Improving Quality of Health Services in the Worst of Circumstances "Take me to surgery!" Sofia screams the words, battling after the hours of pain she has endured. She lies on a small bed in the Cacuaco Health Center maternity ward, where two nurses are doing their best to help her. Sofia arrived several hours earlier, brought in after laboring in her home for hours. Even though she was given three doses of the labor-inducing drug Pitocin, she has not given birth.