"I can't treat you at the hospital, because there is no anesthesiologist. You will have to go to San Juan". That's what my obstetrician told me at my last appointment, when I was already three dilated and the arrival of my son was imminent.
He didn't tell me at the time, but my son's position was with his face forward, when ideally he should be facing backwards.
I just remember the paralyzing feeling of fear. I had no money, I was unemployed, 38 weeks pregnant and it was September 2020. Because of the pandemic, all roads were closed and Venezuela had a severe gasoline shortage.
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There was no public transportation and you needed a safe-conduct to get around. I was in Altagracia de Orituco, how was I going to get to the state capital, which is three hours away?
A Priceless Ambulance
I wanted a vaginal delivery, but my doctor said that, being a first-timer, I needed an anesthesiologist to be available if any problems arose.
The only anesthesiologist available was in another town and it was not known when she would return. As a result, in the emergency room there was a line of pregnant women who needed a cesarean section for different reasons and who could not find a way to get to other hospitals to receive the care they needed.
The only ambulance available charged $100 for the transfer to San Juan. A huge amount of money in our impoverished country. The pregnant women were taking up a collection to see if they could pay it all together.
You Stay at Your Own Risk
When I arrived at the hospital the next morning I was only 5 dilated, but I clearly told my doctor that I had no choice. I couldn't even go and give birth somewhere else. With what money?
He came out of the cubicle and said loudly: "We don't have an anesthesiologist and we can't take the risk of receiving them and having a mother or a baby die. Whoever stays here stays at her own risk."
I, who didn't know what I was facing because I had never given birth before, told him yes, I would stay in those conditions. And he told me that I had to do what he told me to do, because there was no Plan B.
Do Not Shout
I went home and returned to the hospital at 6pm with full dilations. Up to that point, I felt the pain was manageable. The contractions came and went with increasing intensity and frequency.
They put me in a room where there were six beds, but I was the only patient. At least 6 people, including nurses and doctors on duty, were coming in and out of the room where I was with my legs wide open.
My family had already warned me that this would be the case. And they kept telling me that I had to hold on, that I should not scream, no matter how strong the pain was.
The general practitioner and the nurses were telling me that I had to push to get the baby down the canal, but I didn't know how to do it, because there are different ways to push. After a while, the doctor broke my bag with a clamp. I felt the fluid coming down.
My obstetrician came and went, and asked to put me on oxytocin. I didn't know how much time had passed, I just knew it was hours, that I was in too much pain, that the baby wasn't coming down and that I didn't know what to do anymore. I was exhausted from so much unsuccessful pushing.
They wouldn't let any family members come in to accompany me, but not because of the pandemic. In many Venezuelan hospitals the policy is that you stay alone, lying down, and you don't decide anything they do to you. I have never felt so alone in my life.
No Option
I didn't want to lie down, but they wouldn't let me sit up or change position either. At some point I started crying, because I knew it had been a long time and my baby could not come out.
I wondered if my baby would die, if I would die too. The only person who could get the baby out was me and I really felt like I couldn't. What was going to happen? I was in the middle of it when my obstetrician came in and said it was time to move me to the delivery room.
I had no strength. Contractions are supposed to come with an impulse that makes you push the baby out. It's a natural thing. But I was just in pain, I didn't feel like pushing at all.
The Help
My doctor stood next to me and told me he was going to help me. He told me to tell him when the contraction came, to push and he would put pressure on me to push the baby down.
So we did. I felt like I was being squeezed like toothpaste when there's nothing left.
Since I didn't feel like pushing, I just pushed with what little strength I had left and told him when I needed to take a breath. Then my obstetrician would put her arm under my chest and push down with all her strength.
Days later, when I saw myself in the mirror for the first time, I still had red spots in my eyes, because of the great pressure I endured at that moment.
The attending physician said she had enough room for the baby to come out, but she still took a scissors and gave me an episiotomy that I had specifically told her I didn't want.
He Was Not Breathing
A couple of contractions later, my son came out. It was 11 o'clock at night. Everyone screamed with joy. They put him on top of me, but he wasn't breathing. I touched him for the first time and said I love you, even though I didn't really feel anything at that moment.
He just wanted to get out of there. The nurse took him away and in a few moments I heard his weak cry, like an asthmatic kitten, and they told me that they would take him to an incubator and return him to me in two hours.
I was looking at the ceiling, and I still had to put up with the doctor sticking her hand in to clean me and then taking my suture without any anesthesia.
The nurse who was assisting her took the 7th pitcher and poured cold water on the wound, that was all the anesthesia I received.
Not Even a Toilet
There was no water in the hospital. I was taken to a room with three other beds. In one corner there was a pile of old things. The windows were broken.
The only bathroom was at the end of the corridor. It was dark, because it had no light bulb. It didn't have a toilet, but a hole in the floor. So, to urinate you just stood over that hole and did it. And then you would pour water to clean yourself.
I asked for the personal favor of being discharged before 24 hours, and went to my mom's house with my baby. She was completely numb, expressionless.
The Suture Was Torn
I dreamed of a different kind of birth, of the incredible moment when I would see my son for the first time, because I had been looking forward to it so much. Instead, I had had the worst experience of my life and now I was in this emotional limbo.
To top it off, one of the vaccines my son needed was missing. I had to go back to the hospital a few days later to get it. I went on foot because I had no money for a cab and public transportation did not work.
I also could not send him with someone else because he was exclusively breastfeeding and on free demand, which means he could ask for milk at any time and the line for the vaccine could last several hours.
The walk of about a kilometer or so caused my episiotomy stitches to come out and I had to go again to get stitches, so my recovery took much longer than expected.
Two years later, I remember that experience and wish it did not happen to anyone else. Unfortunately, except for the fact that now there is more fuel and you can travel without restrictions, the situation for those who stop at public hospitals in Venezuela today has not changed.
The doctors continue to perform miracles with no supplies, no equipment, no staff. In spite of everything, I will always be grateful to the team that, with the limitations, made it possible for my baby to be born that night.
I hope that the day will soon come when doctors will not have to make these difficult choices for their patients; that people who give birth will be respected and be able to have a humanized birth; that mothers will be able to enjoy that moment of meeting their children without the shadow of trauma.