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.

No More Nursing: Day Five

I feel a number of things about nursing and my journey with it. I've been wondering what caused my issues. When it came to the delayed milk, was it the lengthy exhausting induction? The C section? My uterine infection? The separation from Jack while I was in the hospital? Did my hives signal a bad reaction to breastfeeding?

I think I may have actually been doomed from the start. When I was pregnant, my breasts barely changed. Oh, at first they got tender, but my large A cup only went up to a mid-sized B. This is a minor increase. And what I've been discovering, from extensive reading, this can signal a forthcoming production problem. I never became engorged. When my milk arrived, it only trickled in. I thought it was the result of health issues. But the lack of breast changes may actually have been the issue all along. I can't know for sure, but it's another consideration, and one that gives me strange comfort.

My body just plain screwed me, is all. And it's not the first time. I had four ear infections in my first year of life, then tonsillitis. Double pneumonia in childhood, followed my two bouts of kidney stones in my teens. In my early 20s I was treated to appendicitis and I developed IBS. My body simply does not give a shit, so I sort of wasn't shocked my body wouldn't go into labour. I mean, I was, but I can believe it. I had a nagging feeling it wouldn't happen around 42 weeks.

But I never doubted my ability to breastfeed. Pfft. Stupid me. Lactivists will tell you low supply is rare, that any woman can do it.

But I call shenanigans. My eyes don't need glasses, my pancreas produces all the insulin I need, my blood clots and my kidneys don't require dialysis. However, these bodily woes exist because the human body is not infallible. Why then believe the breast is perfect? Oh, when it works, it is. The perfect baby food.

But here's the thing: nature gives zero fucks about you. It is indiscriminate, it does not care. It will weed out the population at random, with no rhyme or reason, no matter how decent a person someone is, how much they're needed or loved, or how hard they try.

I was born in 1982 with access to modern medicine, born of a C section, myself. My body has nearly died a couple times now, but thanks to modern medicine I was treated unceremoniously and easily.

I can't feed my baby. Thank God he was born in 2013, where he could be born safely and be fed something nutritious when his mother's milk didn't come. And as for me, and all my health issues I've had? Actually, I was breastfed. You can't breastfeed a baby to a life of good health. Like so much else, it's luck of the draw.

I'm enjoying my maternity leave a lot more now, and I'm really starting to bond with my son. I hadn't realized just how much of a barrier that pump put between us. I was prioritizing bottled breast milk over our relationship.

Giggles!

Jack's started to grab things and he's giggling. He's sitting up with assistance and he's able to entertain himself for a little while at a time. My son is so amazing. He's very bright and a great little baby. I'm so lucky to have him.

The Birth pt 2

Okay, the pitocin. I was able to put it off for a stint, but I had been kept awake for 24 hours and lost my resistance. Pitocin, without a doubt, is a terrible experience. And I didn't have the stamina needed to sustain it. After three hours of fast-paced, hard irregular contractions that raked my body with pain, I caved and got an epidural. Meanwhile, they cranked the pitocin all night and by morning I was suffering in an immobilized state. They inserted a catheter into me because I could no longer get up to pee and I still was able to feel it going in.

This is a crappy way to labour.
Fetal monitoring

When the nurses changed shifts, my fetal monitor had slipped. The nurse freaked out at the new erratic numbers and started rolling me around and the OB came in and wanted to attach a monitor to baby's head, up my cervix, which was only 5 cm after all that. At this point I said simply and loudly, "No. Just get him OUT. I want a cesarian."

And that's what happened. It was quick, I was scared, the Dude was left behind with no instructions and I was wheeled out of the delivery room and to the OR. I had to lay in a crucified Jesus pose while I was hooked up to things, given more anaesthesia and prepped for surgery. My midwife came and sat with me, offering comfort and eventually the Dude was given a place beside me.

There was pressure. I held the Dude's gaze the entire time, and it was the only thing keeping me calm. I love that man, I really do. He had no interest in watching the procedure. He was there for me. The curtain draped over my face quite a bit, my torso being so short, and it was yet another minor indignity.

We heard, "It's a boy! And he's peeing!" John was proclaimed a healthy baby, 9 pounds 13, and scored a 9 out of 10 on his Apgar. All the concern over him was unwarranted. The placenta looked in good shape, I'd had a lot of fluid and the cord was great. I cried when I heard him cry. The Dude was crying and we had a son.

He doesn't look a thing like a newborn. He instead looked about 2 weeks old or more. His neck was strong and he could already hold it up some. He latched to my breast within 40 minutes of the birth. Slightly overcooked, but seemingly healthier and stronger for it. My body sustained him well, but never seemed to be able to transition out of the pregnancy.

The recovery was a little rough. We paid a little extra and got a private room since we'd be there awhile. Unfortunately, the sleep deprivation was constant. I was woken up frequently by staff to give me meds, take my vitals or talk to me about various things. And this was on top of Jack (Which is my preferred nickname for my son) waking up and needing us. Rather than go into a lengthy sleep, he began a cluster feed immediately and I was nursing all the time while the Dude changed diapers.

Eventually I developed hives. They spread all over my body and itched horribly. I was given Benadryl, which worked, but they still came back. I was exhausted. I found nursing challenging with my incision and the pain meds were only enough to take the edge off, not eliminate it. I needed help up for everything. I could barely walk. The Dude was in and out a lot running necessary errands and fielding phone calls and texts, getting me drinks, and getting himself food since they would only feed me.

I was discharged after two days, hives in full effect, pain constant and feeling highly depressed about my chances of taking care of a baby. The Dude talked to my aunt and she came a little early to be with me. My father-in-law, now in town, took us home and I was helped into bed. My hives spread to my face and my lips looked like bees had stung them.

My aunt arrived and after more Benadryl my hives subsided. It was a battle for another day or two to keep them away. I developed more nursing issues after that. My milk didn't come in. I was only getting colostrum and Jack was going hungry. After losing 12% of his body weight, he was put on formula and I had to start pumping to generate more milk.

But this proved difficult. I was still exhausted and needed to nap, eat, tend to my body and the manual pump I had was not very efficient. The Dude went out and bought an expensive electric one. It works great, but I only got to use it once.

Last night I developed a fever of 38.6 C (Almost 102 F). It started with uncontrollable shakes and chills. After a couple hours I was heating up. My midwife said to go to the emergency room, and my father-in-law came over and drove us to the ER while my aunt stayed with the baby.

We were there till 4:00 a.m. The woman beside me, separated by only a curtain, was not given much chance to last the night and her family surrounded her as a priest gave her Last Rites.

They took blood and urine and I was sent home with an appointment for an ultrasound for 1:00 pm, which my father-in-law also drove us to. I wrote part one of the story before this appointment. The ultrasound was 45 minutes behind schedule and it was both an abdominal and a trans vaginal. I was uncomfortable.

After going through the ER again I was informed I had Endometritis, an infection of the uterus. I'm now alone in a hospital room away from my family for up to two days. I've cried a lot today. I'm tired. I'm low. I'm afraid of losing my milk. It'll be hard to pump in this room. It's from 1930, the whole ward is outdated and sorta scary and what few plugs there are are inconveniently located. The Dude fought the staff to get me a private room, and that is sustaining me right now.

That and the knowledge that it's either this line of treatment or I pretty much suffer indefinitely. Jack is in good hands, the Dude is home and finally getting some needed sleep and I guess now is the time to rest, myself.

So now I sleep. Tomorrow brings antibiotics, hospital food, pumping efforts, and complicated trips to the bathroom.

The Birth pt 1

I'm a mother. And it came about in spectacularly terrible fashion on April 3. I have a son, his name is John (Though I want to nickname him Jack and the Dude is only calling him John. We'll see who wins), and he is, if I may say so, stupid cute. He doesn't look at all like a newborn, probably because he cooked for 43 weeks.

We went in on April Fools Day and I didn't get my C section. The OB on that day felt it was important to give labour a chance. He sold me a bill of goods about this Cervidil induction, how it's gentler because it takes 12 hours to fully take effect and it ripens your cervix. FYI, I'm going to get graphic from here on out. If this ain't your bag, I'd suggest stop reading now. I'll understand.

My midwife inserted it for me. This was painful. Generally speaking I don't enjoy hands putting foreign unwanted objects into my private crevices. I'm especially protective of my holiest of holies. However, this was the first of many such experiences and I was lucky my midwife was there to do this for me because I know and trust her, whereas I didn't know the OB from Bob.

Cervidil is not gentle, at least not to me. I could feel it chafing my vagina. My cervix, which was clamped shut, began to burn. I could barely walk. 12 hours of a burning nether region is a long time. Couple this with being hooked up to a fetal monitor around your belly and a nurse coming in every 30 minutes to check your vitals. This went on till 4:00 a.m. and meant no sleep for me.

Something this small and innocent looking was the cause of much suffering.

I was able to remove the Cervidil tag (Yes, it's a long tag-like thing. Bizarre.) even though my midwife was called to come back and do it herself. Silliness. There was a slight amount of relief there, but then the resident insisted she check my cervix. My burning, long suffering cervix, which didn't deserve such torture, was not having it. I wanted a cooling off period for it to not feel like it was dying. So I said no. I said no again when she asked me 15 minutes later. And then the Dude said no. That actually got her to stop harassing me.

8:00 a.m. the new OB arrived and she wanted to check for dilation. I'd had bloody show, finally (Don't Google this if you don't know what it is and are squeamish about intimate female matters) and was hopeful that something had happened to make the Cervidil worth it. As the burning had stopped, I let her, and after 12 hours of suffering, the gain was 0 cm. I don't know that "disappointment" is the appropriate word, because I was feeling an otherworldly version of that.

Giving birth should not be this effing complicated.

She wanted to insert a foley catheter. It's a balloon-like object that goes in, yes, the damn cervix. It expands it manually and hopefully painlessly and is not supposed to harm the mother or baby at all. That's all well and good, but I couldn't bear the thought of having something pry open Fort Knox (By this time I had casually named my cervix since it had become such a big part of my life and yet had motivations and goals seemingly opposite to my own).

So they gave me morphine. I was accepting of this. Yes, I was pregnant, yes the effect on the baby, but seriously? At this point, he was cooked, he was healthy and he was coming out and I'm no martyr. They said it would wear off by the time he was born and I went with it.

The morphine was something of a mental vacation from what was happening to me. The insertion didn't feel good, but I kind of didn't care. I stayed in bed hooked up to this monitor and zoned out for a few hours.

The catheter was a success. I got to 4 cm and the OB broke my waters. Now that was weird. It's like peeing yourself except with no pressure, cramping or anything. And it keeps leaking and leaking. At this point I thought I was supposed to be able to walk around and get labour moving. But instead I was re-hooked up to the monitor and kept in bed for an hour. I was let off for 15 minutes to get moving around and when labour didn't start in that time frame, it was declared a failure and that I needed pitocin.

At this point I'm going to have to leave part 2 until later. I need a nap something fierce and there's a ridiculous amount of crazy shit left to tell.

Get Me Out

I'm reading this new book called Get Me Out: A History of Childbirth. It's exactly what the title says it is, a history. And sweet mothernuts, is it full of some scary, scary shite. Like, holy crap. People think giving birth NOW is scary and gross? Even 200, 100 years ago it was worse. It doesn't make for good bedtime reading, because this book is full of things that would keep a sane person up at night.

And I'm fascinated and eager for more! Not that I enjoy cryptic tales about what happened to women after doctors used to do autopsies and then deliver babies without washing their hands, but the fact that it actually happened is what stuns me and propels me into reading more. The vast amount of ignorance and misinformation that people were basing their lives around only makes me cringe to think of what future generations will say about our medical care.

Like when they finally find a cure for cancer, people will say, "WHAT?! They used chemotherapy on actual people!? That stuff is poison! How barbaric!"

I mean, you don't know what you haven't learned yet, right? Washing hands after touching dead bodies sounds like common sense today, but like I was saying, we could be doing all kinds of deadly stupid shit we don't even think about because it's common contemporary behaviour. Frankly, we probably are. Think about the mass disinfectants that are found in so many homes, either babying and weakening people's immune systems or creating superbugs.

One of these days I bet someone's going to link the massive wave of ADD children seem to have now to all the pitocin women are getting now to induce and then speed along labour. I mean, strangers will glare down a pregnant woman drinking a coffee or taking an aspirin and heaven forbid a sip of red wine, but yet hours before delivery a mother can get injected with an epidural into the spine and then IV dripped pitocin, all of which is obviously going to make its way to the fetus. I don't get it.

Oh, I get the desire to end pain and speed things up. Yes, that part makes sense. In the throes of labour, I can totally see wanting anything, anything at all to just get the damn thing out and make the pain end. But what I don't get is why injecting and dripping these drugs into a labouring mother is A-Ok when these same pregnant women are warned not to eat tuna. Tuna no, drugs yes? And since there's no long-term studies following up on the children to see whether or not epidurals are in fact healthy, who knows?

Another thing from the book is that DES was in use by pregnant women for 30 years before it was discovered that it caused some of their daughters to grow up and develop a rare deadly vaginal cancer. Total crap shoot who would get it, but they all linked back to DES. These poor mothers were only doing what they thought was best based on the advice of their doctors. How could they have known?

So it makes me nervous to think about our own contemporary norms, like the epidural. I don't blame women wanting relief or trusting medical professionals to help them. I do worry about doctors examining an apparently healthy baby and then thinking that the epidural must have had no effect and then moving on. I mean, the DES babies looked fine at first and second glance, too.