Midwife Rachel 'Bambi' Chalkowski tells the 'Post' about her work in "the most beautiful career."
By JUDY SIEGEL-ITZKOVICHBambi midwife(photo credit: Courtesy)
The woman nicknamed "Bambi" has done the same thing tens of thousands of times over nearly half a century at Jerusalem's Shaare Zedek Medical Center - but she never tires of it and says every event is different. Rachel Chalkowski enjoys delivering babies so much that despite her official retirement three years ago, she still goes to the hospital two nights a week to bring more souls into the world.
"Nature is pretty democratic," says the French-born Chalkowski, who is called Bambi by almost everyone except her British-born husband Moshe, an educational director at the city's Neve Yerushalayim college for women. "Every human being begins life in the same way. Once I hear the cry, it's a big miracle to me each time. It's a new life, totally original."
Given her gentle touch with newborns, Bambi is a suitable moniker, but it came from when she was a young nurse at Shaare Zedek in the 1950s, and there were two others named Rachel. As her maiden name is Bamberger, Bambi was a natural substitute to avoid confusion.
Last month she was the guest of honor at Shaare Zedek's annual fundraising dinner at the Inbal Hotel, whose proceeds will go to further develop the hospital's Wilf Woman and Infant Center. Bambi, a haredi woman who herself was not blessed by children, adopted with Moshe a young girl named Michal who is now 40 and has two children. "The kids call us 'Grandpa' and 'Grandma.' Michal was my husband's student. We have a big family, as my siblings live in Israel and have children and grandchildren; I don't feel so much that we are childless," says Bambi in her very modest apartment in the capital's Givat Shaul quarter. "Our home is never empty."
BAMBI WAS born in Paris in 1939, and the family moved from one place to another to escape the Nazis. Her parents had two daughters and her mother was pregnant with their brother in 1944 when their father was caught as he went to the Swiss border to check if Jews were escaping. He was murdered in Auschwitz. In 1954, when Bambi was 15, she told her mother she was determined to be a nurse in Israel. Her mother agreed, and having heard of Shaare Zedek and its director, Dr. Falk Schlesinger, she insisted that was where she would study. The teenage girl set sail for Haifa, where an uncle (an obstetrician) and aunt lived.
"I had always wanted to be a nurse. I don't know why. I suppose it was a real craziness. I was attracted to medicine, but didn't have the patience to sit and study to be a doctor," she explains. Bambi went to the Beit Ya'acov high school in Haifa and then directly to Shaare Zedek, where her great-grandfather (Rabbi Bamberger) was one of the five founders more than a century ago. "He had great vision, because Jerusalem had Christian mission hospitals and Jews avoided hospitalization because of that."
Bambi earned her nursing degree there and then took a midwifery course. She never looked back. She was reunited with her mother in 1972 when, at the age of 60, she came to live in the apartment above the Chalkowskis in Givat Shaul.
"Blood," she says, "never bothered me. I couldn't look when doctors removed fingernails for medical reasons, as I had an association with what the Nazis did. But the delivery room is usually a joy. It's more difficult to be in the emergency room after the wounded come in from a terror attack."
When she started at Shaare Zedek's old Jaffa Road building (opened in 1902 and now housing the Israel Broadcasting Authority's management), there were only 80 to 100 deliveries per month. Now there are more than 1,000, making it the second-busiest obstetrics department in the country (after Soroka University Medical Center in Beersheba.)
OVER 80 percent of births are normal, with no difficulties for either the mother or the baby. But there can be complications, struggles or bad news. If a baby is born with Down Syndrome, the nurses are supposed to have a senior physician tell the parents. "But at night, weekends or festivals, there is not always a senior doctor there; if the midwife doesn't tell them, there's a chance the father will go home without knowing. I don't think you have to tell immediately, but you must at least hint that something is wrong," Bambi says.
"Women over 40 fear Down Syndrome; that's the first thing they ask at that age. They can see it on our faces. But there are also Down Syndrome births to younger women," says Bambi. "Today, with ultrasound scans and other tests, there are fewer surprises. But not all women agree to be tested. A lot of studies have been carried out on the best way to tell parents, but almost every couple it strikes have complaints about how they were told, because they have to blame somebody. Yet today, few Down babies are abandoned in hospitals. There are wonderful educational interventions that can make them productive citizens, and they turn into lovely children."
If a fetus is seen to suffer from anacephaly (a severe central nervous system defect in which the brain is missing,) even the strictest rabbis allow an abortion, which they do not approve for other defects and diseases.
But the most difficult delivery for Bambi is when a baby has no clear gender. "It's happened two or three times in my career. It's terrible. You don't know what to tell the parents - whether it's a boy or a girl. You first have to do hormonal, physiological and chromosome tests. I told the parents there was a problem; I couldn't not say something. If a baby dies, it's painful, but God knows how to give comfort. Most couples will have another."
Only about one in 10 babies at Shaare Zedek are delivered by cesarean section - a lower rate than in many other hospitals. Bambi denounces the US doctors who prefer surgery because it is more convenient than being on call. Vaginal births are better in most cases. "We have had discussions on what to do if a woman demands a cesarean even when there is no reason for it. If there is such a request based on past trauma, the doctors are more lenient, but if the woman just doesn't want a vaginal birth, we try to dissuade her." Shaare Zedek midwives and obstetricians encourage women even after two cesareans to have a vaginal birth if there are no complications.
Bambi is a strong advocate of epidural anesthesia to relieve the pain of childbirth. "I am an old woman now, and I don't like to see women suffer. Today, our anesthesiologists do over 500 epidurals on women in labor each month. We try not to make them wait." The delivery rooms‚ staff - headed since Bambi's "retirement" by Hava Hacham and her deputy Naomi Meir - are liberal when women ask to spend time during labor in a jacuzzi or want to bring along a doula (coach) for support. "There are excellent doulas who help the woman, and bad ones who try to take over our responsibilities. I have never seen another country in which doulas take such authority."
Bambi is strongly opposed to giving birth (intentionally) at home, even under the best of conditions. "We saw some wives of men living in Samaria outposts who wanted to give birth at home as a matter of principle. We got the babies and saw the complications, some of which endangered life."
As for having babies while swimming among dolphins in Eilat, Bambi regards that as a mishugas (craziness).
TODAY'S medical centers are more liberal than in previous decades. Midwives were always more flexible than the doctors. But Bambi rules out delivering while the woman sits up or crouches. "It makes it very difficult for the midwife. I don't think it's better for the baby. It's not gravity that speeds up birth."
Despite her deep love for the profession, Bambi worries about the growing number of lawsuits against staff in delivery rooms. "You feel a sword of Damacles over your head. The public think every baby has to come out easily and be healthy. That doesn't happen in the real world. Obstetrics is being run by the courts; as there are so many lawsuits, doctors are forced to perform defensive medicine."
As an Orthodox Jewish hospital that has many haredi and national religious women (and about 12% Arabs) coming there to have babies, Shaare Zedek has a curtain in each delivery room behind which the husband can stand at the actual birth, as they must not see the blood or their wives from the bottom (but can stand next to the women's heads). "Most haredi men and now lots of national religious men prefer to stand behind the curtain. Even some secular women don't want their men right there," Bambi says. She doesn't recall a birth in which a woman - at the peak of labor pains - actually cursed her partner for getting her pregnant.
Among Arab women, "they are either very quiet or very noisy. Ethiopian Jewish women are usually very quiet. And Russian Jewish women usually know how to cope with pain. But many Americans, especially the younger ones, are either very spoiled, wanting to feel no pain, or want natural births with no help at all."
ALTHOUGH RETIRED, Bambi wanted to continue working as a midwife part time - "not during the day, as at night there are no medical students; it is pure midwifery." After almost five decades at Shaare Zedek, she has delivered the grandchildren of women she delivered early in her career. "If something very sad occurs, I will cry. It is very rare that a woman dies in the delivery room - when that occurs, the woman has a serious disease, such as heart disease or cancer."
Although Bambi works at the hospital "only" two nights a week, she is not unemployed. Even before her official "retirement," she established the "Bambi Matan Beseter Fund" to help needy people. "I met all kinds of poor people at the hospital, women who didn't have the basics for their babies," she recalls. Gradually, she built up a cadre of donors, whom she solicits by going on fundraising trips to the US twice a year, and with help from volunteers in various parts of the world now raises more than $1 million annually for the fund, which is headquartered in the tiny Chalkowski apartment at 3 Rehov Azriel in Jerusalem's Givat Shaul quarter.
It is clear from looking at the old apartment bloc - which goes back five decades and is finished with stucco rather than the conventional Jerusalem stone - that the Chalkowskis haven't put any funds into their personal property. The furniture in the tiny flat looks as if it hasn't been changed since their wedding, with the old bookshelves filled with religious tomes. The personal computer, screen modestly covered with an embroidered cloth, is the only sign of modernity. Although Bambi earned a very respectable salary as director of the delivery rooms for so many years, she is clearly not driven by a desire for comfort.
"I turned off the phone during our interview," she says matter-of-factly, "because if I hadn't, we would be disturbed by constant calls from people seeking help." As it is, several times there is a knock on the door, followed by people walking right in to ask for money or eyeglasses.
"We grew up as children in great poverty, although I didn't really feel it. After the war, we received packages from an American family 'matched' to us who for 10 years donated money and things. So I knew what helping and taking responsibility for others meant," Bambi recalls.
"During the Yom Kippur War, Jews abroad wanted to help. My sister who lived in Switzerland asked what she could do, so I suggested starting a charity project. She and her husband 'adopted' three Israeli families. I have seen a great deal of poverty, and in the past 20 years, the gaps between rich and poor have widened."
She sees the gap especially in health services. "There are many people with cancer who can't afford co-payments for oncology drugs, and disabled children and their families don't get enough state support. This used to be a socialist country, but not anymore."
Bambi decided early on not to buy food with money her fund receives; the logistics of storage and distribution are too complicated. Instead, she gives money or coupons good at local food stores. "Just for the High Holy Days we spent $130,000!" Sometimes she helps pay the rent or electricity bills for desperate people recommended by social workers, teachers or rabbis. Of course there are always people who are not needy but beg anyway. "One has to be careful of imposters, but it's difficult to know. Some people have enough money to live on but just don't know how to manage," says Bambi. She also tries to help people find work, but "when they are mentally ill, this is very difficult."
Bambi strongly favors haredi men going out to work for a living, as her husband did, and not just studying Torah and leaving the child rearing, housekeeping and wage earning to the wife. "Those men who learn seriously may be justified, but if they don't, it's terrible. But things are changing, and studying part time is becoming more socially acceptable."
Bambi was not enthusiastic about being honored at the Shaare Zedek banquet. "I didn't really want it, as when I retired they made me a big bash," she says. "But Moshe said to go ahead if it was for the good of the hospital." The round tables were decorated with dolls and other baby toys, and over the balloon centerpieces hung mobiles with photos from the obstetrics department.
Rounding up the words of thanks was a mother of 15 children, all delivered by Bambi, who said: "You know, I don't know how to give birth without you being there." There was a "live feed" from the delivery rooms during the dinner, and two women interviewed during labor delivered a singleton and twins between the first course and dessert - without delivery being induced.
"Being a midwife," says Bambi, "is most beautiful career in world."
Rachel "Bambi" Chalkowski can be reached at bambich@zahav.net.il, Rehov Azriel 3, Givat Shaul, 95477 Jerusalem. Telephone (02) 652-6721.
