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Running head: GIVING BIRTH BACK THEN AND NOW

Giving Birth Back Then and Now


Bobbie Chahal
California State University, Stanislaus

GIVING BIRTH BACK THEN AND NOW

Giving Birth Back Then and Now


An interview with Gurpreet Sandhu, a 64 year old Punjabi woman, will shed light on how
health care in the area of labor and delivery has evolved and how these changes affect the
experiences of women giving birth. The interview took place during tea time at the Sandhu
familys home in Modesto. She is from the Sikh religion and speaks primarily in Punjabi.
Gurpreet Sandhu is Bobbie Chahals grandmother and has lived in America since 1997, the year
she emigrated from India. (Sandhu, personal communication, October 26, 2013).
Birth Setting
Gurpreet gave birth to her first child in the city of Amritsar in Punjab, India. She gave
birth on January 15, 1966. Gurpreets delivery took place in her home with the family seated
outside the room. The doctor helping her through the delivery did not allow any of the family
members to be present inside the room. She was helped through the process by the servant, a
nurse, and a doctor. All of the people helping her were females.
The second birth was also in the same location on the date of December 15, 1970. Once
again, the same servant, a different nurse, and the same doctor helped her through the process.
All those helping were females. The family once again waited outside of the room.
Today, hospitals are the most popular choice of location for a childbirth to take place.
These hospitals rooms can range from standard single/double patient rooms to luxurious suites
that are designed with additional furniture, a jacuzzi, and music systems (Essortment Staff, n.d.).
The hospital is an option that has the benefit of having more supervision by medically trained
staff, more pain control, and medical interventions and monitors that a birthing center or home
might not have (Essortment Staff, n.d.). A second option women have is a birthing center. These
centers might not have all of the medical interventions, but have trained personnel that can
deliver the baby and make the call to an ambulance in case there are complications in the
delivery (Essortment Staff, n.d.). Lastly, women can choose the traditional location and deliver at

GIVING BIRTH BACK THEN AND NOW

home. Women delivering at home can have the comfort of being in a familiar environment and
delivering in a more natural way without all of the monitors, medications, and medical
interventions of a hospital (Essortment Staff, n.d.).
Pain Management
Gurpreet describes having zero control over pain during her first childbirth which
consisted of a 12 hour labor period. The doctor was summoned as soon as the labor pains started.
The family did not allow the doctor or her nurse to leave until after the delivery took place. She
says that the doctor told her to bear her teeth down in a clenching manner as a way to take
control of the pain so that she would not have to scream and frighten the family sitting outside
the room. Gurpreet says that bearing her teeth did nothing for her pain and so she screamed
throughout the pain. The doctor did give her injections but she does not remember what they
were for. Regardless, her pain neither decreased with the doctors injections, nor with the teeth
grinding technique. The nurse and the servant massaged her head and placed warm towel rags on
her body to help increase her comfort. Gurpreet says that although the massage and towel rags
boosted her comfort level, they did nothing for her pain. Overall, Gurpreet rates her pain control
as zero.
For Gurpreets second delivery, her labor lasted for around ten hours. She
says that the same massaging, teeth bearing, injections, and towel rag placement
interventions were used and once again, these actions did nothing to control her
pain. She describes this delivery as having zero pain control.

In the present time, there are more pain control interventions available. First, there are the
pharmacological interventions such as sedatives, anesthesia, systemic analgesics, nerve blocking
analgesia, nerve blocking anesthesia, spinal blocks, opioid agonist analgesics, opioid agonistantagonist analgesics, and nitrous oxide (Lowdermilk, Perry, Cashion & Alden, 2012, p398).
Second, non-pharmacologic interventions such as music, massage, breathing techniques, water

GIVING BIRTH BACK THEN AND NOW

therapy, waking, rocking, heat or cold applications, aromatherapy, imagery, and changing
positions are just few of the many methods in todays world to manage pain (Lowdermilk et
al., 2012, p391). The non-pharmalogical interventions used today such massage and heat

applications are the only similar pain controls Gurpreet had available to her during her deliveries.
Paternal Involvement

For the first birth, Gurpreets husband, father of the baby, was not present
because he was out of town for work-related meetings. However, once he reached
the city, he came to her aid immediately to help take care of her and the baby.
Gurpreet says that her husband was extremely helpful in taking care of her first
born. She says he was excited and would help clean the baby, hold the baby, burp
the baby, and help her position herself to breastfeed the baby.

Gurpreets husband was present for the second babys birth and waited outside of the
room with the rest of the family. He repeated his extensive involvement in helping Gurpreet take
care of the baby just as he had with the first born.
Nowadays, paternal involvement in the childbirth and childrearing process is being
encouraged by the health care teams. Nurses encourage informing and offering support to fathers
by various nursing interventions (Lowdermilk et al., 2012, p516). Nurses can give teaching to
fathers in the postpartum period. Nurses can also aid fathers in finding parenting classes, having
home visits by nurses, and giving the paternal parent opportunities to ask questions.
Role of the Nurse
Gurpreet describes her nurse as a very helpful one. For the first baby, the nurse was
instructed heavily by the doctor for every task. Because the family did not allow the nurse, nor
the doctor to leave the house until Gurpreet had successfully delivered, the doctor was present to
supervise Gurpreets care for the whole labor process. The nurse was brought in by the doctor as
an assistant. The nurse was called the health visitor in India at the time. During the labor
process, the nurse would clean Gurpreet, pray out loud with her, provide encouragement, and

GIVING BIRTH BACK THEN AND NOW

would watch over her whenever the doctor went outside to update the family. After the delivery,
she would sit Gurpreet down and have her watch and learn how to clean the baby, change the
babys langot (a type of loincloth that was traditionally used in India), place the baby at
alternating breasts and maintain posture for breastfeeding, and how to balance the babys care
with her own needs as a mother. The nurse made visits every day for about a month.
For the second baby, the nurse was a more experienced one and did not need 100%
supervision or guidance by the doctor. Gurpreet says that this one was great at praising and
guiding, cleaning her, praying, and supervising her progress. The doctor was forced again by the
family to stay for the whole labor process
In present time, nurses have much more clinical and evidence based roles in taking care
of mothers that are delivering and their babies. Nurses are more educated and have more
autonomy in healthcare today. Nursing interventions today consist of performing amnioinfusions,
reducing bleeding, assisting in breastfeeding, caring for circumcisions, preparing mother for
childbirth, fetal monitoring, risk identification, resuscitation, setting up phototherapy, grief
support, fertility preservation, prenatal care, teaching, giving medication, umbilical tube care,
environment management, labor induction, and labor suppression (Lowdermilk et al., 2012,
p10).
Use of Technology
Gurpreet reports that there was not a lot of technology in India in those times for
childbirth. She remembers the doctor having injections, a stethoscope, and a bag in which she
kept all of her notes and medicines. This level of technology remained the same for the next birth
as well.
Today, labor and delivery units are equipped with ultrasounds, fetal monitors, maternal
monitors, stethoscopes, forceps, hemostats, speculums, vacuumes, scalpels, scissors, amniotic
hooks, and of course relaxation aids such as a birthing ball (The Bump Staff, 2012).

GIVING BIRTH BACK THEN AND NOW

Care Routine
After the delivery of the baby, Gurpreets nurse cleaned the baby while the doctor cut the
cord. Gurpreet was handed the baby while the nurse and the servant cleaned the room to get it
ready for the family to come in. Gurpreet was cleaned and allowed to sleep while the doctor and
nurse taught the family how to hold the baby. The nurse left along with the doctor and the servant
took over in cleaning Gurpreet and helping her with the baby. There was no routine after this
other than the nurse visiting every day to teach Gurpreet and help her learn how to clean, feed,
comfort, and burp the baby. The nurse would sit Gurpreet down and have her watch as the nurse
demonstrated all of the baby care. Gurpreet says that the nurse really made the transition of
becoming a mother smooth and low in anxiety. This routine was the same for the second baby as
well.
In the present day, nurses monitor the unborn baby with monitors and various palpation
and auscultation techniques, monitor the mother for progress in the onset of delivery, assess
health of both patients after delivery, perform patient teaching, perform assessments, update
physicians and family, administer medication, and document their interventions (Lowdermilk et
al., 2012, p10).
Events Surrounding Birth
Gurpreet does not remember any significant events happening in her family around the
time of the delivery. She does remember that the Prime Minister in 1966 and 1970 was Indhira
Gandhi. Indhira Gandhi was Prime Minister from 1966-1977 and was from the Congress party
(Prime Ministers Office Staff, 2013). Gurpreet also remembers a Kargil war going on in India
in those years. She is unable to remember anything else happening in history at that time.
Cultural Beliefs/Practices
According to Gurpreet, in Punjabi, the world baanj (barren) is used to label women
who have not ever become pregnant. The society associates these baanj women with

GIVING BIRTH BACK THEN AND NOW

transsexuals or even hermaphrodites. These women are often made outcasts amongst those
traditional Punjabi people that have not been educated to know better. Gurpreet goes on to say
that these infertile women are not valued and mother-in-laws will begin to push their sons to
remarry so that they can have children with a fruitful woman. Gurpreet says that infertile
women are considered bad luck and so on the other hand, becoming pregnant is perceived as
good luck or a blessing from God. These beliefs and society values remained true for the second
babys delivery as well. Gurpreet adds that males are considered more valuable in her culture in
comparison to females. She says that often, families will be saddened, irritated, or indifferent by
the birth of a girl baby. In the Punjabi culture, a woman who is pregnant or has just delivered a
baby should not go to a deceased persons house because this kind of environment is considered
unlucky. Gurpreet says this rule will last for about ten weeks after the delivery of the baby.
Today in the diverse population of America, the culture and beliefs of each patient will be
different. Although a nurse might not be able to become an expert in each culture, the nurse can
definitely accommodate or even help preserve her specific patients backgrounds.
Personal Meaning of Birth
Gurpreet has always viewed and still views birth as a happy event. According to
Gurpreet, childless mothers suffer by the worlds mistreatment of them due to the negative view
of women who are infertile. Gurpreet believes that getting pregnant should be a celebrated news
rather than one that awakens fear and dread. She thinks that no matter what the gender of the
baby, the baby should be surrounded by love and smiles so that the baby can have a happy and
prosperous life. She thinks that children should be sheltered from bad news and arguing within
the house so that the family does not invite negative emotions such as anger, revenge, and
depression into the childs personality. Gurpreet believes that the pain experienced in birth is
nothing compared to the joy a mother gets by living her life with her offspring. She says that she
would go through childbirth all over again in a heartbeat.

GIVING BIRTH BACK THEN AND NOW

A nurse today can certainly accommodate and preserve a woman and her familys
meaning of birth by avoiding the pushing of her own values onto her patient and her family.
Summary
A lot has changed in childbirth since the 1960s. There is more technology, more pain
control interventions, a wider range of nursing responsibilities, more encouragement of
family/paternal involvement, and even the beliefs and practices associated with diverse
populations. Even though childbirth is full of so many possibilities, a pregnant woman today can
certainly take control of her options of how she wants her birthing process to go by creating a
birth plan (Essortment Staff, n.d.). This plan can list certain actions the woman wants her health
care team to focus on if there are no complications contraindicating them. Examples of such
plans can be the father being the one to cut the cord, the woman being allowed to change
positions and walk around the unit, not aiming for an epidural, and avoiding episiotomies
(Essortment Staff, n.d.). One important thing to keep in mind is the importance of becoming
educated and planning for the childbirth process. Being informed can always help make
childbirth and pregnancy a more positive experience.

References
Essortment Staff. (n.d.). What Birthing Options Do Women Have Today? Essortment. Retrieved
from http://www.essortment.com/birthing-options-women-today-50984.html
Lowdermilk, D. L., Perry, S. E., Cashion, K., Alden, K. R. (2012). Maternity and womens
Health Care (10th ed.). St. Louis, MO: Mosby Elsevier.
Prime Ministers Office Staff. (2013). Prime Ministers of India. Government of India. Retrieved
from http://pmindia.gov.in/pmsofindia.php
The Bump Staff. (2012). Delivery Room Tools That May Freak You Out. The Bump. Retrieved
from http://pregnant.thebump.com/pregnancy/child-labor-delivery/articles/labor
tools.aspx

GIVING BIRTH BACK THEN AND NOW