Tuesday, March 24, 2009

De-Briefing Tool (Part 1 Question 2)

What happened in the events leading up to the birth?

My pregnancy was never easy. It was unplanned. My husband didn't want to be a father. He sucked it up, and accepted it, but he was never supportive, excited, or happy about it. It was stressful knowing his feelings on the subject, but I just kept plodding along.

At 13 weeks, I had a scare. I had some spotting over the weekend. About the time I thought I should go get it checked out, it stopped. I went to the doctor right away on Monday morning. He did an ultrasound, figured that some blood got trapped behind the placenta, and put me back on the routine prenatal visit schedule.

At 19 weeks, I had my "big" ultrasound. They diagnosed me with partial placenta previa. Since it was still early, I knew there was a possibility that the placenta would move, but I started researching c-sections. I put off my childbirth classes until I could find out if it had moved. It seemed silly to spend all of that money only to end up with a c-section.

At 27 weeks, I went in for my partial placenta previa follow-up ultrasound and the one hour gestational diabetes screening. That night, the doctor called me at home. I had failed the one hour test, and had to schedule the three hour test. I failed that one too, so off to the dietitian I went. No candy, no cake, no ice cream, for Pete's sake I'm pregnant, but I can't eat anything but vegetables and meat. No more eating cereal for my bedtime snack. No more drinking OJ. Nothing. It sucked. The good news was that the placenta had moved, so I'm back to looking at a vaginal delivery. This is also the time when the doctor first mentioned that he "didn't think I'd make it to 40 weeks". What a crock, of course I was going to 40 weeks. I had been 3 weeks late, and I expected that peanut would be 2 weeks late as well.

Because of all of the GD issues, I started seeing the doctor weekly instead of bi-weekly. We finally got to week 33, and he told me that I could skip week 34's visit. Woohoo! I went to my family baby shower, and after I got home I noticed that I was really swollen. My legs were the size of watermelons. My husband hounded me to call the doctor, so Monday morning, I give him a call. I left a voicemail for the nurse, and not an hour later, she calls back. COME IN NOW! I'm thinking, it's just some swelling. Everybody swells up at the end of their pregnancy, what's the big freaking deal? But, as a dutiful, if resentful, patient, I trot my 34 week belly into the clinic. I walk in, and got on the scale. I gained weight. Finally, 34 weeks had gone by without me gaining any weight. I'm thinking I'm finally acting like a pregnant woman. I sit in the chair, they take my blood pressure, and it's high - too high. All of the sudden, he's telling me to go immediately to the hospital for an NST - what the heck is that? I drive up to the hospital parking lot, and call my husband in tears. I don't know what's wrong. I'm at the hospital. They're going to do some tests. I'm scared out of my mind. He tells me he's coming, and I head up to Labor and Delivery. I get to the desk. No one from the clinic has called, I'm trying to remember what the doctor said to have done. They get me into a room, hook me up to the monitors, and I just sit there alone, staring at the TV, crying, and hitting the joystick thing-a-ma-jig when peanut kicks. My husband calls, he's at the hospital, but can't find me. They didn't "admit" me as a patient, so the reception desk is useless. He finally makes it up to the floor, and into the room where I am. The doctor comes in, and says no more work, stay home, keep my feet up, no anything. Great - NOT. He says they'll induce, but they want me to make it to 37 weeks. He's kind of vague, and my husband hates him on sight. I'm frustrated because this wasn't part of my plan, but I'm a good girl, and head home.

My husband arranges for my in-laws to take the dogs for the remainder of my pregnancy. They're German short-hair pointers, so extremely energetic. There's no way for me to stay off my feet if they're at home.

I hang out at the house, watching Dr. Phil and Oprah. I'm bouncing off the walls with boredom. I feel like I have nothing to talk about. My husband keeps asking me for answers on when the baby is coming, but I don't know, and the doctor is vague. I only get out of the house twice a week. Once for the doctor appointment, and once for the NST.

A couple of weeks go by, and finally we get my induction date. My best friend comes to the house to help me with my "birth plan". What birth plan? This isn't the spontaneous experience that I wanted. I'm going to be hooked up to every monitor imaginable, there are no more choices to be made. I tell her that all I want is to walk out of the hospital as a healthy mom with a healthy baby. Whatever we have to do we'll do.

Friday, March 20, 2009

Memory of Pain linked to Childbirth Experience

http://www.foxnews.com/story/0,2933,508961,00.html

I saw this article the other day. I found it interesting that women who have rotten birth experiences tend to remember their pain at the same or a worse intensity than women with positive birth experiences. It only takes me moments to remember the pain I experienced. It definitely hasn't diminished with time.

Wednesday, March 18, 2009

De-briefing tool (Part 1 Question 1)

I found a link to a blog that defines some questions for de-briefing from your child's birth. I thought that they were pretty good, so I thought I'd answer them on here.

Part 1: How was your birth?

1. What was your birth like for you?

Well, my pregnancy wasn't easy. I felt isolated before I ever got to the delivery room. When I took my childbirth education class, I was the only person who hadn't gained any weight. I was the only person who had gestational diabetes. I was the only one who had been forced to consider a c-section. I knew then that my pregnancy was far from normal. The last four weeks leading up to my delivery were frustrating. I hated being stuck at home. I hated not working. I hated having my dogs shipped off to the in-laws because they were too much work for me to take care of them. I hated being trapped. I hated not being able to eat. I hated being pregnant. I hated knowing that I wasn't going to have the birth I wanted. Don't get me wrong, I was resigned to the complications. I acknowledged, and still acknowledge, that they were real. I was willing to do whatever it took to have a healthy baby, but it doesn't make it any easier to handle the emotions of watching your dreams fade before your eyes.

For me labor wasn't that bad. Since I had resigned myself to the induction, the tubes, the wires, the monitors, etc. I didn't find it to be very traumatizing. It went the way I was expecting it to happen. I was trapped in bed, but I knew that. I had lots of tubes, but I knew that too. There were monitors everywhere, but after having NST's for the four prior weeks I knew about those too. Truthfully, I really didn't find it very painful. That may piss some people off, but to me it wasn't that bad. I was frustrated that information didn't seem to be flowing smoothly between the nurses at the hospital and the doctor at the clinic. I was also frustrated about justifying, arguing, whatever you want to call it with the anesthesiologist over the epidural. However, neither of those things contributed to my PTSD. I was irritated that the nurse didn't believe me when I told her the epidural wasn't working. It's not like I wanted her to do anything about it other than mention it to the doctor. I remember the contractions piling one on top of the other. It seemed like there was no break from them, but I just concentrated on the fluorescent light fixture, and breathed through them. I remember one of the nurses offering to dim the lights, and I was pretty emphatic about wanting them left on. Other than the bathroom, the only thing I could see while lying on my right side was the light fixture. I needed the focal point to center my breathing to ride over the pain of the contractions. I remember feeling like it was time to push. It seems weird that everyone believed me when I said that, but no one believed that the epidural wasn't working. I pushed, and pushed, and Mel asked me if I wanted help. I told her yes, and she told the nurse the next time she came in. It seemed to take forever for the doctor to show up with his handy dandy vacuum. I remember him asking if I was okay with that, and I answered yes. I remember tearing and the feeling of relief when my daughter slid out. I remember being exhausted and collapsing on the bed. There were several frustrations and some irritations, but overall it was about what I had expected. Not what I wanted, but what I resigned myself to when I realized that the complications had derailed my plans.

The real problems started after my daughter was born. I remember thinking, wow, I'm a mom. I knew it was going to happen, but there's something kind of odd about having them place a new baby in your arms. I was relieved, anxious to spend time with her, and introduce myself. However, I was completely repulsed by all of the goo and blood covering her body. At that point, I really wanted them to clean her up. I started feeling woozy. Just a little bit off. I was about to ask a question about the way I was feeling when the nurse asked if I wanted to hold the baby. I said no. I knew something wasn't quite right, and I was afraid to hold her at that time. Mel brought her over to me, and I reached out my hand. PAIN! It shot through my whole body. I've never experienced anything like it. Everything went black. The pain consumed me. It was in me, around me, smothering me. I couldn't scream. I was trapped by it. I clawed at the sheets. I tried dragging myself away from it, but I lost the battle. The pain was inescapable. I heard snippets of conversations. We're going to need to go to surgery... Where the hell are they... What's taking so long... It's about time you got here... The sides of the bed snap up. I'm moving fast down the hallway. The lights were beaming down on my eyelids, they're moving me to a hard surface, they're poking me, and then nothing.

Some one's talking to me. I can't focus. I just go back to sleep. I hear people talking again. She won't be able to breastfeed. I can't stop shaking. They're piling blankets on top of me. What happened?

Tuesday, March 17, 2009

How do we change the culture of birth?

Sunday morning, I got up early with Peanut and the dogs. We all settled down in the living room, and I turned on the TV. There's not much to watch on Sunday mornings, so I chose a re-run of 90210. It just happened that this episode focused on the birth of Steve's daughter. I found myself struggling to watch it because it hit too close to home.

Supposedly, Steve's wife needed an emergency c-section. The doctors come tearing in, ignoring Steve's requests for more information, and hustle his wife out to the operating room. A bit later, the doctors come out to tell him he has a baby girl who's in the NICU, and demanding that he signs some consent forms or his wife is going to die. He tries to ask questions, the doctor brushes them aside, and demands he sign the paperwork. They don't discuss options, diagnosis, or risks. Just sign the blankety-blank thing. One of the next scenes is in the hospital room. His wife's coming around, and is asking questions, but Steve doesn't really know. He just keeps giving her this vague answer, you lost a lot of blood.

There's so much wrong about this episode, but there was no outcry when it was first aired. No one yelled and screamed about informed consent. No one freaked out over women not being told exactly what had happened. Yes, it's a TV show. They're allowed some dramatic license, but our culture is so accepting of this type of treatment being okay.

It's not okay. Women aren't incubators. We're autonomous human beings choosing to reproduce. We're entitled to true informed consent. We're entitled to respectful, non-coercive information about the complications. We're entitled to time to process, and choose a course of action. However, that's not going to happen as long as we, as a culture, continue to allow doctors to get away with this type of treatment. We'll classify it as emergent, and batter everyone down until they submit.

So, how do we change it? The attitude is so pervasive, that it's like putting out a forest fire with a garden hose. How do we open up the minds of pregnant women, their support people, and the nurses, midwives, and doctors who are caring for them?