To Push.

The tale I will tell you relates one of my funniest and most embarrassing moments as a midwife.  My four years of high school Spanish coupled with 2 years of college Spanish allows me to understand more than I speak.  Therefore, I have just enough Spanish in my brain to make major flaws in my communication while thinking that every word I'm saying is correct.   

As a Student Nurse Midwife finishing up my clinical rotation in a Norfolk, VA hospital, I was lucky to work with women and families of many flavors.  Some of those families that chose to give birth in the low-intervention unit desired water birth and low-tech care. Some families chose the unit because it felt more like the birth care with midwives that they were used to in their home countries of Europe or Central/South America.  One family stands out in my mind as exceptional--not because of the beautiful way they gave birth, but the grace and humor they exhibited as I insulted the mother during her labor!

Near the end of my clinical rotation I was caring for women on my own.  This would be one of my last births as a student and I had met this wonderful family during their prenatal course.  We were in the same boat--they understood more English than they could speak and I understood more Spanish than I could speak.  Usually, the family always brought an interpreter to their visits, but on the night of their birth, their family member interpreter was at home watching the other children.  After admitting the couple to the birth unit, my preceptor asked if I was confident enough to care for them without her oversight in the room.  I jumped at the chance to be independent and told her I would call as we got close to pushing.  

The beautiful Latina woman labored quietly in the tub.  Her husband was always a few feet away, wearing his best jeans, a pressed Western shirt and his cowboy hat.  Not many words were needed or exchanged. A gentle touch and quiet looks of confidence and assurance were displayed.  As the mother felt the urge to push, she wanted to go to the bed and to lay down.  I called my preceptor from the call room and a nurse to come assist for the birth. As the woman laid on her side, her leg rested on my shoulder as I crouched on the bed. I desperately searched my brain for the Spanish verb "to push."  Was it empujar? Pujar?  Putar?  Yes!  It was putar!  

With all the compassion and encouragement I could muster, I conjugated my Spanish verb, "Puta bien.  Puta fuerte, mama!"  Her eyes met mine and widened as I could see a little bit of her baby's head with her push.  As I encouraged his wife, the father moved closer and took off his cowboy hat and covered his face. "Oh, he's shy or getting emotional," I thought, as I saw his shoulders shake.  The rest of the birth team arrived and prepared the setting.  The strong laboring woman and I kept our eyes locked as I continued to quietly encourage her pushing with, "Puta muy bien....  Puta mucha fuerte! Puta despacio....," as her baby made his way into the world.  Little did I know, but putar and the verb conjugation puta was NOT the correct word.  

One week later the family came in for a postpartum visit to the clinic.  They had specifically requested me!  I felt like a real midwife!  The family brought in their interpreter and their new baby, along with a beautiful bouquet of flowers for me!  And then the interpreter told me the family's rendition of their birth story with a smile. I was incredulous. What?!  I called this beautiful mother a "strong bitch," a "good whore" during her labor?!  I was mortified and embarrassed!  The father assured me that when he took his hat and covered his face, he did so because he was laughing so hard he was crying.  The mother said that she could tell how much I cared about her because there was so much love in my voice, even when insulting her.  The gift of flowers was to show how much my kindness and care meant to them.  They had told their entire family this birth story and they said they had never laughed so hard in all of their lives.  It goes to show that how you say words, not just what you say, matters.  

Now I know the Spanish verb empujar means "to push."  I will never forget.  But later, I had some confusion over the words "cabello" and "caballo."  One means "hair" and the other means "horse." Saying that I see a horse in a woman's vagina, versus seeing her baby's hair, can literally make her laugh her baby out!  But, that is a story for another time.....


Tracy Ryan