Months after giving birth, when my husband again starts in the night because our baby has made a little noise in her sleep, I realize that there’s one aspect of medical care in Turkey that I distinctively do not like: the instilled anxiety.
My husband is not usually (was not previously) an anxious person. He likes to do things well and won’t let certain things (like a odd noise coming from the car) slide. But high-tension he is not. Not, that is, until the night after our daughter was born.
She was born via [planned] cesarean at 8:46 am on a brilliantly sunny June day (just the day after my husband’s 34th birthday to be exact, on the auspicious date of 16/06/16). It was hot in our 9th floor hospital room, with the unblocked sun baking the room overlooking rolling green hills on the city’s western side. Our daughter fed at 11 am, and then mostly slept until dusk when the simmering city began to cool, refusing to be fully roused. She fed again at 7pm, and later at 11. Every few hours the doctors and nurses had been coming around to check our vitals, but at 10pm, as it was after hours in the maternity ward, we had to take her up to the intensive care unit on the 14th floor. There they weighed our baby and, while I waited long minutes in the half-darkened hallway outside the swinging metal doors leading to that sanitized ward, told my sleep-deprived and shocked husband that, if our baby’s weight dropped any further (she’d gone from 3.1 KG at birth to 2.8, though one erroneous chart listed her birth weight at 3.3), she’d have to stay – days, weeks – in the ICU. My husband looked around at the blue-white premies attached to tubes in their tiny plastic crates and shuddered to think of our daughter so small and alone under those same fluorescent lights. As soon as we were back in our room he rushed out to the night pharmacy to purchase formula, a syringe and a bottle, and for the next two nights we tried (with laughably low success) to syringe 30ml of formula into our unwilling baby’s mouth every 3 hours. It was only later (when I’d caught up on sleep and had time to read), that I found at that many doctors in the US now don’t encourage supplementing unless the baby hasn’t regained birth weight after 2 weeks – or even a month (!). As I’d initially thought, it was just better to bring her back to the family’s cool and shaded flat, where neither excess sun nor heat would force her to sleep.
But it didn’t matter by this point. For everywhere we turned there was anxiety in the Turkish hospital system. Was she too hot? Was she too cold? Would the dust from the street strangle her if we went on a thirty-minute walk? Would she have complications from jaundice? How many times today did she eat? When she was first born I attemted to write down every time she ate, slept and wet her diaper. Drank for 3 minutes, from 2:14-2:17 am on the left breast? It went in the book. At one point I resigned myself to her having lifelong thyroid complications and we rushed back from our mini new-family vacation in nearby Safranbolu, skipping the relaxing day we had planned wandering the old town, to head to the local health clinic…and find out that a nurse at the hospital where she was born had just taken one blood sample a few days too close to birth. During our drive to Antalya a few weeks later (for a much, much-needed five day stay at an all-inclusive resort where all we did was sleep, eat, swim, lie on chaise-lounges and stroll around with the baby) we stopped every two hours on the dot to wake her up, feed and change her because we were still so nervous about her losing weight. Poor baby. She probably just wanted to sleep. Experiencing an entire new world at once is exhausting, without anyone shaking you out of respite.
My anxiety gradually lowered. Over the ensuing weeks and months I spent enough time around her to realize what she could handle, to differentiate cries of hunger pangs from fear or pain or just plain boredom or discomfort. From our old apartment, situated right across the street from one of the local maternal hospitals, I also watched enough women carrying and taking care of their babies in ways that completely flew in the face of everything I had read to realize that, while we should still be careful, our baby probably wouldn’t break even if we didn’t follow everything every doctor and every child-rearing manual said to the letter. Instead of “doing this will immediately and undoubtedly bring instant and unalterable harm to your baby”, I realized that, for the majority of warnings leveled at new parents, the message was more likely “if you do this, there is a small chance that, for some babies, there may be non-optimal results ranging from slight discomfort to more serious reactions”.
However, my husband still viewed our baby as a most fragile thing, and – six months on -still starts at the smallest whimper. And no wonder – for all we were fed in the Turkish hospital system was fear. From the 32nd week on we were worried that the baby would be born too early – that she’d already dropped into the birth canal, that she wouldn’t be able to turn around, that I didn’t have enough amniotic fluid, that I’d go into labor early. My husband almost flew out to Ankara a month before he was due. One night I stayed in the hospital just to be hooked up to an IV and pumped full of fluid again. But I felt perfectly fine afterwards and continued walking everywhere up until 10 days before her original due date, when we went in for a checkup and were told I needed a cesarean immediately as she had dropped into the birth canal without turning and my amniotic fluid levels were down again. Could we have waited for a normal birth? Would she have turned around during labor, as do half of babies in similar positions? We’ll never know.
After she was born all we heard for weeks was nervous advice – look out for this, watch out for that, be sure to do this, that doesn’t look quite right. I think sometimes we even doubted whether we’d given birth to a whole child. Looking back upon this – of course it makes sense (in a way). People don’t go into Turkish hospitals as much for ‘soft’ checkups or little complaints. The problems doctors see, and that doctors are accustomed to looking for, are usually severe. What kind of babies does and ICU employee most often come in contact with? Not those who are discharged from the hospital within the first few days.
At our first visit to the [American] doctor in Bishkek even I faced her positive assessment with initial disbelief. Surely there had to be something wrong. Jaundice – clearing up nicely. Spots on the skin – a combination of sensitive new born skin and prickly rash from the Bishkek heat. Weight – exactly at he 50th percentile. Teary eye – stuffed nose. Sleep patterns – pretty normal. Reflexes and neck strength – excellent. Strangely, there was nothing for me to worry about.
These past few months our daughter has fallen sound asleep at 7pm – only to wake slightly twenty minutes or two hours later when she rouses herself from that first cycle of sleep. Sometimes she dozes off by the time I make it up the stairs, or if we pop a pacifier back in her mouth. Other times she wakes completely, giggles her ‘good morning’ laugh and thumps her legs against the bed in wakeful excitement. The past few weeks I’ve been (slowly) working on my husband to use the 5-10-20 method – go in and see if she’ll go back to sleep easily, but if she doesn’t, calm her down and then wait 5 minutes before gong in again, then 10, then 20. It’s usually during the 10 minute wait, when her chatter turns to cries, that he begins to break. “It’s been long enough” he pleads after a mere 7 minutes. “Can’t we go in now?”. Wait, wait, I caution. She needs to learn to fall back asleep on her own, and she’s perfectly fine. We just went in, and she knows we’re here if she needs us. She wails again and my husband turns to me with wide eyes, voice rising to an anxious pitch, “She’ll never fall asleep like this!”. Wait, wait, I tell him. Two minutes later we hear nothing but the occasional murmur as she rolls back and forth a few times settling herself into sleep. Five minutes pass. “Shouldn’t you check on her to make sure she’s alright?”. I tell him I’ll most likely just wake her if I go in before she hits deep sleep. We wait a bit longer, and she sleeps long and deep through the night, until the grey morning light begins bringing hue to the sky at 7:45.