Images of pregnant women in the last throes of labor filled the projection screen, and sounds of childbirth--moans of pain, barked orders of "push!" and the wail of a newborn baby--flooded the room filled with expectant couples.
Sheri and Emilio Fernandez, like the other couples, watched the intense film with rapt attention, but for them it was a silent movie.
The Fernandezes, who are deaf, shifted their eyes between the screen and the ever-moving hands of a woman sitting in front of them, translating the powerful sounds into sign language.
When the film showed a nurse putting a stethoscope on a pregnant woman's abdomen, the pulse of the fetal heartbeat was translated into a beating motion over the ear. "Push!" became a hand-on-fist pushing gesture. The infant's cry was translated into fingers tracing tears down a face contorted with a silent wail.
"Forget the whole thing, I don't want to do this!" Sheri Fernandez, 21, jokingly gestured in sign language to interpreter Alicia Speare as a woman on screen panted her way through a painful contraction.
To Understand Everything
But the truth is, the Fernandezes are thrilled to learn natural childbirth and prepare for their baby, due Aug. 24. With natural childbirth, communication among the expectant mother, labor coach, physician and nurses is imperative, and if expectant parents cannot hear, then fear, frustration and miscommunication reign, Speare said.
The Fernandezes, though, will understand everything that is said, from the onset of labor until mother and child are wheeled out the door of Chapman General Hospital in Orange, thanks to Speare's unusual program, which provides interpreters for deaf patients.
Special Task Interpreters for the Deaf (STID) provides interpreters for hearing-impaired patients for all medical procedures at Chapman General Hospital and for appointments with staff physicians. It is the only hospital-sponsored program for the deaf in the county--which has about 230,000 people, or one-tenth the population, who experience some degree of hearing difficulty--and one of the most comprehensive programs in the nation, Speare said.
Health care is a particularly difficult issue for the deaf, advocates for the deaf said. There is a lower level of awareness of health care among the deaf, advocates said, because so much medical information comes through the media, and anything transmitted over the radio or television is lost to them. And if the information is written, "they have to see it the same number of times as a hearing person hears it, (for it) to have the same impact," said Johanna Larson, a community educator with Orange County Deaf Equal Access Foundation (DEAF).
The deaf are unfamiliar with many medical or anatomical words that might be used during a doctor's visit, Speare said. English, to a deaf person, is a second language, and many words--such as abdomen or cyst--may not exist in the deaf person's sign language.
When deaf patients go to the doctor, "they have no idea what will happen," said Pauline Annarino, director of Life Signs, an emergency sign language interpreter service in Los Angeles County.
"They have no basis for deciding what is right or wrong, for knowing when to say, 'Stop doing that.' They can't anticipate anything," Annarino said. "Compound that with the problem that they can't get any clarification; they can't ask: 'Is this going to hurt? How many times do I take the medication? When do I come back?' "
It is estimated that 80 to 90% of a doctor's diagnosis is based on the interchange between physician and patient, deaf advocates said. True, the doctor and deaf patient can communicate through notes, they said, but that is a long, tedious process that discourages full communication. Beside, doctors are not known for legible handwriting.
Some deaf patients will take a relative with them to interpret, but that undermines the independence of the deaf person, advocates said. Relatives will often edit what the doctor says if the condition is sensitive or embarrassing, or they become privy to information that the patient alone should have, they said. And even the best lip readers miss about 70% of what is said. advocates said.
Always at Hand
Under Speare's program at Chapman, an interpreter accompanies a deaf patient through tests, examinations, physical therapy sessions, childbirth preparation classes, labor and delivery or any other medical procedure requested, as long as it is connected with the hospital or its staff. If a deaf patient comes to Chapman General's emergency room, an interpreter is called, no matter the hour. The same interpreter stays with the patient for subsequent appointments and procedures to develop trust and rapport during intimate examinations, Speare said.
Even the operating room is not off-limits. The interpreter stays with the deaf patient through the entire surgical procedure if local anesthesia is used, translating everything that is said.