In the waiting room - Page 4
From Griffith REVIEW Edition 17: Staying Alive
© Copyright Griffith University & the author.
Written by Sarah Kanowski
THERE'S A KNOCK ON THE WAITING ROOM DOOR, and a cheery middle-aged man pokes his head around the corner. It's Rob, the medical rep who has come to spruik the new vaginally inserted contraceptive, NuvaRing, that had been on TV the night before. Carol invites him to take a seat but he's confused and a little put out by the number of women in the room. "This presentation is just for staff," he says, looking around.
"That's alright, love," answers Carol. "The others won't listen. So how's it work?"
We sit back expectantly. He is less confident than a moment ago, but starts his pitch. The questions and comments come from every direction: "Can you feel it?" "When do you change it?" "It costs too much!"
Carol asks if the ring comes in other colours, and Rob answers no, that their test groups showed people were put off by anything other than a clear ring. "Well they didn't test it around here then!" Sharon exclaims to woops of laughter.
Carol agrees, saying that glow-in-the-dark condoms are always the first to go in this clinic. She suggests they release a model with spikes.
Compared with the GPs Rob would usually see, this is more like a hens' party. But his nervousness has subsided as he sees how good-natured and genuinely interested – even enthusiastic – his audience is. He takes the plunge, discussing the mechanics of sex. He explains that if your partner falls into the small percentage of men who can feel the ring and don't like it, then it is possible for you to take it out for up to three hours while you have sex. Carol comments that if you're lucky enough to have sex for three hours you probably won't care if you get pregnant.
He ends with a caution about the small group of women to whom the contraceptive ring isn't suited – those who've had prolapses or who have unusually large vaginas. Kerri-Lea looks shocked and Sharon's face falls. "So if you've had six kids and your muscles are gone to buggery it won't work?"
Rob considers such a client – one unlikely to have appeared in NuvaRing's trial groups. "No," he concludes.
"Well there goes me then," she shrugs.
An hour or so later, Kerri-Lea has returned from seeing the doctor and is sitting back on the couch with a cup of tea. She turns to Carol, "So love, what's all this about big vaginas?" Seeing it's a genuine question, Carol – without missing a beat – explains that women are differently shaped all over. Steven looks uncomfortable but Kerri-Lea and Carol are determined to sort this out. Once Kerri-Lea is satisfied with the anatomy briefing, she announces they'll go and wait outside for Minna to give them a lift home.
IT'S PAST MIDDAY AND THE NUMBER OF WOMEN and children in the waiting room are starting to thin out. Jana arrives to show off her eight-day-old baby girl, Skye. Kathy has come in to see whether she's needed and exclaims how much mother and daughter look alike. Jana is concerned about the gunk in Skye's eye and Carol explains how to give her a salt-water wash. Folded into the corner of the opposite couch and watching the conversation is Amanda. She's a few days past her due date and I ask her whether she's ready. She turns her large eyes towards me and shakes her head.
"Are you scared?" asks Carol.
Amanda nods.
There are good reasons for Amanda to be frightened. She is sixteen and this is her first baby. She knows already that it is a boy and that he will be born with a cleft palate. Carol is running through what will happen after the birth, explaining that the baby will be taken straight to the hospital's Neonatal Intensive Care Unit. Amanda stays silent, occasionally drawing small circles on her belly with a finger, while staring at Carol.
Carol asks if Amanda would like to go with her to meet the staff at the hospital. She nods, and Carol makes a time for Monday. She repeats that all of Amanda's information is on the registration card at the hospital and it directs them to ring her as soon as Amanda arrives. "But if you start feeling pains over the weekend you ring me anytime and I'll come, okay?"
Amanda nods again. Jana is rocking her baby girl. "This one's birth was horrible," she says. "Even though it was my second and I thought I knew what was happening, I haemorrhaged."
Amanda's eyes widen.
"I'll come and show you my card from the hospital," Jana tells Carol. "I want you to go through it, so I know what happened."
Kathy calls Amanda in to her room, Jana takes Skye home, and Minna and the Aboriginal Health Worker, Veronica Henry, return from dropping off clients. The women discuss Amanda. "Her home's not good," Minna says. "It's really overcrowded."
"And her mum's volatile," adds Carol, "kicking her out and then letting her back." Cindy mentions a supported hostel she knows about in Parramatta which will let both Amanda and her boyfriend stay. Then Carol asks Minna how she keeps her AMS polo shirt so white. A lively discussion about laundry and the possibility of getting some new uniforms follows. Everyone agrees that the Health Education Team members have good shirts.
THE 2005 AMA REPORT CARD ON INDIGENOUS HEALTH focused on the rates of low birth weight among Aboriginal and Torres Strait Islander babies, arguing that "the solutions to premature and low birth weight babies are relatively straightforward". In practice, though, there is little that is "straightforward" about the social changes required to really improve maternal and child health among Indigenous Australians. Even in an antenatal program as grounded in the community as AMS Western Sydney, health outcomes still have a long way to go to approach the norms of white mothers. Yet this antenatal waiting room is providing benefits that go far beyond the physical. Whatever else these women have had to confront in their lives, in their families, schools, or with their partners, here they are listened to and encouraged. The "health outcome" of sharing a cup of tea, of having an open ear to listen, and a hug if you want are difficult to graph but they are life-changing nonetheless. And it sure beats leafing through old copies of New Idea.
Amanda returns from seeing the doctor and Carol talks to her about the possibility of the hostel, saying she and her boyfriend are going to need all the help they can get "when that little baby comes". Carol takes Amanda over to monitor her baby's heart, explaining to Minna how to operate the machine as she does so.
Suddenly the room fills with the rhythmic wet squelch of a foetal heartbeat. Carol turns around, smiling. "Isn't that a beautiful sound?" ♦