Even when I didn't know anything, I knew SOMETHING!

My birth story with my first son sounds like it should have been traumatic: around 24 hours of labor, 5.5 hours of pushing, posterior baby (epidural was insufficient to block out the resulting back pain), failed vacuum extraction, ending in cesarean. To be honest, it really wasn't. I want to kick myself for how stupid I was back then, and how I so blindly trusted people who know nothing about the birth process at all, but that's another story.

I didn't know anything about birth either. I'd read What to Expect When You're Expecting, but that's all. I didn't even attend the hospital's How to be a Good Patient class. I'm not going to blame myself for that lack of education either. I was taught I could trust my doctor to tell me any pertinent information. That's what our culture believes right now. I won't fault anyone for trusting someone too much.

But even though I didn't know anything, there were some things that even then felt absolutely WRONG! After everything was over and I was recovering well from surgery, I was mad! Here's why:

I was freaking STARVING! They only let me have flavored ice chips the whole time I was laboring there (about 16 hours), and before that all I'd eaten was a single pudding cup since dinner the day before. Then when they announced I would have surgery (notice I said "announced" not "recommended" or "asked"), they wouldn't even let me have water! So I went about 36 hours without any food (minus the pudding cup). In the morning I was hoping for a decent meal, and what to they bring me? Chicken broth! That's ALL! What the crap! I felt like I had just run a marathon and then been hit by a truck at the finish line. The least they could have done is bring me a stupid bowl of Corn Flakes. It was another full 24 hours before they let me eat anything more solid than jello. I think my mom may have sneaked me a granola bar somewhere in there, but my point still stands. Why exactly are we starving women in maternity wards?

I know the whole "just in case" anesthesia argument, and frankly, I think it's totally invalid. Sure, if someone KNOWS they're going to have surgery, tell them not to eat or drink. That's fine. But I'm willing to bet that at least some of the time, laboring women are given surgery for reasons directly related to not having eaten or drunk anything in labor. Rather than give a blanket denial of nutrients to someone doing something physically taxing, instead provide a list of the top ten worst foods to eat in case of impatient doct--oh, I mean surgery. I understand peanuts are especially bad, for instance.

The other thing that bothered me was sleep. I got about 3 hours of sleep in early labor, then I couldn't anymore. When I went to the hospital and got an epidural, I managed to catch a little bit of sleep here and there, but nothing really to speak of. So after surgery, I figured I'd finally have a chance to sleep. I took advantage of the nursery for this reason. But for some reason, the nurses felt the need to wake me up every 15 minutes THE ENTIRE NIGHT! I was even more pissed about that than my measly broth breakfast. Is that REALLY necessary? Really? Really?! I'm hooked up to monitors, so they knew I wasn't dead.

Conclusion? Even people having babies need to eat and sleep. I knew that even when I knew absolutely nothing about birth. So why didn't the hospital staff get it?

How to recognize if a friend has experienced birth trauma

There are in no particular order. Every woman reacts differently, so good luck.

External signs that a woman has experienced birth trauma:

(Note: Some of these signs show up immediately, but many won't manifest themselves for several months)

• She may isolate herself

• She probably cries often

• She doesn't smile much

  • Or she may feel guilty for being sad at a time when society says she should be happy, and smile for everyone else's benefit

• She doesn't notice her baby growing up

  • She might often dress her baby in clothes or diapers that are too small

  • She might swaddle her baby tightly long after the first three months, when swaddling begins to be less effective

• Her memory may be worse than usual

• She may get angry easily

• She may be very anxious or fearful

  • Especially near the site of her trauma

  • Or especially when you discuss birth stories

• She may be obsessed with the topic of birth

• She may feel the need to tell her story over and over again

  • She's trying to process what happened in her own mind

• She may appear catatonic at times

  • She's not catatonic, her mind just isn't in that place or time

  • She's usually reliving her birth experience

• She may suddenly look very afraid or sad

  • She may be having flashbacks

• She may mention having flashbacks or nightmares

• She may ignore the cries of her children

• She may be unable to ignore the cries of her children

• She may become very debilitatingly anxious at the cries of her children

  • She may then either freeze up

  • Or explode

Whether or not a woman experiences birth trauma is not dependent on her giving birth in a way that appears traumatic to others, however there are some birth experiences that women are more likely to find traumatic than others. She's more likely to feel her birth experience was traumatic if:

• Her baby spends any amount of time in the NICU

• She has an emergency cesarean

• She has a non-emergency cesarean after a long labor

• She has a very long labor

• She has severe tearing during a vaginal birth

• She transfers to a hospital after an attempted home birth or birth center birth

• Her baby experiences shoulder dystocia (shoulders get stuck upon exit)

• Her baby required resuscitation

• She attempted VBAC and still had a cesarean

• She had an emergency hysterectomy

• Her baby died at birth, or shortly thereafter

  • Keep in mind that her birth experience is still separate than the outcome. She will need to grieve each part separately.

ATTENTION ALL BIRTH ATTENDANTS!

For anyone out there who is a birth attendant of any kind: please, please, PLEASE! It doesn't matter if you do everything absolutely perfect, but don't EVER take a mother's choice away. It is SO damaging when you do. Don't just follow your routine and go through the motions. ASK FIRST. And if she says 'no', DON'T pressure her. It's HER choice, not yours. And if you take it from her, she will remember it for years, and suffer like you would never believe. Her permission is all she has left to give. Don't betray her trust.

Sorry, been to the Solace for Mothers forum, and I'm always appalled at the kind of treatment women get while they're in labor. Just because you've seen a few (or even thousands) births, doesn't make you an expert on THIS birth. Only the mother can be that. Trust her.

/rant

Satan's plan for women:

• Through media, teach women that they are best suited for seduction or stupidity.
• Through media, hold women to an unnatural and unrealistic physical standard, thus convincing them that they are physically inadequate: too fat, too skinny, too short, too tall, too much acne, wrong color hair, crooked teeth, etc.
• Through women’s liberation, convince women that making a home and raising children are beneath them.
• Through the rising cost of living, convince the few women who still want to raise their own children that they cannot do so without two incomes.
• Take away the most empowering experience of a woman’s life: giving birth.
• Put men in charge of birth, instead of women.
• Change the language of conversation so women don’t “give birth,” instead doctors “deliver babies.”
• Through the green movement, convince them that having children is selfish and a waste of limited resources.
• For those women who still aren’t convinced, teach them that birth is painful, and they need twilight sleep or an epidural to block this pain, which will also block the empowering feelings and hormones that come immediately after birth.
• For those women who aren’t convinced that birth is painful, convince them—and the doctors who advise them—that birth is incredibly dangerous, and they must have a doctor present to intervene excessively, “just in case.”
• To make absolutely sure, give the system a misogynistic god-complex that will teach otherwise good doctors to intervene with extreme—usually surgical—measures for even the slightest, non-emergency complication.
• To keep women from having too many children, make her experience so miserable that she suffers from varying degrees of post-traumatic stress and depression, which her doctors will pretend they don’t see, so they continue undiagnosed (see Solace for Mothers for proof).
• For the women who make it through all that, bring in lawyers to threaten doctors into refusing to allow women to labor and submit them instead to surgery which is three times more dangerous to both mother and baby (source available upon request).
• If a woman still refuses to believe all these lies, and overcomes every other obstacle, have a government agency take her children away when she later seeks medical treatment for them (look up baby Ruth Light).
  

Any of these sound familiar? How many have ensnared you?

"Demeaning" is right

I found this comment on a forum, and it perfectly expresses some things I've never come close to correctly expressing. Anyway, I'm going to refrain from commenting any more on it:

"In reality, the health of our children can have very little to do with the way we perceive our birth experiences. The death of my first child was undoubtedly a more all around life impacting, devastating experience, but the birth experience itself was not traumatizing. To say having a healthy child is all that matters, well that is demeaning to all women who have given birth with strength and bravery to a dead child, as well as to all women who have been harmed emotionally and physically during the birth of their healthy child."

The Hospital Hero-Complex

How hospital policies create emergencies to make themselves into saviors
(Oh, and how they’re setting you up for failure)

Step one: Turning a laboring mother into a patient

• Put laboring mothers in wheelchairs to convince them they can’t do things on their own

• Not only does this psychologically convince the mother to be dependent on hospital staff for her needs,

• But it also takes a woman off her feet, slowing labor
  

• Tell the woman she can’t eat or drink in case she needs surgery

• More doubt in a woman’s ability to give birth at a time when she desperately needs support
• A laboring woman burns a lot of calories and needs to replenish herself to keep her energy
• Dehydrating a woman can cause fetal distress, necessitating an emergency cesarean
• Necessitates an IV
  

• Require an IV

• Overhydrating a woman can cause swelling and slow down labor
• Ties a woman to a pole, which often makes her think she needs to stay in bed
• Even if the woman gets up to walk around, she has to worry about tubing and bags when she needs to be concentrating on her body
• Psychologically makes a woman think she’s ill and weak and perhaps unable to push out a baby
  

• Hook up continuous electronic fetal monitoring

• Ties a mother to the bed so she can’t walk around to stimulate labor progression
• Makes a mother constantly watch the monitor and watch the monitor instead of focus on her body
• False positives cause stress, slowing labor (if she’s even allowed to continue)
• A 1982 study showed a 74% FALSE positive rate. And though I don't know of an official study on this next part, several doctors have observeda number of false negatives as well, when there was actually severe oxygen deprivation or or even infant death. If you're going to use technology to determine when I should be cut open, I would hope the technology is a little more than 25% accurate.
  

Step two: “First do no harm,” unless avoiding a lawsuit or arbitrarily adhering to traditions with no basis in evidence

• Make a woman labor on her back

• This crushes the vena cava which can deprive the baby of oxygen and cause fetal distress
  

• Give the laboring woman an epidural early in labor

• All drugs cross the placenta in similar doses as is administered to the 180+ pound mother
• This freezes an unborn baby, often making it difficult for the baby to descend properly, or can get the baby “stuck” in the birth canal (this one happened to me)
• Puts a woman out of touch with her body and unable to respond properly to what her laboring body needs
• Keeps a woman from walking, slowing down labor
• (Giving an epidural to an exhausted woman late in labor can allow her to rest and revitalize, giving her the needed energy to finish giving birth)
  

• Put the woman’s feet up in stirrups, or have a nurse hold her legs up in a similar position

• This puts undue stress on the perineum, which can cause tearing
• This position isn’t as open as is often necessary to push out a baby
  

• Yell “PUSH”

• A woman instinctively knows when to push, as labor is quite a bit stronger than peristalsis, and a woman doesn’t need to be told when to push poop out (unless she has an epidural)
• Pushing hard too early can cause tearing, hemorrhoids, and other damage in that area
  

• Perform an episiotomy

• Takes longer to heal than a tear
• Often causes MORE tearing instead of less
• Risk of infection, hemorrhage, and anything else involved in surgery
• Possible permanent pain during future intercourse

• Enforce labor time-limits

• Labor takes as long as it takes; stress (as in the kind that comes from only having a time limit) makes it longer and more painful
• Once the woman’s time is up, she’s coerced into unnecessary and dangerous surgery
  

• Lie, or withhold essential information pertaining to risk and benefit management

• You’re baby’s obviously too big to come vaginally
• This labor process has taken a dangerously long time
• Cesareans are safer than vaginal birth, and you can always have a vaginal birth next time
• Vaginal birth after cesarean (VBAC) is more dangerous than a repeat cesarean
• You’ve experienced a “failure to progress”
• We’ve tried everything, you’re baby’s not coming out
• There’s no risk involved in an epidural
• There’s no risk involved in circumcision
• A cesarean now is no risk to future pregnancies
• Cuts heal faster than tears
• Your baby has to be measured, cleaned, and vaccinated before you can nurse
• Just to name a few…
  

• Did I miss any?

Can each of the above things be lifesaving when used properly? Minus the lying, YES! But there’s no reason for them to be routine on healthy women, and plenty of reasons for them to be discontinued unless medically called for.

Something needs to change.

Follow-up about empowering women to give birth coming soon...whenever I get around to it.

Pain and Lies

I'm fuming right now, so I apologize in advance. I know this will come out more like a rant than anything I've ever written before.

When a hospital administrator decided to override my doctor's and my decision to VBAC and thought it'd be better (for him) if I had an arbitrary major surgery I was understandably upset. But I understand he was just trying to protect himself from legal parasites who suck the life and health from women and doctors in this country for their own personal gain. I was upset, but I'm okay with that (now). What really took months to recover from was my own guilt that I hadn't stuck to my guns, told the man to step off, and did what I instinctively knew was best for me and my family.

When I say it took "months" to recover from that, what I really mean is that I finally came to terms with my decision to give up, and its consequences, about a week ago. I can finally think about the birth of my son without bursting into tears or curling up in a ball somewhere in a dark closet until the sickening wave of guilt passes. I know it may sound stupid to those of you who haven't experienced it--especially to those of you who have experienced traumatic births yourselves and think what I went through was nothing because my baby and I are both physically fine--but after months of lurking on support forums, I now know that many (and probably most) women in my position felt the exact way I did. Our trauma was real, but it was also internal--practically invisible. The worst part is having to lie to everyone later, knowing that not only would they not understand, but would ridicule my pain, diminish it with assurances that "it could have been worse," even think I was making it up to get attention.

But that's all in the past now. One thing I gained from this experience is a new understanding of courage. I now know that courage is fearing the consequences of inaction more than the consequences of action, or even failure. And though that insight could never negate the pain I experienced, if it brings me success in the future, it will be worth it.

By the way, this experience is part of the reason I don't I don't silently bite my tongue out of politeness anymore. If I've said something rude to you, I apologize, but it was only because I would rather risk losing you as a friend, than allow you to experience what I did when opening my mouth could have saved you the pain.

Since I finally feel better about myself and my future childbearing prospects, I've been seriously looking into options that don't involve the medical establishment that so mistreated me. I checked out a number of books from the library. I just finished a very informative book by Dr. Bradley, and this evening proceed to the next book in my pile: Natural Childbirth After Cesarean by Karis Crawford, PhD and Johanne C. Walters, BSN, RN (the same ladies who run The Childbirth Connection). I'm only 36 pages into it and I had to stop. I knew I would never be able to sleep until I got this off my chest. I'm still fuming. When I learned that someone removed from my medical care made a critical medical decision for me, I was upset, but I wasn't really angry. Now, anger doesn't even begin to describe what I'm feeling.

I. Am. Pissed.

The kind of anger that makes my hands shake and my heart pump dangerously hard and fast.

I know I went into my first pregnancy knowing virtually nothing about childbirth. I trusted my doctors to tell me what I needed to know when I needed to know it. That was my first and critical mistake. I know now my care was critically mishandled, and I consented to things without a full understanding of the risks and other possible medical options, but I just figured it was mostly a misunderstanding on my part. I knew I could probably only name about ten internal body parts, so between my doctor’s vast expanse of medical knowledge and expertise and my relative ignorance on the matter, I figured the gap wasn’t entirely closeable. I trusted my doctor had my best interest at heart. Even before my second son was surgically removed, I figured my doctor knew what he was doing and wouldn’t take excessive risks unnecessarily.

Boy was I mistaken. The risks of VBAC and benefits of cesarean that I was presented with on my “consent” form seemed to be near the range of numbers I had discovered independently, so I didn’t think anything of the slight differences. Turns out those differences weren’t slight at all.

They LIED.

You know the penultimate card doctors always play on VBACs? That whole uterine rupture thing? A lie. Flat out. Sure the numbers they showed me were basically correct (though I remember they rounded up quite a bit), but they lied about what those numbers actually meant. Yes, uterine rupture happens, but the number they provided me with (1%, though it’s really closer to .5%) represents not only uterine rupture, but very slight separation (not particularly dangerous) and even mere thinning. What the number also fails to reveal is how that compares with non-VBAC groups. Did you know that 75% of uterine ruptures occur in women who have never had uterine surgery (a cesarean)? Even in the remaining 25% of women with uterine scars, much of the time, the rupture doesn’t even happen on the old scar! It USED to be a problem when cesareans were done with a classical incision—practically unheard of today—but not in women with low transverse incisions (90% of cesarean incisions).

As for the ultimate “dead baby” card obstetricians like to play, turns out the risk of a baby dying from uterine rupture (which we’ve already established has little to do with a previous cesarean) is at most 1 in 1000 (since 1950), and that includes women with classical scars, powerful labor inducing drugs, and forceps used during birth (all of which are known to dramatically increase the risk of a catastrophic rupture). “If you look only at the most recent medical studies in North America, excluding developing countries, the risk of infant death in VBAC seems to be less than 1 in 5000” (Natural Birth After Cesarean, p. 33).

And to top it all off, did you know that “hemorrhage during cesarean leads to hysterectomy 10 times more often than scar rupture in VBAC does” (Cesarean p. 36)?

Can you understand my anger just a little? I was given bad information that could have (and still might) result in hysterectomy or even my death, in order to make a decision I was legally obliged to make, with only one actually available option. All on bad data!

Okay, I just deleted some unladylike language from this space; I think that means it’s time for me to wrap up.

Now I come to the begging point of this rant: please. Please. Please don’t go to a hospital unless you are sick or dying, or you suspect your unborn baby might be dying. American hospitals are very good at saving dying people. That’s what they’re for. What they’re not good at is saving perfectly healthy pregnant people and their perfectly healthy babies. As a matter of fact, they suck at it. In fact, they have a very disturbing tendency to make things worse—otherwise they couldn’t convince you that they made things better.