Babies can be very expensive. Our obstetrical set fee schedule and the way it was implemented made prenatal, delivery, and post natal care affordable to virtually anyone. Theoretically, the patient paid a fixed amount of money ranging from 50 dollars to 500 dollars for all the OB services necessary to deliver and care for the baby. In practice many of the patients paid nothing. A charity hospital really did offer care when needed to just about anyone showing up. What a refreshing situation and such a contrast to health care today. Uh, oh don't get me started on that one!
The clinic was staffed primarily by OB residents and nursing students. A diverse group of medically underseved women attended the clinic. I often questioned why women of limited means were always referred to as "medically underserved." There were many plenty of doctors and nurses in the vicinity so this was really a contrived term. I guess medically underserved sounds better than needy or impoverished.
As student nurses we were responsible for weights, checking vitals and then getting patients settled in one of the exam rooms for a resident to assess. A petite, quiet, very young woman with shockingly blue eyes named Lisa caught my attention as she looked unusually apprehensive. Her stylish dress was a marked contrast to the other prospective mothers in the waiting area. I chatted with her while checking her vitals and without hesitation she revealed that she was a prostitute and this was her third pregnancy. The previous 2 pregnancies had been terminated in the first trimester with the assistance of "her boss" assumed by me to be her pimp.
"I really want this baby" she said with dogged determination. "The father is a very smart lawyer. I was very busy at that last big convention a couple of months ago so it must have been fathered by one of those lawyers." Tenaciously she proudly stated, " My girlfriend and I will raise this child and I want this baby to become someone." This lady seemed committed to raising the child. "I never had much of a chance and I want more for my baby."
I helped her up onto the exam table and positioned her stirrups. Dr. Rebondo came in and did one of his comprehensive check ups. At the conclusion of the exam we always obtained an anaerobic culture from the cervix to check for gonorrhea. The doctor handed off the culture applicators to me and I immediately plunged them into an anaerobic culture bottle to maintain an oxygen free environment. Lisa was watching me with a puzzled look on her face as I fiddled with the culture bottles.
We used to call them trans-grow culture bottles because the bacteria would replicate in the media while in transit to the lab. These bottles were clear glass and the growth media was a nasty looking brown/green color. To maintain anaerobic conditions the wooden applicators were snapped off at the bottle neck after being submerged in the culture media and the caps tightly closed. The crunch and crack of breaking the wooden applicator always seemed to startle some patients so I usually explained what I was doing.
As I helped Lisa back up from the gyne table she happened to glance off to the side where I was standing. With shock in her voice she asked me, "Did that come out of me?" I quickly deduced she was referring to the anaerobic culture bottles with their nasty looking brownish culture media. I realize prostitutes have negative self-image problems, but I could not imagine what frame of mind caused her to think the bottles were from her body. She was genuinely worried.
I explained that she was looking at the culture medium and this was not a bodily substance that came from her. Her relief was immense and she thanked me repeatedly for the explanation. She asked how much longer I would be in school and told me she would ask to see me after the baby was born.
One day before senior banding ceremonies there was a note in my mailbox that Lisa was on the post partum floor and asked to see me. I eagerly hustled over to the unit only to fimd Lisa cradling a beautiful baby girl. She was glowing with pride and said she was working on a name. Time went by and Lisa faded from my memory.
Many years later I was orienting a new group of student nurses to the OR. I happened to comment that our 2 cysto rooms at the end of the hall had previously served as delivery rooms. Our OB suite with integrated delivery rooms was fairly new.
A petite, young student nurse that looked very familiar with those crystalline blue eyes remarked, "I was born at this hospital. Is this where I was born?" I affirmed her birth place and just to make conversation asked when her birthday was. "It was June 3rd." Something about the date and her familiar appearance immediately clicked, but I still could not place her. Memorable moments from nursing school are seared into my consciousness and June 4th was the date of Senior banding which occurred one day after Lisa gave birth. It took me some time to put all this together, but eventually, I learned something interesting. The young student nurse was Lisa's daughter named Colleen. I hoped that Colleen's birth had renewed Lisa's life and brought forth a new beginning. She certainly did a fine job of raising her daughter under challenging circumstances.