also felt awfully out of place at times. I look forward to the day where I will not only be learning medicine, but practising it. For now, it brings me great joy to detail what I’ve experienced and share them with you, hoping to keep the conversation alive about the many complex, often untold, facets of womanhood.
This article was first published on issue 6 of CUriosity, my university's student-run magazine. I've made some edits here, the original version is also linked here. Bonus points if you can find the poem I published there too!
