Saturday, September 14, 2013

A Letter, An Admission

This has been hard to write. I know people who know me will read this. If you see me in person and want to let me know you read this story, that's okay. But I likely will not want to talk about it. 

Some time ago I wrote a letter to patient relations at the hospital I birthed at. My midwife had spoken to the manager of obstetrics on my behalf, but had encouraged me to actually write a letter because that would be the sort of thing that would amount to real results. My cousin, a nurse, also told me she knew that would be the only way anyone would hear my story or that any change may happen.

 It took me four months to do it. It took that long for me to get into the right head space to first be able to really remember what happened to me, but then to actually write it down. It was hard to do. I know I shook and sobbed when I typed out my story and I hesitated before hitting send. I was so scared that I'd get a reply back and hear to the effect that it was a personal problem and that I should get over it.

 I spoke to the manager of patient relations soon after. She went over my letter and got more information from me and was compassionate in her questions. She asked me if I wanted a call from specific persons on staff. I realized, no, I didn't. Again, I didn't think I could handle hearing any excuses, and if that could possibly happen then I didn't want to go through that. I asked for the manager to call me back herself and let me know any follow up.

 A couple days ago I got that phone call. And here's what happened:

The head of obstetrics went over my medical information from the birth and said that a C section was medically indicated, that I did have a good reason to have one and that I didn't need to have been put through an induction if I preferred surgery.

Staff in the department were read my letter and will be given more training in handling patients with my sort of situation.

I was given an apology.

I didn't have much to say on the phone. I was sitting on the floor, holding Jack and quietly crying. It's hard to remember that experience without becoming emotional, but I was so relieved. I felt vindicated. I'd been walking around with this wound in my heart from how I was treated and now I feel like I've been acknowledged as a person, not just as the former vessel for my baby.

I'm going to post the letter I wrote, and then I'm going to have to explain one thing I mentioned in there, which I've rarely ever discussed before. I feel like it's time.

I gave birth at *** on April 3 of this year. I'm unsure of where to start, but perhaps laying it out in point form will help give you an idea of what I'm upset about with regards to the birth of my son. It's been a long time coming, writing this, but I must. I go to a dark place when I relive my son's birth but I have to do this.

1. I was admitted on April 1. I was 43 weeks along with a midwife and was 0 cm dilated and not effaced. I had tried every natural induction technique known to woman kind with no progress. I requested a C section since I felt strongly inducing from zero would be a hellish and unsuccessful experience. I was denied this on the basis that it would be better for baby to birth vaginally. This doctor, Dr. D, seemed to give little regard to my concerns for my own wellbeing at being put through an induction, which of course carries its own risks.

2. The nursing staff treated me like an emergency because I was 43 weeks along. I told them my grandmother gave birth 10 times all at 43 weeks, and successfully. This did not alter the air of anxiety they approached me with. One nurse said she'd bet me $100 there would be meconium in my waters.

I understand the stats about stillbirths and going 43 weeks. I also know that study was performed in the 50s prior to the age of ultrasounds and non-stress tests to detect pathologies in overdue pregnancies. My scans and tests (Performed every other day) were always perfect. There was no need to treat me like a ticking time bomb.

3. The Cervidil caused me to burn internally for 12 hours. I could barely walk. This garnered me 0 cm of dilation. The resident, a young redheaded woman whose name I don't recall, badgered me into allowing a cervical check. I wouldn't allow it because I was suffering so badly. Only when my husband intervened and told her to back off did she stop hounding me. I very very disregarded by this woman. She was condescending and dismissive of all of my concerns. She cared only about being textbook and had no bedside manner.

4. I have a history of sexual abuse. It was incredibly challenging to share this with my midwife, who was good enough to share this information with the staff in the hopes of getting their support. This did not sway staff from wanting to insert their fingers inside my vagina multiple times (sometimes with no real compassion for my emotional and physical pain) or reconsider the C section for my mental wellbeing.

5. I was given a foley catheter next, and morphine to sustain the pain. It was very painful, but thankfully due to the drugs I didn't care and I can't recall how it felt. This was the only part of my induction that didn't bother me.

6. They broke my water when the foley dilated me to 4 cm. I was okay with this, but was not alright with being forced into staying in bed. I wanted to walk around to try and start labour, but was not allowed to. When labour didn't begin within an hour I was bullied about being given oxytocin. 

7. I declined the oxytocin many times. I said I didn't want to have it. I would have (Obviously) been happy to have a C section at this point, but they were hellbent on forcing labour to happen against my body's will, and to use methods against my own better judgement.

8. I'd been kept awake all this time, not allowed to sleep. The nurses would wake me to check my vitals every 30 minutes. At the point I was forced to have the IV (I had lost my will to fight at this point) I'd been awake since 8:00 a.m. on April 1, and it was late into the night on April 2. It was inserted into my hand in such a way I could not put pressure on it, removing my ability to bear weight during labour. After I started crying, a nurse agreed to relocate it.

9. I couldn't sustain more than three hours on oxytocin and needed the epidural. This didn't prevent me from feeling the catheter go in. For the rest of the night I was stuck flat on my back in bed, awoken every 30 minutes and by 7:00 in the morning I had dilated to 5 cm.

10. When the nurses changed shifts, a new nurse came in and didn't check the positioning of the fetal monitors. She noticed a drop in the heart rate and everyone started rolling me around. The OB wanted to insert monitors on the baby's head. Another internal violation of my body, a body I could no longer use half of. I could have had this all over with if I'd just had surgery when I asked for it. This was when I broke and demanded the C section. Finally, mercifully, after two days I was granted my request. I think it's hypocritical to treat a woman like her baby's in imminent danger for being 43 weeks, but then not allow a C section. Which is it? 

11. My recovery was terrible. I developed hives and no one knew why. I was awoken by a nurse every hour or so to check my vitals, and this was on top of my baby waking me. I got no sleep for the two days I was in recovery. This may or may not be the reason my milk didn't come in.

12. I developed a uterine infection five days post partum. I was told I'd go back to Labour & delivery so I could take my son with me. Instead I was taken to a post-op wing with only a communal bathroom and no space or accommodations for my baby or a companion to help me care for him. My milk had trickled in and now I was removed from the one thing that would have helped build my supply: my baby. 

13. There was no support for me to pump. The sink in my room only ran luke warm water and I couldn't clean my pump, nor could I keep track of the time or get up without assistance. I had to ask for Tylenol and was treated with suspicion for wanting pain relief at all, despite being only five days post surgery. My midwife came to visit me and was very worried about me developing PPD.

The end result is I couldn't breastfeed. Perhaps had I been given the C section rather than being exhausted for two days first this wouldn't have happened. Maybe if I'd been cared for post op in a location that better suited my needs as a new mother, this wouldn't have happened. No one gives you any information about formula in the hospital, it's all about breastfeeding. But then I was set up to fail. I live with that failure every day.

From time to time I cry about what I went through. My son, who everyone was so worried about, was as healthy as his scans and tests indicated he would be (And 9lb 13 oz). I, on the other hand, who was treated like a vessel, deteriorated. I'd chosen midwifery to avoid this very sort of birth. But I wasn't so committed to a natural birth when it looked unlikely. I was willing to go 43 weeks and let it happen naturally, but it didn't. I was flexible about my plans. I was ok with a c section to avoid the complications of inductions and risky vaginal birth of a huge baby. For reasons I will never understand, I was put through the ringer against my will and put at risk of an infection I, of course, developed.

I don't feel my best interests were considered. I didn't bond with my son for two months due to this terrible birth. I was in a very dark place and through the support of my family and midwives I was able to break free. 

But thanks to the experience I had at ***, I will never have another child. I will never go through that again. 

When I was 16, my first boyfriend sexually assaulted me. It took me over 10 years to admit that is what happened. When I was a teenager, I knew about rape. I knew it meant a man forced his penis into a woman against her will. But I didn't know other types of assault were possible. I didn't know they were assaults.

This boy, who I only dated because I had very low self esteem at the time and didn't believe I could do better (I was being bullied in school and didn't think anyone would ever want me), used to penetrate me with his fingers. I'd say no, he'd do it anyway, fast, forcibly and it hurt. It happened all the time. Sometimes I bled. Sometimes I mentally went somewhere else. I didn't know what to do. I was out of my depth.

I didn't know why he was doing that. I had no experience with boys, didn't know what was normal, didn't know how to respond. My mom, who was vigilant in teaching me to leave any relationship that was abusive, didn't know. She always said if he hits you once, leave before he can hit you again. But we never discussed sexual things. I just didn't know better, and so I suffered and was confused and after a brief time of dating him, I dumped him because the abusive behaviour became verbal. I knew enough to dump him for that. And I learned I'd rather date no one ever than anyone I didn't care about or who was an obvious loser.

And for years I didn't think about what he'd done to me. I was jumpy with new boyfriends in my life when it came to sex. I had to force myself to relax and calm down, which became my normal. I experienced stinging pain from being tense and anxious about being out of control of my body when I was intimate with someone. Exams at the doctors caused me to melt down, shaking, sobbing and frequently leaving the doctor unable to perform the task at hand.

And then I got pregnant, and knew I had to see a midwife because they don't require pelvic exams. 

On the first day I saw my midwife, I asked about internal exams and got the answer I needed: They were unnecessary. And she asked me if I'd experienced any sexual trauma in my life. And I heard myself saying yes, and knew I wasn't lying. I didn't know what the trauma was, though. I hadn't admitted what I allowed to happen to me was an assault. Because that's how I remembered it: I allowed that boy to hurt me and did nothing. Therefore, it was my fault and not an assault.

But I slowly came around. I eventually was able to go there.

While I was lying in bed, hooked up to my epidural, with the oxytocin going, exhausted from lack of sleep and having been violated by all the hands that had been inserted to me in the past day and a half, I told my doula what happened to me when I was 16. 

I was scared she would think it was no big deal, that worse things had happened and women deal with that stuff all time time, and what was my problem? But she responded with distress that I'd gone through that, and acknowledged what happened to me was, in fact, an assault. 

I can't say enough about what it means to me to classify that experience as such, instead of it being a bad sexual experience I didn't fight hard enough against, something that was my fault for not stopping, for allowing to happen more than once. To have someone tell me I was wronged. It was normal for me to feel this way. I was not overreacting. 

That gave me courage to share my history in the email. Because it was a part of the problem and they needed to know. It was also part of the reason I took so long to write the damn letter, because I knew I'd have to share that part and I never fully felt ready.

My vindication from my letter was not just for knowing I should have had a C section, it was knowing they're planning on training staff better on how to treat labouring women who've been assaulted. 

My heart has been broken for so long over how broken my body has felt for half my life. I feel like I've turned a corner of some kind, like I'm ready to move forward with my eyes open. I feel so raw. Maybe now I can finally start dealing with this.


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