The Ghost of Labor & Delivery

Trigger warning!!!! There are some fairly graphic things described below, so please read with caution. 

You probably don't remember me. But I remember you. I remember your face, the weight of your leg, your dark brown roots showing under your yellow-blond hair. I remember the frustrated cry of your husband. I remember your baby's first breath. Her first cry. The dark purple of her soft newborn skin. Those are things that you most likely don't remember. But anyway, there is something I wanted to say to you; something that is going to be very hard to hear but very important for your heart to understand. 

Your cesarean was unnecessary. 

I say this not because I want to stir up any sort of mommy war between those who had a c-section and those who had vaginally deliveries. I say this because we are both victims, and I understand that an important step in the road to recovery is understanding the event as deeply as possible. 

So you had been laboring for what in sure felt like a long time. I don't remember exactly how long, but it was long enough that you and your family were settled into your hospital room. Your bags had been opened and Chargers were filling every available outlet. When I met you, you were sitting up just needing to be unhooked from your monitors to go to the bathroom. But you had a Foley catheter in your bladder, and an epidural in your back. Honestly I was confused as to how you had enough feeling to even get yourself into the position I found you in. 

No one had turned the epidural pump on, and no one told you that you had a catheter. It was news to you, and it shouldn't have been. Your young age is no excuse to not inform you, and that was your nurses fault. 

Later, you were having too many contractions. You were on pitocin, and I wonder if your nurse told you about that. Regardless, she didn't turn it down, and she didn't turn it off.  You were still feeling a lot of pain, pressure, and contractions. Normally this might be a helpful thing for pushing effectively, but it turned out to be a bigger problem than you could have imagined before. 

I went into your room again when I saw that your baby's heart rate was not doing well. Your nurse was already in your room, trying to turn you side to side, give you oxygen, but she did not turn your pitocin off until it was too late. During all this time you were constantly asking questions. You wanted to know if your baby was okay. You wanted to know why there were suddenly so many people in your room. You looked at your nurse and asked her if your baby was going to die. Through all of this your nurse bearly answered you. She told you it was fine, and to "just calm down" and to stay quiet. I wanted to rush over and give you the facts so you might have time to prepare yourself for the inevitable, but that isn't my job. 

After your baby's heart rate had been in the 80s for over five minutes, and trying the vacuum on the baby's head several times, the doctor finally called for an emergency cesarean. 

You were moved, and hap-hazardly strapped to the OR table. The drape covered your face because the anesthesiologist was too busy to move them. He was trying to put medications into your epidural to numb you quickly, because it was obvious you could move and feel far too much. 

I put my hands in you. I cut you. I put my fingers in between your abdominal muscles and ripped them open. At that point your leg, which you had some movement in, fell off the table. I held it with mine, and stood on one leg with your body against mine so you wouldn't fall. It is the oddest feeling, after all these years of surgery, to feel a body move under that sterile drape. It's not right. 

I tried to move the drape from your face, because all I could think about was that no matter the outcome now, you will never be able to put your head under a blanket. 

Giggling with your husband on cold nights; blanket forts with your children; peekaboo. These are things that are lost to you know. They might seem like minor things to anyone else, but I understand. I understand how it feels to loose normal things, how it makes you feel crazy and disconnected. I get that. 

You had tried to move it yourself, but were yelled at, and told that you would break the sterile field of you touched it. They yelled at you. They were panicked. They were convinced your baby was going to not be okay. You were convinced you were both going to die. 

I'm not sure who let your husband into the OR. Whoever did that was an idiot. After you were put out and the baby had been born, he didn't hold his daughter. He sat by the OR doors on the floor next to the security guard. Your husband didn't move till you came out of that surgery. Please understand that he will also have emotional scars from this experience. Hold onto each other through this. Partner birth trauma is very real, and it can cause a wide range of problems for him and for your marriage. Don't let your marriage fall apart because of this experience. 

Even in a planned cesarean, when the pain management is impeccable, I don't know how women can handle a full grown man putting all his weight on her pregnant stomach to push the baby out. But you did it without anesthesia. You tried to scream, but you could t because there were easily a few hundred pounds on top of you. 

Somehow, the anesthesiologist managed to put you under general anesthesia. Finally. Someone come and put your leg back on the table. Your baby was born. She was beautiful. She was perfect. And I want you to know that in that moment, I did my best to honor the birth of your firstborn. I wiped the mucous off her face, and said hello. I welcomed her, and told her she was beautiful. I told her that her mother loved her, and handed her to the nurse so that they could work on getting her to come around. 

After your baby was gone. The OR was quiet. We all took a few moments to catch our breaths, shake out our legs and nerves. 

The nurse that had been with you all night was on her phone. 

Later the doctor told you that in "in the future you should just cut your losses and have c-sections" and I wanted to punch her in the throat for that. 

A nurse manager asked you how you felt about the experience, not four hours after the fact. You responded that you were happy everyone was okay. You told her that you were okay.  I'm not sure if you are aware, but that response is written down and kept for some time so that staff can keep track of how they are doing. This has been shown to increase the hospital satisfaction rates.

When she reported to the doctor that you were "okay with how everything went down," I also wanted to punch her in the throat. I hope you understand how unrealistic it was to have expected you to completely integrate that experience. You don't have to stick with that response either. You can change your mind and not be okay with it. You can decide that you were never okay with it, and that you said you were because you were in shock. By some extreme psychological poweress you WERE okay with it, that's okay too. What ever you feel is okay, and that nurse had no business asking you a question like that. I could go on and on about how it is so inappropriate to ask that question even after a good experience. But that is another subject for another day. 

If you wanted to seek legal action, I imagine you might have a case. But birth trauma doesn't get the attention or validation it deserves in society or in our courts of law. 

I guess my point is this: your body didn't fail you. You are not broken. Your baby isn't and never was naughty or broken.

 

The system failed you.

 I failed you. 

I can't tell you how much I wanted to rush over and grab your hand and tell you exactly what was going down. I wish I was the kind of strong and brave person who would put my job, with a paycheck that pays for health insurance and food and a roof over my baby's head, all on the line to do the right thing. God Almighty, I wish I had that kind of courage and faith. I wish I could have told that doctor and that nurse how I felt about those comments. I should have told you. 

And I'm sorry. I want to ask for your forgiveness, but I am too ashamed. The quote "The only thing evil needs to triumph is for the righteous to do nothing" plays over and over in my mind. Your scream as I tore open your body haunts me to this day. I will never forget you. I will never forget what I did to you. 

You are so young. I hope and pray that someday, if you choose to bring another beautiful baby into this world (because seriously, you make cute ones!), you find a care provider who believes in you and who respects you enough to obtain your informed consent for every procedure and every drug and intervention. Find someone who will look you in the eye. If they tell you a drug or procedure has no side effects, RUN! That is always a lie! Even a simple vaginal exam has risks! You deserve to know, and you deserve a care provider who knows and cares. And I hope that the birth of your next baby brings healing to your whole family. 

Good luck,

Undercover 

Abuse

It's a sickening thing when abuse occurs to anyone, in any way. In my opinion, it is slightly more heinous when a Midwife or OB gets verbally abusive, and/or manipulative with a laboring woman. And since I'm a home birther, I'll speak particularly of abuse by Midwife.

Manipulation, coercion, and abuse is not isolated to hospital births. Unfortunately, there are Midwives who make birth a business, and end up treating clients as such. They push and manipulate in order to achieve what they want. Then, they justify.

A Midwife sticks her hand in her client's vagina while she's having a contraction. Client says no. Midwife says sorry, and backs off. Next contraction, Midwife does it again. Client says no again, adding a kick to the Midwife's hand.

Guess what? That's sexual assault. Client said no to vaginal penetration, Midwife did it again anyway.

There's no two ways about it. It doesn't matter if the Midwife felt it necessary, the woman said NO. Clearly, without any ifs, ands, or buts. And the Midwife may say, "I need to do this because...". Manipulation. In a situation which intervention is clearly needed, a woman is not likely to say no, because she understands intuitively that intervention is necessary. Thankfully, this only happens rarely. A woman knows when it's not necessary, but this type of assertive, abusive behavior confuses the woman who is feeling her intuition, but having authority contradict intuition.

The description of how an abuser operates:

Covert abusers are the worst and the hardest to confront. They do their abusing and controlling in a hidden, manipulative, secretive way. They say one thing with their mouth and appear to be loving and kind, but their actions are controlling...

Another:

They are in control of their actions, not out-of-control. They do not harm everyone they meet. They are very careful to abuse people they feel confident they can get away with harming. 

Another:

 They blame others for their behavior. “The abuser shifts responsibility for his actions away from himself and onto others, a shift that allows him to justify his abuse because the other person supposedly "caused" his behavior.”

The justification and shifting responsibility are particularly important in the operation of an abuser. To say it was necessary because you weren't progressing in labor, to say that it was necessary because you said you wanted to avoid a cesarean, to say it was necessary because you didn't want to tear...these all play into the deep emotions that are present at birth. And in heavy labor, rarely is a woman going to argue with these justifications. My "favorite" one that I just heard:

I am not responsible for a woman being unhappy or traumatized with her birth. If she didn't like what was going on, she should have said something.

Yep. Except often either women DO say something, and are ignored or coerced by justification, or they are too ingrained in the belief that a Midwife is the authority figure, and must know what she's doing. This is still abuse and victim blaming.

I have been abused. Emotionally and verbally. By both parents, and doctors. It's not okay, in any situation. But when it happens in your home by a care provider whom you hired because you thought she would help you lovingly through a deeply spiritual and intimate moment in your life...it's nothing less than heinous.

 

 

 

Entitlement and Birth as a Business

Today on a birth forum that I am a member of, there was an article posted about why Doulas in training (aka, totally inexperienced with actually attending/supporting women) should NOT attend births for free.

You deserve an abundant life so that you have more to offer. Your playing small serves no one. It sends the message that you are unworthy, and that what you have to give is of no value. None – as in, less than a Happy Meal toy. This is not the message befitting of the services we provide.

Ah yes. Even though you have zero practical experience to offer a woman in labor, you deserve an abundant life. YOU DESERVE. Not, "The laboring and birthing woman deserves to have a humble, experienced support person before she pays for one."

Is birth valued so little? What about the very fact that the birthing woman is providing much more to the inexperienced doula, than the inexperienced doula is providing to the birthing woman? Ah, apparently some people over on this forum don't believe this. Doulas, even completely inexperienced ones, have the RIGHT to be paid. After all, gas and childcare are not free.

Except, that's not the problem of the birthing woman. Here's where I'm really going to get opinionated:

IF YOU CANNOT AFFORD THINGS LIKE GAS AND CHILDCARE, IT'S NOT A GOOD TIME TO BECOME A DOULA. 

Chances are, if you are complaining about the cost of gas and childcare in the timeframe in which you are going to be honored with the privilege of serving women in birth...you are likely going to see being a Doula as a business. And many do make it about that. I have seen Doulas charge nearly as much as Midwives. And I am blown away every. Single. Time.

When you are in school, learning your field, you pay the school...the school does not pay you simply because you have gas, childcare, textbook, and supply costs. YOU ARE LEARNING something valuable, that you can offer to the world once you know what you're doing.

As a whole, our culture has lost so much when it comes to the fact that birth is sacred. And I will be honest and say that I abhor the modern Doula. The modern Doula seems to be doing it for one thing, and one thing only: A cool new business venture. I have seen doulas ask for a backup because they're going away for a few days when they have a client who's due. Where the HELL is the fact that the birthing mother hired *them*? Why is there such a lack of acknowledgement that a mother being comfortable with who is in her birthing space is supposed to be absolute priority?!

Birth is not a business. You don't get paid while you learn. And once you do, if it is truly a calling and not a business, you will charge only what is needed and fair, and you will still make exceptions when you can, for families who need it. Don't ever expect to become wealthy from a position that literally means SERVANT.

Again, just my opinion. And not a very popular one, I realize.

Spoiling Babies

Hey, did you know that by responding to your baby's biologically wired needs, you're going to spoil him? Did you know that by holding him too much (quantitative specifics still being calculated) you are letting him know that HE is boss, and not you?

Did you know that by allowing him to sleep in your bed, or next to your bed is allowing him to manipulate you? By you not sticking him in his own room and allowing him to cry, sometimes for hours at a time, you are letting him run YOUR life?!

Ways to make sure that time-sucking brat doesn't completely ruin your life: 

1. Make sure he knows who is boss. 
2. Don't hold him too often. Make sure he's in a swing or car seat or bassinet more than he is in your arms. Don't let him get any funny ideas! 
3. Don't feed him too often. Put him on a strict schedule for breastfeeding. Don't let his cries throw you off, he needs to learn to self-sooth ASAP. 
4. If he's crying through these things, he's trying to manipulate you. Put him in his crib, and walk and and shut the door. Again, show him who's boss! 
5. Why should your sleep schedule get fucked up, just because he hasn't learned how to sleep? That's why cribs look like lockdown cells with no roof! He can't get out. Let him learn that he has no choice but to sleep. 
6. If you're out and about, keep him in the car seat. DO NOT hold him or wear him in any hippy carrier. You're going to break rule 2. 
7. Don't worry about the hippy freaks who say his cortisol levels will be raised unnecessarily. Shit, life is stressful. The sooner he learns this, the better off he'll be. 

Babies are, after all, a huge inconvenience in our lives. The sooner they learn that we're not putting up with their manipulation, the more calm and controlled the house will be. Because that's what life with kids is. Calm and controlled, scheduled. Maybe Skinner had the right idea with the baby-in-a-box. You give them the right temperature, clean diapers, scheduled feedings....that's all a baby needs. A mother is simply an incubator, supporting the baby's life until he's on the outside. Then he only needs the basics, and nothing more.

While we're at it...I was born in a time where car seats and seat belts weren't used. I was raised in an extremely emotionally abusive household with two parents obsessed about their own lives to worry about mine, other than control. I drank and drove as a teenager.

I lived. And that's the bottom line, right? As long as the kid is fed and housed...everything else is inconsequential. 

"Butter Birth"

If you've been in the birthy world long enough, you've heard the term "butter birth". Essentially, this means a labor and birth that was smooth as butter. A labor where mom hardly had any pain, a very short pushing stage, no extra bleeding, and probably not any tearing. Butter birth.

While I get the sentiment and glee over a "butter birth", I think that perhaps it does a disservice to women who don't have easy births. I don't have easy labors or births. I have really sucky, mostly excruciating and long labors. Would I LOVE to have a "butter birth"? You bet your ass I would. Just ONCE, it would be nice to have an easy-going labor where I'm in labor for less than 24 hours. And no, I'm not a mom who counts the early contractions that you can ignore as labor. I'm talking the, "gotta be up and moving, this shit hurts!" point in labor when I start counting. I'd love to be in labor for less than 24 hours, NOT have my back feel like it's splitting in two (thank you, asshole with no insurance who rear-ended me, leaving me with permanent damage). I'd love to only have the fetal ejection reflex for only a few minutes (rather than hours) before my baby slides out into my waiting hands.

That's not in the cards for me. I'm done having babies now. But I have to wonder, for women who are physically and emotionally scarred by how tumultuous their labors are...can there ever be a peace about variations in normalcy? Sure, we get the "I don't know how you did it, you're amazing!" compliments. But really, I'd much rather a "butter birth" than the bravery comments.

I recently saw a woman complain about birth stories. She searched "Peaceful birth stories", and was irritated that some of the stories contained long, difficult labors. She missed the point entirely...and I think part of it was due to this idea that peaceful = butter birth. You see, while my labors completely sucked, they were peaceful. I was at home. I didn't have strangers coming in and out. I didn't have anyone freak out because I was past my due date with a HUUUUGGE baby (10+ lbs), or because my labor was long. I didn't have an IV. I didn't have anyone making decisions FOR me. To me, after some of the experiences that I've had in the hospital, this was the epitome of peaceful. Even with the sucky labors, and really difficult births.

But women don't want to hear about that. We have this idea in our culture that a good birth is the "butter birth" with a relatively small baby.

I really believe that this is a part of the problem with women thinking that they can't possibly have a birth without intervention and drugs. Because they don't have butter labors. They don't have butter births. Therefore, it's not even worth trying. 

The Know-It-Alls

Isn't is just so much fun when you post something like this on Facebook: 

And then you get the know-it-all friend(s) who decide to tell you just how dangerous co-sleeping is, how breastfeeding doesn't always work out (didn't for her, after all!), how cloth diapering is just a fad and just as bad as disposables....oh, and don't be crushed if you end up with a c-section, even though you're planning a natural (home, did she miss that?) birth. Because, you know, "things happen". After all, it did to her.

Then another friend jumps in and says that she agrees with most, but that co-sleeping is absolutely positively dangerous, because it increases the risk of SIDS. Because, she read that one article. And the AAP recommends against bed sharing. And March of Dimes says, "Co-sleeping may..."

Ah. Yes. The non-researchers. We all know at least one. That friend who either doesn't do any actual research at all, and goes off of online articles or what a friend/family member/neighbor told them. Or, they say that you can't trust research because you can find studies that say anything you want them to.

MmHmm. It's funny that when we follow the way of life of the generations before we had hospitals for birth, or this idea that babies need to learn independence and sleep in their own room....things are generally safer and healthier!

Natural birth outside of a hospital? Fewer complications, fewer injuries, and lower cesarean rates.

Breastfeeding? Healthier baby, stronger immune system, more attached bond.

Co-Sleeping? Lower rates of SIDS (when done correctly), ease with breastfeeding at night, and a more secure attachment.

No shit! It's amazing!

Our culture is so backwards. Our culture belittles and dismisses women who have a grasp on biological parenting, even though they're doing things in ways that science and history have shown to be best for babies and families. Home birth and even simply natural birth is considered extreme and dangerous. Co-sleeping is considered "enabling behavior", spoiling, and dangerous. Extended (aka, full-term) nursing is considered perverted, instead of normal.  If you wear your baby in a sling instead of keeping them in the damn bucket seat all the time, you're considered a hippy freak who is spoiling her kid. If you cloth diaper because you'd like to save money, save waste, and not expose baby to the chemicals in disposables, you're paranoid and ridiculous.

And the sad part is, us paranoid hippy freaks don't just get crap from other moms. We get crap from the media, from doctors, from nurses, from family members...hell, sometimes from the stranger that happens upon us during one of our hippy freak rituals.

If only our culture valued natural, biologically modeled parenting.

The "Natural" Cesarean

Looking back on my fifth delivery, I get really upset. Some might say that I am nit-picking, as MOST of my wishes were respected. I wasn't supposed to have another cesarean. I was supposed to have another HBAC. I had already had two HBACs. However, a situation arose that necessitated a cesarean delivery, much to my heartbreak. I was able to advocate for quite a few things, like absolutely no vaccines or heel pricks for ANY reason. I wanted to see him immediately, and I wanted my husband with him at all times.

I told the OB, who had seen me a few times, that I wished to have delayed cord-clamping, and skin-to-skin. He told me that was not possible. I was in a position to be able to state my wishes, but didn't have the strength or time to argue (long story...). He also discharged me less than 48 hours after surgery.

I look back on it, and I am convinced that he was punishing me in some way. I read about "natural" or "family" cesareans all the time. I know delayed cord clamping CAN BE DONE. I know skin-to-skin immediately after a cesarean CAN BE DONE. I also know, looking back, that while I really really wanted to get the hell out of the hospital...my body wasn't anywhere near ready for it after the beating I had endure *before* the cesarean, and then surgery on top of it. But he discharged me less than 48 hours later.

I know all of the, "You should be grateful" thoughts and comments. But, it could have been done better. Period. He could have listened to what I needed. I think his ego got in the way. He was only willing to go so far for this stupid woman who "tried" to VBAC at home (and did with previous babies!). I read these beautiful (as beautiful as major surgery can be) stories of cesareans that were done gently and immediate bonding facilitated. And it makes my heart hurt.

Not that  my baby and I didn't bond. We absolutely did. Probably one of the best out of all of my kids. And I was heard, mostly. I have several regrets about my last labor and delivery, all of which I think will haunt me unless I try to let go. But that's pretty hard sometimes, eh?