We successfully had a baby in Tunisia, like millions of Tunisians everywhere. Our daughter, Reeve, was born this past weekend. Everything went well, and the key players are all healthy and fine.
We arrived at the hospital after something like 18 hours of labor. It had been relatively easy labor (if such a thing exists, and if a man has a right to say something like that), though tiring, with contractions sometimes as close as five minutes and sometimes as long as 15 minutes apart, and none so painful that speech was impossible. But they were accelerating a bit, and so we thought we ought to head in. We pulled up to the Polyclinique (ah, that fancy French talk--"Polyclinique" is just a private hospital, as contrasted with a "Clinique", which is a public hospital where they sell high-quality makeup products) at around 12:15 AM Saturday morning.
And it was dark. The front doors were locked, so we went in through the emergency room. There was no on in sight for a few seconds, but then an attendant sleepily came to the door to talk to us. A quiet hospital, in theory, means that one can expect more attention, because the staff isn't overwhelmed with patients. But I've got to say that I sort of prefer that the hospital have kind of a buzz around it--something to suggest that people are on top of their game, that they're busy saving lives and delivering babies and removing appendices and whatever else. I like my hospital to send a message: "This is a place where people WORK."
I felt like the message here was "This is a place where people SLEEP."
Now I should pause here and say that we were not in the slightest bit concerned about this. Our first labor and delivery were relatively uneventful, no real problems, all natural. There was nothing to suggest that this would be any different, and indeed ultimately it all went swimmingly. There's just a lot more confidence going into a second delivery if the first one went well, I think. And, on the whole, Tunisian medical care is better than adequate. I mean, I wouldn't have Lasik at the local shawarma stand, and if I had to get a hand transplant I'd probably go elsewhere, but it's fine.
They led us up to the labor room, which was also the room where Melissa and Reeve would sleep afterwards. The contractions were increasing in intensity, and dilation was accelerating. The doctor arrived at around 1:15 AM, and it looked like things were happening fast, which was good. But the pain was definitely increasing for Melissa, and she was leaning on me more as contractions came. This, evidently, was an ideal time for the staff to demand that I go fill out forms for admission. Apparently, they were afraid that we would dive out the door immediately after the birth without giving our names or paying. So I ran down to the desk, had a halting conversation in my terrible French before discovering that the staffer's English was far better, and filled in a couple of forms. All the while, I was nearly gagging on the cigarette smoke of the five orderlies sitting in the lobby. By the time I was done, about fifteen minutes later, Melissa was awfully close to being fully dilated. It was going to happen really, really quickly.
They wheeled her into the delivery room, which is really an operating room. The OR was probably the place where I felt the West v. Non-West contrast most acutely. The room was clean, but every OR I've seen in the States is sort of preposterously shiny and bright. This was a bit dingy, with oldish equipment and lights and such. This is the difference between the hundreds of billions of dollars spent on health care in the U.S. and the probably millions spent in Tunisia. With mysterious hooks and a burned out light bulb, I realized that if this place had had a canvas roof I would have thought that I was in the OR tent on M*A*S*H. I kept waiting for Hawkeye Pierce to come in and deliver the baby while BJ Honeycutt performed some meatball surgery nearby.
Our doctor was excellent, working with our needs and desires and taking good care of Melissa. And the nurse seemed to know her business, but her bedside manner was pretty awful. Cultural differences really played themselves out here. I don't feel like it's an unfair generalization to say that there are certain ideas about medicine and nurses and doctors that haven't made their way to Tunisia yet. In the U.S., medical staff are still godlike, but they at least increasingly have a sense that the desires of the patient can be considered as much as the needs of the patient. Here, they're at least a decade or two behind the West on the notion that the patient can control how things are done, or at least should be informed and have some say. Coupled with a culture that makes Arab women much more timid in the face of medical (and other) authority, this made Melissa a bit of a freak show. She knew what she wanted, how she wanted to labor, and what she wanted from the medical staff. The nurse didn't like this at all. AT ALL. She wanted Melissa to lie in this position, to not sit in that position, to do that, to not do this, etcetera. She didn't like it that Melissa wasn't lying down the whole time.
This played itself out most obviously when Melissa did lie down and the nurse reached--no exaggeration here--for the restraints so that she could strap her to the table. I may never have given anyone a nastier look than I gave to that nurse, and she saw it. The doctor waved her off quickly, and thankfully Melissa didn't see that little incident.
Again--this was an aberration in otherwise excellent care.
Another element of this whole scene was the language barrier. Melissa speaks passable French and excellent Arabic, the dominant languages in Tunisia. I have zero Arabic and only slightly more than zero French. So Melissa had to do the talking when it was needed. Pretty impressive to conjugate Arabic verbs while in the midst of the pushing phase.
Fathers are such an appendage during labor and delivery, and in addition to the standard level of uselessness, I couldn't even understand what was being said. I just stood there, drool pooling on the floor underneath my slack jaw. During our first birth, I actually felt like I was helping out, talking her through contractions, rubbing her back, doing whatever I could, and I genuinely contributed as much as I could, which is admittedly not much. This time, I was like some cretin standing by, watching everything unfold. Talk about an opportunity blown--if I'd been the one with the language, I could have been a contender! Instead, a cretin.
After Reeve was born, washed, and we were sent back to our room, (no nurseries here) we discovered the disconnect between care and service at the Polyclinique. The medical care was perfectly fine, if different. But the service? Yikes. For instance, at about 3:30 AM, an attendant offered Melissa a cup of coffee, which is every woman's dream an hour after giving birth. That was the beginning and the end of the fluids offered to Melissa. No water, no juice, nothing. No one came to check on the baby until the pediatrician arrived a few hours later, and only mildly more attention was paid to Melissa. This undoubtedly would have been different had there been any problems. But there weren't, al humdi l'allah.
We went home only about 12 hours after Reeve arrived in the world--they were pretty relaxed about that, which was a nice difference as compared to the U.S. Overall, the experience in the hospital was fine, the care adequate to good, the doctor excellent, Mistress Head Nurse surly. I'm glad nothing was out of the ordinary, but that's of course true no matter where one delivers a baby. I just hope they don't try and tie me down if I need to go to the dentist or something. Either way, we got a cute kid and a good story.
