I bet you're thinking you stumbled across the wrong blog. I don't usually write about frivolous things like the latest TV show. However, it's pertinent in this case to my healing.
I remember watching the first episode of ER. I was hooked. I loved the interplay of Dr. Greene, Dr. Ross, Dr. Benton, and Dr. Carter. So many things in my life have changed since that day, but that has been one of the constants - Thursday night at 9 pm. I haven't watched consistently in a long time, but I decided to watch last night's episode.
It started off okay. They got to the twin labor and delivery, and I was okay. (I can finally watch re-enactments of the happy deliveries without freaking out.) I watched them deliver the second baby, and I was still okay. The first gush of blood came out of mom, and I started to get a little tense, but I was okay. The second gush came, and I'm starting to think maybe I should switch to something else, and then... gush number 3, uterine inversion, mom starts losing consciousness, call for blood, start IV's... I jump off the sofa, grab my daughter, and run for the stairs. I rush to get her put to bed, and run back downstairs to change channels before the commercial is over. I'm shaking, edgy, panicking, and trying desperately to calm myself. I was up half the night crying.
Right after Peanut was born, I kept asking my husband and best friend questions about my birth. I have no visual memories after the attempted manual removal of the placenta. I have some memories of sounds, but no pictures. My nightmares were terrifying to me because I didn't have the pictures, so I kept looking for them to give them to me. I'd ask, What did they do? What did it look like? Anything to get a description of what had gone on. I've accepted this lack of visual information. I've gotten used to the missing time frame. Having that visual experience last night totally has me freaked out.
I'm achy, hollow, anxious, edgy, and exhausted. I want to hide in a small dark place, and forget what I saw. I want to forget the fear, the anger, the panic. It was like they wrote MY story into the script. The baby was in the warmer, Dad standing to one side watching, and it all falls apart.
I haven't been this bad in a long time.
I HATE feeling like this. I HATE being this new person. What did I do to deserve this?
I wrote this on Friday morning. I'm glad to say that by noon, I was feeling better. Still edgy, but not jumping out of my own skin edgy. By the time I got home, the stranglehold was gone. I could think about other things, talk about other things, be myself.
I sometimes forget how far I've come. It came in such small, baby steps that you miss where things began to change. Despite my being triggered, I'm grateful to realize that this experience doesn't control me the way it did in the past. Within 36 hours most of the intrusive thoughts were gone. I didn't have another nightmare, and the flashback was only in the immediate time frame of being triggered.
My husband wants to delete the recording from the DVR, but I won't let him. I know I have to watch the entire thing. I won't watch it today, and probably not tomorrow, but in the future I need to see it. In order for me to be free, I have to face it.
This was my story. It may have a few tweaks, but it's the story I live with everyday.
Showing posts with label birth story. Show all posts
Showing posts with label birth story. Show all posts
Monday, April 6, 2009
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.
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.
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?
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, December 9, 2008
Uterine Inversion
I haven’t advertised my blog. I don’t link to it on any bulletin boards. I don’t include it in my online signatures. I have only told a few people about it, my husband, counselor, and best friend; however, I did set up the tools to see how or if people are finding it. Some of the queries have been sort of interesting, and I thought I’d try to address one today.
I had a partial uterine inversion after my daughter’s birth. According to Baby Center’s website, since I don’t feel like delving into a journal article today, a uterine inversion is defined this way:
Uterine inversion is a potentially life-threatening complication of childbirth that occurs in as many as one in about 2,000 births.
Normally, within about 30 minutes of a vaginal birth, contractions cause the placenta to separate from the wall of the uterus. After it separates, it comes out through the vagina on its own or with the help of the doctor or midwife, who may pull gently on the umbilical cord. (With a c-section, she manually removes the placenta right after delivering the baby.)
Sometimes, a placenta doesn't separate normally. And, in rare cases, attempts to deliver it cause the uterus to literally turn inside out such that the top of the uterus (the funds) comes through the cervix or even completely outside the vagina. This is called a uterine inversion and it's a true obstetric emergency. It can cause serious bleeding and shock, and requires immediate treatment.
So, my uterus didn’t come all the way out through the cervix, it just collapsed on itself. I had a low-lying, anterior placenta. This means that the placenta was below my belly button in the front. Some studies have shown a correlation between cord traction being applied to the umbilical cord and the incidence of inversion. I’ve never really believed that to be true in my situation. The doctor did attempt cord traction, but the umbilical cord tore off the placenta. Given the location of the placenta, I’ve never been able to figure out the physics of how this would cause the uterus to collapse from the funds, top of the uterus. The doctor then tried to manually remove the placenta. At this point in time, he still hadn’t diagnosed the inversion. It wasn’t until much later after I’d gone into shock that they diagnosed the inversion as part of the problem.
I had so many complications, that things sometimes get tangled up in my brain. I’m never really sure which complication or procedure caused the results; however, I was in massive amounts of pain. I was hemorrhaging, and I went into shock. I know the blood loss caused me to become hypertensive, extremely low blood pressure, but I don’t know if that was from the inversion or retained placenta. It was probably a combination of both.
There are several ways they can attempt to correct an inversion. In my situation, the doctor used nitroglycerine to relax the uterine muscle, so that he could put it back in place. After that, they performed the D & C, and used cytotec and pitocin to get my uterus to contract back down to the normal size.
There are some advantages to having this happen. I really didn’t have any blood clots because the doctor had done such a good job scraping out my uterus. I only bled for about a week, and then had discolored discharge for an additional couple of weeks. I couldn’t go without using personal hygiene products, but it was much less than I’ve heard some women discuss.
Unfortunately, there are some disadvantages as well. Obviously, since I was in surgery I missed out on the first hours of my daughter’s life. I needed blood transfusions. I had a difficult recovery. I ended up with PTSD because of my feelings of helplessness. I was incredibly weak from the blood loss. Just carrying my daughter upstairs to her room exhausted me. I’m also at risk of this happening again in any future pregnancies. The odds of having another placenta accreta / retained placenta are very high due to the D & C they performed. Because I’ve already had one partial uterine inversion, the risks for that are increased as well.
I had a partial uterine inversion after my daughter’s birth. According to Baby Center’s website, since I don’t feel like delving into a journal article today, a uterine inversion is defined this way:
Uterine inversion is a potentially life-threatening complication of childbirth that occurs in as many as one in about 2,000 births.
Normally, within about 30 minutes of a vaginal birth, contractions cause the placenta to separate from the wall of the uterus. After it separates, it comes out through the vagina on its own or with the help of the doctor or midwife, who may pull gently on the umbilical cord. (With a c-section, she manually removes the placenta right after delivering the baby.)
Sometimes, a placenta doesn't separate normally. And, in rare cases, attempts to deliver it cause the uterus to literally turn inside out such that the top of the uterus (the funds) comes through the cervix or even completely outside the vagina. This is called a uterine inversion and it's a true obstetric emergency. It can cause serious bleeding and shock, and requires immediate treatment.
So, my uterus didn’t come all the way out through the cervix, it just collapsed on itself. I had a low-lying, anterior placenta. This means that the placenta was below my belly button in the front. Some studies have shown a correlation between cord traction being applied to the umbilical cord and the incidence of inversion. I’ve never really believed that to be true in my situation. The doctor did attempt cord traction, but the umbilical cord tore off the placenta. Given the location of the placenta, I’ve never been able to figure out the physics of how this would cause the uterus to collapse from the funds, top of the uterus. The doctor then tried to manually remove the placenta. At this point in time, he still hadn’t diagnosed the inversion. It wasn’t until much later after I’d gone into shock that they diagnosed the inversion as part of the problem.
I had so many complications, that things sometimes get tangled up in my brain. I’m never really sure which complication or procedure caused the results; however, I was in massive amounts of pain. I was hemorrhaging, and I went into shock. I know the blood loss caused me to become hypertensive, extremely low blood pressure, but I don’t know if that was from the inversion or retained placenta. It was probably a combination of both.
There are several ways they can attempt to correct an inversion. In my situation, the doctor used nitroglycerine to relax the uterine muscle, so that he could put it back in place. After that, they performed the D & C, and used cytotec and pitocin to get my uterus to contract back down to the normal size.
There are some advantages to having this happen. I really didn’t have any blood clots because the doctor had done such a good job scraping out my uterus. I only bled for about a week, and then had discolored discharge for an additional couple of weeks. I couldn’t go without using personal hygiene products, but it was much less than I’ve heard some women discuss.
Unfortunately, there are some disadvantages as well. Obviously, since I was in surgery I missed out on the first hours of my daughter’s life. I needed blood transfusions. I had a difficult recovery. I ended up with PTSD because of my feelings of helplessness. I was incredibly weak from the blood loss. Just carrying my daughter upstairs to her room exhausted me. I’m also at risk of this happening again in any future pregnancies. The odds of having another placenta accreta / retained placenta are very high due to the D & C they performed. Because I’ve already had one partial uterine inversion, the risks for that are increased as well.
Thursday, November 13, 2008
Meeting w/ Hospital Cancelled
So, I'm cancelling the meeting with the hospital. I met with my counselor yesterday, and she noticed that my PTSD is nasty bad again. We started trying to track it back to the trigger, and I realized that I've been spiraling out of control since my doctor asked me to talk to the hospital. The easiest solution to getting myself feeling better is to cancel the appointment.
However, I don't want to ignore the request. Therefore, I typed up a copy of my birth plan, and wrote down my reasons for why I included each line. It was hard to do, but I feel much better now. Some of the items are really difficult to admit.
Here's a copy below.
However, I don't want to ignore the request. Therefore, I typed up a copy of my birth plan, and wrote down my reasons for why I included each line. It was hard to do, but I feel much better now. Some of the items are really difficult to admit.
Here's a copy below.
Hi, I’m Traumatized Mom, and I’m writing this to explain how communication could have made my daughter’s birth a better experience. I developed PTSD that night, and I’ve been struggling with it for 18 months. I know it sounds weird to say that childbirth, a normal physiological event for most women, caused PTSD. After all, I wasn’t a victim of the I-35 bridge collapse or a soldier returning from duty in Iraq, but PTSD can occur during any event where the person experiencing it feels out of control and like their life is at risk. The National Center for PTSD defines it like this:
Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.
So, how does my situation fit the criteria for PTSD? I experienced a lot of complications after my daughter’s birth. I had a PPH, placenta accreta, and partial uterine inversion. My daughter’s birth was induced for PIH, but after her birth, I became hypotensive. I was in massive amounts of pain. I didn’t understand what was happening, or why. I felt like I had no control over what was happening within my body or to my body by the medical staff. I was thought I was dying. I thought I was going to abandon my new baby girl. I never expected to wake up the next day.
The effects of that night have rippled throughout my life. I’m now scared to go to the doctor. I do it, but I have nightmares for a week or so leading up to a well-baby checkup or annual physical. I struggle with flashbacks every time I give my daughter a bath. I’ve struggled with finding a new form of birth control since that night. Condoms give me flashbacks, and I can’t stand the thought of putting anything like a diaphram or IUD inside of myself. I also have to watch out for things that can trigger my temper. Something as simple as a co-worker not listening to me can send me into a rage. It sends me back to the hospital room where I felt like I was not listened to, dismissed, or ignored.
The PTSD drives me to do things that some people would consider a little screwed up. Before my annual physical this year, I was driven by this demon to write out what I called a “birth plan” even though I’m not pregnant or planning to become pregnant in the future.
So, please let me explain to you why I wrote what I did.
Introduction:
This isn’t the typical birth plan. I know that things can go wrong very quickly. I don’t care about IVs, pitocin, dim lights, or vaginal exams. I expect that I’ll be trapped in the bed by a multitude of cords coming out of nearly every orifice. I expect that things will go crazy wrong, all hell will break loose, locusts will descend upon the earth, and the plague will rage throughout the land.
I don’t know if any of you have had the opportunity to see a birth plan recently. Most of them harp on not wanting an IV, wanting the lights to be dimmed, not wanting vaginal exams unless requested, and believing that pitocin is evil. Those are the least of my worries if I have another child. Those things to me are minor inconveniences. Is it fun to be tethered to the bed, no, but I know that I’d do anything to have a healthy baby. So, if my blood pressure is skyrocketing, and lying on my left side lowers it, I’ll do it. If having an epidural reduces my blood pressure to a point that the doctors are comfortable letting me continue working towards a vaginal delivery instead of being shipped off for a c-section, no problem. Vaginal exams are not a big deal as long as they ask before doing them. As for the rest, well after the last birth, I have no expectation that things will go well. I know I’ll be waiting for the shoe to fall. Keeping me calm and in the “labor zone” will be the only goal. Everything else is easily ignored.
Item number 1:
Please talk to me constantly, especially when I can’t see what you are doing.
This is because of the PTSD. Information and education reduce anxiety. I cope with medical procedures much better when I know what’s happening, when people are talking to me, and when I understand why things are being done. I would prefer to have the noisiest room in the hospital – not because I’m screaming or yelling, but simply because I don’t want peace and quiet. Talking, information, and education calm me.
Item number 2:
Please follow this protocol when explaining interventions to me because I may not ask the appropriate questions.
Why do you want to intervene?
What intervention do you want to implement?
Are there any long-lasting side effects or consequences of this intervention?
Write it down for me before you discharge me from the hospital.
When things were going wrong, I retreated into myself. I focused on what was happening inside of me. I focused on the pain. Nothing got through to me unless it was an emotionally charged statement like, “where the hell are they”, or “what took so long”. Things spoken in a calm manner didn’t register, so getting my attention was essential to understanding what’s happening. For me, the pain I experienced after my daughter was born was 1,000 times worse than the pain of labor. I described it to a friend this way:
The pain is all consuming. You can't think. You can't breathe. You can't hear what they're saying. You can't process what's happening. It wraps around you smothering you in a cloud of darkness and fear because you know it's not supposed to be like THIS. You can't form the words to question what's happening. You're sucked down into the black void of semi-consciousness not caring what they're doing to you because all you can focus on is the pain. It's the only thing that exists. They're pricking you with needles, people come running in and out, and someone straps a mask over your face. You feel the doctor's hand shoved all the way inside you. How the heck did it get there? The pain sucks you away. You struggle to breathe and continue to fight. Try to breathe through it, but you can't ride the waves. It's consuming your body. Don't quit. Don't abandon the baby. Keep fighting. Some comments break through. You can hear the anger and fear in the doctor's voice, and it scares you even more. But you're sucked back down into the depths of hell wondering what's happening. You feel the bed being wheeled down the hall. You sense the bright lights of the operating room beaming down on your eyelids, but the pain pulls seductively at you. Just give up. Stop fighting. Surrender to your death. Abandon your baby. Just let go. And then the anesthesia sucks all your thoughts away.
That’s a lot to overcome when you’re trying to get a patient to understand what’s happening and be a participant in their own care. I’ve been told that the doctor did a “really good job” of explaining what was happening, but I was already sucked into this hell.
My husband didn’t get it either. He was watching the doctor. He remembers the doctor having a slightly puzzled look on his face, but then he did a little fiddling. He remembers the expression changing to a more this isn’t quite right look, and then he did a little more fiddling. Finally, he remembers the “oh, shit, I’m fucked” look on the doctor’s face. My husband checked out then. Once he realized that it was all falling apart, he wasn’t listening. He was too scared.
The other reason for this being included is after I got out of surgery, and recovery, and I tried to ask about what had happened, I only got ½ answers. The first answer I received, was that “I had a lot of bleeding”. As you can see by the list at the beginning of this document, a whole lot more went wrong than a lot of bleeding. Everyone made the assumption that I had understood in the delivery room what had happened, and I never really got a full explanation until my 6 week post-partum appointment when I was more capable of asking questions. Even then, I didn’t know that surgery itself was called a D & C until I interviewed a new doctor 6 months later. Also, no one ever used the clinical diagnostic names with me. I was told my uterus turned inside out, the placenta was stuck, and my blood pressure crashed. This information was inadequate when it came to researching the complications after I got home. I didn’t know if the search results were returning the correct information or not. So, here again, information and education reduce anxiety. The more information that the patient has available, the less anxious they should feel.
Good communication requires that one person is listening or receiving the information that the other person is trying to give them. The message that the doctor tried to send couldn’t get through the fear, anger, or pain that we were experiencing. You have to pull the patient out of that mode for them to understand what’s happening.
Item number 3:
If there is any disagreement between caregivers over what treatment option is appropriate, please work it out between yourselves. I don’t wish to take sides, or argue with either of you. If there is a legitimate choice for me to make, please present me with both options in a non-confrontational manner, and allow me a few moments to reflect upon my options prior to making a decision.
When the anesthesiologist came in to perform the epidural, I made the mistake of telling him that the doctor wanted the epidural to decrease my blood pressure. The anesthesiologist felt very strongly that epidurals should only be used for pain relief, and he argued with me about whether I should or shouldn’t be given the epidural. From my standpoint, I knew that having a vaginal delivery was at risk. From moments after I showed up for the induction, we’d been trying to bring down my blood pressure. We tried different positions, and, without my knowledge, they’d tried IV blood pressure medication. I knew that if it didn’t level off, that I could be headed for the operating room. As far as I was concerned, I’d need the epidural if I got forced into the c-section, so why not try it for the blood pressure? The last thing my blood pressure needed was an argument over whether I was in pain or not. I was in labor. Last time I checked, labor is painful, so it seemed ridiculous to be arguing over this issue. Also, I’d never seen the anesthesiologist before this time. I didn’t know if he knew “my” medical history, if he’d seen the blood pressure readings, or if he knew that they’d already tried IV blood pressure medication. It seemed like he was not in the best position to be making decisions about what treatment methods I should be following. The last thing I needed was more stress / anxiety in that delivery room. There was enough stress in being induced for complications instead of having the spontaneous, un-medicated vaginal delivery I desired.
Item number 4:
If I tell you that something isn’t right or isn’t working, please believe me instead of dismissing my comment as a fallacy because I’m not acting the way YOU believe I should be acting to make that comment a truth.
Towards the end of my labor, I told the nurse that I didn’t think the epidural was working properly. She responded in a very snotty manner that, “epidurals don’t take away ALL of the pain”. First off, I didn’t want her to do anything with this information other than mention it to the doctor. I was handling it not working. I didn’t need her to go find the anesthesiologist, and have him fix it. I just wanted the information passed up the chain of command. Second, everyone deals with pain in different ways. For me, I was focused and breathing through the contractions. I didn’t yell, scream, curse, etc. I was in control. My best friend was there to support me, and she told me that I was boring because I didn’t need her to do anything to help me cope. I was self-sufficient. This became incredibly important later. I know there’s no way anyone could have predicted the way things happened, but the doctor made the choice to try manually removing the placenta without telling me because he believed I was anesthetized. Please reference my description of pain under item number 2
Item number 5:
Please tell me the name of every medication that you are giving me whether it is given orally or through an IV at the time you administer it, and write it down for me before I am discharged.
Here again, I had no clue what was being pumped into my body. When my daughter was born, I had one IV. When I woke up, I had 7 or 8 IV’s. I knew something wasn’t right. But, I couldn’t formulate the questions. I had no clue what was running through the IV’s it was so odd to me that each time they brought me a medication to be taken orally, they told me exactly what it was, but no one ever told me what I was hooked up to. The only things I knew about were the pitocin for the induction and the blood transfusions. So, here again, information and education reduce anxiety. The more information that the patient has available, the less anxious they should feel.
Procedures:
My uterus has a history of flipping inside out, so please don’t pull on the umbilical cord.
I only consent to manually removing the placenta if I’m fully anesthetized. Please verify this with me prior to proceeding with the procedure.
If I’m hemorrhaging, have another accreta, and my uterus has inverted again, then don’t take extreme measures to save my uterus. I won’t be using it again.
Well, I did term this a birth plan, so adding a few things that are really specific to my desires / experiences seemed appropriate.
Suggestions:
After my experience, I do have a few suggestions for how you can improve your patients’ experiences.
I have problems dealing with the level of violation I feel about the attempted manual removal of the placenta being performed without my knowledge or consent. I know in my head that this was a medical procedure, but my body and my heart don’t believe that to be a truth. To me, this was a procedure that shouldn’t be covered under the blanket consent form everyone signs upon admission. I can understand that there wasn’t time to go dig a form out of a cabinet, but I do think that it should require specific verbal consent from the patient.
I’d like to see you create a support group for moms with post-natal mood disorders like PPD, PTSD, PPA, etc. I know that I’m not the only mom who has walked out of your hospital feeling isolated. New moms are isolated enough without having mental health issues that isolate them even more.
I’d like to see you start giving patients an opportunity to de-brief from their experience. They say that this de-briefing can help patients assimilate their experiences more effectively than by trying to handle it themselves. This would also allow the patients to have their feelings validated.
I’d like to see some training offered to the doctors, nurses, and other caregivers on the maternity floor on how to handle moms with traumatic births. One of the things I found difficult was having everyone tell me that this was “normal”. I’ve visited dozens of friends after their babies were born. I knew it wasn’t normal to not care that the baby was in the nursery. I knew it wasn’t normal to still be hooked up to machines. I knew it wasn’t normal to be sleeping with those goofy massaging socks / leg warmers. These women need their feelings to be validated. They need to be told its okay to be sad, angry, or disappointed. They don’t need to here, “all that matters is a healthy baby”, “at least you had a healthy baby”, or “you’ll change your mind in a year”. They need to know that their experience was difficult.
Don’t avoid the hard questions. I was so angry that I didn’t get real answers that I wanted to sue the hospital / doctor. Ignoring the questions isn’t going to get a patient to not file a lawsuit, but giving them answers and apologizing for things that shouldn’t have happened might. As for why I didn’t sue, I re-live this event every day. I still can’t bring myself to discuss it without tears. I blame myself for choosing a caregiver that didn’t treat me respectfully, and I’m ashamed that I can’t get past this. I didn’t want to sit on the stand, and bare myself to the world. It’s hard enough to live with this every day.
Sunday, October 26, 2008
Birth Rape?
Birth Rape
Isn’t that an ugly term? The first time I heard it, I thought a bunch of radical feminists were making a big deal out of nothing. How can those two words possibly be spoken together? Birth is about innocence. Is there anyone more innocent than a newborn baby? Rape is so ugly, so violent, so brutal. It offended me at the core of my being. However, I think there may be something to it.
Some people believe that birth rape can only occur if a woman has been previously assaulted. They believe that the birth itself isn’t a rape, but that the woman is experiencing a flashback to a prior criminal act. This flashback is so real, that they transfer their feelings about the original assault to the act of giving birth.
This experience impacted me the night my daughter was born:
I’d met this guy six months before that night. At first, I saw him only occasionally, but over time I’d started seeing him once a week. I invited him into my room. After 6 months, I trusted him enough to let him come inside. I was sitting on the bed, and he was sitting in a chair at the foot of the bed while we were talking. All of the sudden, he shoved his hand inside me. I tried to push him away with my legs, but I couldn’t move them. I tried clawing at the sheets to drag my body away from him, but he wouldn’t get his hand out. I was in massive amounts of pain… This couldn’t be happening to me.
Doesn’t this sound like a date rape experience? I trusted this person. I invited them into my personal space. I didn’t give permission for this to happen. I tried to get away. I was violated. I must have had a flashback to this prior crime during my birth if I think birth rape is a valid term.
Now, let me change six words:
I’d met this doctor six months before that night. At first, I saw him only occasionally, but over time I’d started seeing him once a week. I invited him into my room. After 6 months, I trusted him enough to let him come inside. I was sitting on the bed, and he was sitting in a chair at the foot of the hospital bed while we were talking after my daughter’s birth. All of the sudden, he shoved his hand inside me. I tried to push him away with my legs, but I couldn’t move them. I tried clawing at the sheets to drag my body away from him, but he wouldn’t get his hand out. I was in massive amounts of pain… This couldn’t be happening to me.
Does that change you opinion of my experience? Do you believe this behavior is suddenly acceptable? Why is it that behavior that is unacceptable every where else in society suddenly becomes acceptable in a delivery room? Before my daughter was born, I’d never been the victim of a violent crime. I’d always been treated respectfully by the men in my life. No one had ever touched me in an inappropriate manner. This wasn’t a flashback. It’s my reality.
Birth is an incredibly intimate act. It requires you opening parts of yourself that you keep hidden from the world in order for it to happen. It’s deserving of the same respect that women expect when giving themselves to their lover. It’s something to be treasured. If consent is so essential to a healthy sexual experience, consent is also necessary to healthy birthing experience.
It took several months before I admitted that my daughter’s birth had resulted in my birth rape. I didn’t want to admit it had happened. I tried hiding from it. I tried ignoring it. I didn’t report it. I blamed myself for it. But I’ve learned that this doesn’t help, so now I’m talking about it. I’m not sure yet if I’ll discuss this when I meet with the doctors at the hospital, but I’m thinking about it. I know they don’t want to admit that this happens. I know they want to bury their heads in the sand, but someone has to speak out. There was a time when people didn’t believe that one spouse could rape the other, but now we recognize this as a truth. In this time we live in, people believe that a woman in labor cannot be raped, but a time will come when we will believe in this truth also.
Isn’t that an ugly term? The first time I heard it, I thought a bunch of radical feminists were making a big deal out of nothing. How can those two words possibly be spoken together? Birth is about innocence. Is there anyone more innocent than a newborn baby? Rape is so ugly, so violent, so brutal. It offended me at the core of my being. However, I think there may be something to it.
Some people believe that birth rape can only occur if a woman has been previously assaulted. They believe that the birth itself isn’t a rape, but that the woman is experiencing a flashback to a prior criminal act. This flashback is so real, that they transfer their feelings about the original assault to the act of giving birth.
This experience impacted me the night my daughter was born:
I’d met this guy six months before that night. At first, I saw him only occasionally, but over time I’d started seeing him once a week. I invited him into my room. After 6 months, I trusted him enough to let him come inside. I was sitting on the bed, and he was sitting in a chair at the foot of the bed while we were talking. All of the sudden, he shoved his hand inside me. I tried to push him away with my legs, but I couldn’t move them. I tried clawing at the sheets to drag my body away from him, but he wouldn’t get his hand out. I was in massive amounts of pain… This couldn’t be happening to me.
Doesn’t this sound like a date rape experience? I trusted this person. I invited them into my personal space. I didn’t give permission for this to happen. I tried to get away. I was violated. I must have had a flashback to this prior crime during my birth if I think birth rape is a valid term.
Now, let me change six words:
I’d met this doctor six months before that night. At first, I saw him only occasionally, but over time I’d started seeing him once a week. I invited him into my room. After 6 months, I trusted him enough to let him come inside. I was sitting on the bed, and he was sitting in a chair at the foot of the hospital bed while we were talking after my daughter’s birth. All of the sudden, he shoved his hand inside me. I tried to push him away with my legs, but I couldn’t move them. I tried clawing at the sheets to drag my body away from him, but he wouldn’t get his hand out. I was in massive amounts of pain… This couldn’t be happening to me.
Does that change you opinion of my experience? Do you believe this behavior is suddenly acceptable? Why is it that behavior that is unacceptable every where else in society suddenly becomes acceptable in a delivery room? Before my daughter was born, I’d never been the victim of a violent crime. I’d always been treated respectfully by the men in my life. No one had ever touched me in an inappropriate manner. This wasn’t a flashback. It’s my reality.
Birth is an incredibly intimate act. It requires you opening parts of yourself that you keep hidden from the world in order for it to happen. It’s deserving of the same respect that women expect when giving themselves to their lover. It’s something to be treasured. If consent is so essential to a healthy sexual experience, consent is also necessary to healthy birthing experience.
It took several months before I admitted that my daughter’s birth had resulted in my birth rape. I didn’t want to admit it had happened. I tried hiding from it. I tried ignoring it. I didn’t report it. I blamed myself for it. But I’ve learned that this doesn’t help, so now I’m talking about it. I’m not sure yet if I’ll discuss this when I meet with the doctors at the hospital, but I’m thinking about it. I know they don’t want to admit that this happens. I know they want to bury their heads in the sand, but someone has to speak out. There was a time when people didn’t believe that one spouse could rape the other, but now we recognize this as a truth. In this time we live in, people believe that a woman in labor cannot be raped, but a time will come when we will believe in this truth also.
Friday, September 26, 2008
A letter to my doctor
I wanted to take a few minutes to let you know why I decided to file a complaint against you this winter, and explain to you the lasting consequences of your actions the night of May 11, 2007.
I trusted and chose you to be a part of my transformation from a woman to a mom. I know for you it was just another delivery. It was just another series of complications to overcome, but for me it was a life changing event. For 32 minutes, I experienced the joy that comes with that transformation, and then you forced me into another transformation, a rape survivor. I know that wasn’t your intent. You were trying to avoid worrying me with another complication when you believed that you could easily and painlessly eliminate it. However, a yellow plastic gown, latex gloves, and a medical school diploma hanging in your office don’t make you God. It was my body that you violated. You humiliated and shamed me in front of my husband, daughter, best friend, and the nursing staff. I was vulnerable and trusting, and you betrayed me. Instead of treating me like an adult capable of making decisions, you treated me like an unfeeling object. Epidural or not, labor or not, my vagina is private. It’s up to me to decide who and what invades it. You abused your power, and denied me the opportunity to consent. You denied me the ability to process the event as a medical procedure. There was no warning, no understanding. The pain was indescribable. I know you tried to explain what was happening afterwards, but the pain was an incredible barrier to my understanding. The blood loss was too great, the change in blood pressure too rapid for me to process what was happening. I became legally incompetent so rapidly, that I can’t even figure out who signed the consent form for the D & C.
My primary care physician told me once that he really enjoyed delivering babies. It’s one of the few times that someone goes home with something after being in the hospital. I went home with a lot of things. I went home with a newborn. I went home with nightmares. I went home with flashbacks. I went home isolated because births like mine are not to be discussed. You don’t discuss birth rape over a cup of coffee at Caribou with an infant beside you.
Do you want to hear my version of Jennavive’s birth? I’m sure my version differs from yours?
“One more push to get the shoulders out.” I hear the doctor say. Despite not having any breath left, I try once again to push. I feel myself tear as the baby slides out, and they lay this gooey baby on my stomach. I’m in shock, she looks like an alien. There was nasty gooey mucus covering her whole body along with streaks of blood. I wish I could say I loved her at the point, but I was appalled by how she looked. I was relieved when the nurse took her away to be measured, weighed, tested, and cleaned up. At 11:45 pm, the doctor asked the nurse to tell him when 15 minutes had passed. I thought it was kind of odd at the time, but I was really starting to feel a sense of accomplishment and joy. I was watching the nurse cleaning her up while my friend took pictures. I was starting to feel a little odd, but I remember telling the doctor that “his 15 minutes was up”. The nurse asked me if I wanted to hold the baby, but I said no because I was feeling really woozy. My friend brings her over for me to touch. I reach my hand out to her. PAIN!!!! My hands are fisting in the sheets, and I’m fighting not to scream. My breathing is ragged, and I don’t know why the doctor’s hand is in my hoo-ha. I try to get away, I’m scrabbling with my hands trying to drag my body up the bed, but with the numbness in my legs I can’t escape. My vision is blurry, and I start seeing spots when I hear the doctor tell the nurse to get the surgical team. I’m struggling to stay conscious to focus on my daughter, but everything fades to black. Why do I need surgery? I don’t know what’s happening. The baby’s already here. I can’t leave her. I hear the angry voice of the doctor, “what took so long, where are they?” The nurse answers, “They left for the night. It will take an hour to get back to the hospital.” Why is he so angry? I don’t understand what’s happening. The pain is so intense it takes my breath away. They strap the oxygen mask over my face, and I feel the pricking of needles. Are they doing a hysterectomy? I still can’t see. Where’s my baby? I can’t abandon her. I hear fear in the doctor’s voice. “Where the hell are they”, he yells at the nurse. I’m so scared now. Am I dying? I can’t abandon my baby. My husband will never forgive her if something happens to me. I have to stay here to raise her. Do whatever it takes, but keep me here to raise her. Alarms are going off. What’s happening? I hear a new voice, and I feel the bed moving. They’re rolling me down the hallway to the operating room. I sense the bright lights, and feel myself being transferred to the operating table. The voices are frantic. I feel more needles pricking me, and everything fades to black…
This is what you left me with. Each year on her birthday, this is the story that I will remember. Do you remember your children’s births? Do you remember the joy you felt? I don’t. It was so fleeting. I remember the pain, anger and fear. I’m glad that you’re skilled enough to have kept me alive. I’m glad that I’m here every day to enjoy my daughter, but I can’t forgive you for the pain you caused.
I wrote the complaint to the state medical board because you crossed a line that should never be crossed. It’s my small attempt to remind the medical establishment that patients have rights. I wanted to remind you of the Hippocratic Oath. Isn’t there a line in there about “doing no harm”? You caused harm that night. It’s my small way of facing my attacker, and while you’ll probably get off scot-free at least I tried to change it for the women who will tread this path after me.
I wrote this several months ago, but I'm finding myself struggling again. My co-worker's induction is scheduled for next week, and I'm worried about how things will go for her. I just don't want to see her end up in the same place I am.
Reading this today made me realize just how much anger I still harbor towards the doctor. I guess the PTSD comes in waves. I feel strong for a while, but then something sucks me back down. I know part of the problem is a story on my SOLACE forum that really struck a nerve. A mom went through a post-birth experience similar to mine, and has never felt validated in her feelings. Reading her story, and feeling her pain, anger and fear radiating through it just smacked into me.
Sometimes criminal activities take place in the bright lights of a hospital. It's not intended to be that way. I know there's no intent, but the action itself is criminal. If a patient is fighting to get away from you, they're in pain. If they're screaming at you to STOP, stop. If you're more worried about what their family members are seeing there's something wrong with your morals. Patients are humans. We're autonomous. We have feelings. We're not objects. Treat us with the respect that you expect us to treat you with. Listen to us. Answer our questions. Allow us to trust you. Don't betray us in the heat of battle.
I trusted and chose you to be a part of my transformation from a woman to a mom. I know for you it was just another delivery. It was just another series of complications to overcome, but for me it was a life changing event. For 32 minutes, I experienced the joy that comes with that transformation, and then you forced me into another transformation, a rape survivor. I know that wasn’t your intent. You were trying to avoid worrying me with another complication when you believed that you could easily and painlessly eliminate it. However, a yellow plastic gown, latex gloves, and a medical school diploma hanging in your office don’t make you God. It was my body that you violated. You humiliated and shamed me in front of my husband, daughter, best friend, and the nursing staff. I was vulnerable and trusting, and you betrayed me. Instead of treating me like an adult capable of making decisions, you treated me like an unfeeling object. Epidural or not, labor or not, my vagina is private. It’s up to me to decide who and what invades it. You abused your power, and denied me the opportunity to consent. You denied me the ability to process the event as a medical procedure. There was no warning, no understanding. The pain was indescribable. I know you tried to explain what was happening afterwards, but the pain was an incredible barrier to my understanding. The blood loss was too great, the change in blood pressure too rapid for me to process what was happening. I became legally incompetent so rapidly, that I can’t even figure out who signed the consent form for the D & C.
My primary care physician told me once that he really enjoyed delivering babies. It’s one of the few times that someone goes home with something after being in the hospital. I went home with a lot of things. I went home with a newborn. I went home with nightmares. I went home with flashbacks. I went home isolated because births like mine are not to be discussed. You don’t discuss birth rape over a cup of coffee at Caribou with an infant beside you.
Do you want to hear my version of Jennavive’s birth? I’m sure my version differs from yours?
“One more push to get the shoulders out.” I hear the doctor say. Despite not having any breath left, I try once again to push. I feel myself tear as the baby slides out, and they lay this gooey baby on my stomach. I’m in shock, she looks like an alien. There was nasty gooey mucus covering her whole body along with streaks of blood. I wish I could say I loved her at the point, but I was appalled by how she looked. I was relieved when the nurse took her away to be measured, weighed, tested, and cleaned up. At 11:45 pm, the doctor asked the nurse to tell him when 15 minutes had passed. I thought it was kind of odd at the time, but I was really starting to feel a sense of accomplishment and joy. I was watching the nurse cleaning her up while my friend took pictures. I was starting to feel a little odd, but I remember telling the doctor that “his 15 minutes was up”. The nurse asked me if I wanted to hold the baby, but I said no because I was feeling really woozy. My friend brings her over for me to touch. I reach my hand out to her. PAIN!!!! My hands are fisting in the sheets, and I’m fighting not to scream. My breathing is ragged, and I don’t know why the doctor’s hand is in my hoo-ha. I try to get away, I’m scrabbling with my hands trying to drag my body up the bed, but with the numbness in my legs I can’t escape. My vision is blurry, and I start seeing spots when I hear the doctor tell the nurse to get the surgical team. I’m struggling to stay conscious to focus on my daughter, but everything fades to black. Why do I need surgery? I don’t know what’s happening. The baby’s already here. I can’t leave her. I hear the angry voice of the doctor, “what took so long, where are they?” The nurse answers, “They left for the night. It will take an hour to get back to the hospital.” Why is he so angry? I don’t understand what’s happening. The pain is so intense it takes my breath away. They strap the oxygen mask over my face, and I feel the pricking of needles. Are they doing a hysterectomy? I still can’t see. Where’s my baby? I can’t abandon her. I hear fear in the doctor’s voice. “Where the hell are they”, he yells at the nurse. I’m so scared now. Am I dying? I can’t abandon my baby. My husband will never forgive her if something happens to me. I have to stay here to raise her. Do whatever it takes, but keep me here to raise her. Alarms are going off. What’s happening? I hear a new voice, and I feel the bed moving. They’re rolling me down the hallway to the operating room. I sense the bright lights, and feel myself being transferred to the operating table. The voices are frantic. I feel more needles pricking me, and everything fades to black…
This is what you left me with. Each year on her birthday, this is the story that I will remember. Do you remember your children’s births? Do you remember the joy you felt? I don’t. It was so fleeting. I remember the pain, anger and fear. I’m glad that you’re skilled enough to have kept me alive. I’m glad that I’m here every day to enjoy my daughter, but I can’t forgive you for the pain you caused.
I wrote the complaint to the state medical board because you crossed a line that should never be crossed. It’s my small attempt to remind the medical establishment that patients have rights. I wanted to remind you of the Hippocratic Oath. Isn’t there a line in there about “doing no harm”? You caused harm that night. It’s my small way of facing my attacker, and while you’ll probably get off scot-free at least I tried to change it for the women who will tread this path after me.
I wrote this several months ago, but I'm finding myself struggling again. My co-worker's induction is scheduled for next week, and I'm worried about how things will go for her. I just don't want to see her end up in the same place I am.
Reading this today made me realize just how much anger I still harbor towards the doctor. I guess the PTSD comes in waves. I feel strong for a while, but then something sucks me back down. I know part of the problem is a story on my SOLACE forum that really struck a nerve. A mom went through a post-birth experience similar to mine, and has never felt validated in her feelings. Reading her story, and feeling her pain, anger and fear radiating through it just smacked into me.
Sometimes criminal activities take place in the bright lights of a hospital. It's not intended to be that way. I know there's no intent, but the action itself is criminal. If a patient is fighting to get away from you, they're in pain. If they're screaming at you to STOP, stop. If you're more worried about what their family members are seeing there's something wrong with your morals. Patients are humans. We're autonomous. We have feelings. We're not objects. Treat us with the respect that you expect us to treat you with. Listen to us. Answer our questions. Allow us to trust you. Don't betray us in the heat of battle.
Tuesday, August 26, 2008
The first request for help
This is the first version of my peanut's birth story. It’s so weird to read such an emotionless, sanitized version of the story, but it was my first attempt to reach out for help, validation, and understanding. I hadn’t yet asked for and received my medical records, so I didn’t know how serious everything had been. I didn’t really know what had happened, why it had happened, or how it had happened. I knew that it wasn’t “normal”, but that’s the extent of the information I had. The anger and fear hadn’t really sunk in yet, and I hadn’t yet asked for help in coping with the PPD that I thought I had. I hadn’t yet spoken to a counselor, or tried drugs to help with the anxiety. I was so naive.
I posted this on a bulletin board for women who had difficult / traumatic birth experiences. I really didn't know that this happened. I honestly believed that there was no safer choice than having your baby in a hospital with an OB. In all reality, this probably was the safest place for me. The same complications would have existed at home, so location really was immaterial. If we'd transferred from home, it probably would have taken longer to receive a diagnosis. I would have waited for the ER doc to figure out what he needed, and waited for him to call in an OB and anesthesiologist.
I still have a lot of questions. I still struggle with the decisions that were made, but here's the story I knew at the time.
I posted this on a bulletin board for women who had difficult / traumatic birth experiences. I really didn't know that this happened. I honestly believed that there was no safer choice than having your baby in a hospital with an OB. In all reality, this probably was the safest place for me. The same complications would have existed at home, so location really was immaterial. If we'd transferred from home, it probably would have taken longer to receive a diagnosis. I would have waited for the ER doc to figure out what he needed, and waited for him to call in an OB and anesthesiologist.
I still have a lot of questions. I still struggle with the decisions that were made, but here's the story I knew at the time.
My daughter was born May 11th. I've never told the entire story of her birth to anyone, and until this week I never realized just how bothered I am by how it happened.
I had the easiest pregnancy until I reached my 24th week when I was diagnosed with Gestational Diabetes. Changing my eating habits was very difficult at first, but after a couple of weeks I had it down pat. At 34 weeks I began to experience pregnancy induced hypertension, and my doctor placed me on modified bed rest. By the time I reached 37 weeks it had progressed to pre-eclampsia, so I agreed to be induced the following Friday.
Things started in a pretty typical manner. The doctor broke my water, and they started me on pitocin. However, things started to change rapidly. My blood pressure started climbing, so they had me lay on my left side for what seemed like forever. Things didn't improve, so they tried to roll me over to the other side. However, as soon as I got to my back my blood pressure started to decrease. The contractions started to settle into a steady rhythm, but my blood pressure started to climb again. At this point, my doctor wanted me to have an epidural to reduce the blood pressure, so I complied with his wishes. Unfortunately, the epidural didn't really work. It resulted in slowing labor to a crawl and putting my leg to sleep, but I didn't receive any pain relief from it. Finally, around 9:00 pm I had the urge to push. I pushed for two hours before I came to the realization that after being on bed rest for a month I simply didn't have enough energy to push my peanut out on my own. The nurses finally tracked my doctor down, he wasn't responding to his pager, and he gave me a little help with the vacuum.
My daughter was born at 11:32 pm, but that's the beginning of the story. The placenta didn't detach right away, so the doctor was stitching me up while he gave my uterus time to work on expelling it and the nurses were cleaning up my daughter. At midnight, he once more gave the umbilical cord a tug. I nearly jumped off the bed the pain was so intense. Instead of the placenta detaching, my uterus flipped inside out and started to come out through my cervix. The doctor asked the nurse to call the c-section team. Unfortunately they had all gone home after I had delivered, so they had to be called back to the hospital. I started hemorrhaging and my blood pressure dropped as I started to go into shock. Things get pretty fuzzy about then, but I do remember my doctor once more asking for the c-section team with a hint of panic in his voice. People started streaming into the room, and they rolled me into the operating room.
When I came to, I was back in the delivery room with my husband, and I had the worst case of the shakes. I'm not sure what they were pumping into me at this point. I had one IV line in my hand when my peanut was born, but I had seven lines in my hand when I came to in the delivery room. (I found out later that they had left my husband alone in the delivery room with my daughter, and they didn't tell him what was happening. According to him, the room looked like the nastiest crime scene he'd ever seen on CSI.) At this point, my husband was so overwhelmed that he called a friend to come and sit with me so he could go home, get some sleep,and begin to deal with all of the emotions the day had brung. Finally at 5:00 am I was up to actually holding and naming my daughter. After some time with my peanut, our friend called the grandparents to tell them that my peanut had been born. When the doctor came to do rounds, he told me that he had managed to save my uterus and the placenta had to be manually removed. It turned out that the placenta didn't detach properly, and it came out in twenty pieces. It was also the first time my doctor had experienced a uterine inversion. Apparently it is a very rare complication.
While every decision was made with my and my daughter's best interest in mind, it was an amazingly difficult time. I'm struggling to focus on being grateful that I'm still alive and my body still has all its parts.
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