Letters About Birth #2 (Midwives): Your Voice Counts Day

21 11 2012

Your Voice Counts Day is a day going around the internet on which, for Thanksgiving, we are supposed to submit letters to our caregivers regarding our labors. We mail or hand them in to let them know how terrific or horrible our experiences were in the hopes that it raises awareness for the level of treatment we are receiving. I’ll be doing mine here, in a series of 3.

The reason I hesitate to actually send these consists of several reasons. One, I believe that mainstream people will disregard me. Two, many people are mentioned, and it isn’t overall praise or blame for the whole, and some are nameless.

Image by Flickr: Wonderlane. Contains a parable on the Buddha and praise/blame.

Three, some of these people already know how I feel. Four, at the end of the day, I’m not sure if this is more for me, or for them. Or maybe it’s for you. It’s not that I think I can’t make a difference, but it’s about too much wasted effort in one direction that feels like barking at the wind. Anyway, this series will stand here, and maybe it will help you, or maybe those people will actually find their way here and it will matter to them.

Just like in my book, names have been anonymized in part or completely to protect real identities. For those who read my book, this may be a nice accompaniment, but it’s not a prerequisite to appreciate this.

Dear D & L, LK, & Hospital Staff,

You are the main reason I do not believe in midwives anymore. I went this route which was meant to include homebirth because, inexplicably, I still believed in myself and my body. The prior hospital experience had crushed my spirit and proven me wrong, yet something inside me would not let go of the idea that I was meant for this and it was attainable and preferable. My experience with you I believed would empower me, and instead it sent me further into the abyss.

I don’t know if I can “blame” you. I think all in all there is a system problem, and you (just like all health care workers, including doctors) probably truly want to help people, and feel you do so every day. Just like OBs, you receive praise and adoration for your great works, but through my eyes it is not without its casualties.

After “40 weeks”, I had to undergo the hospital non-stress tests, even though the due date was not based on my body’s rhythms, but on flawed measurement tools. One flawed measuring tool, the ultrasound, indicated my fluid *might* be low. I wish you had listened to me and not these tests or guidelines. I was fine, the baby was fine, yet talk of induction began. You knew I didn’t want this. Yet you gave me less than 24 hours to drink water and take baths to replenish fluid you can’t even measure right or I was going to be admitted to the hospital for mandatory induction? I wish you hadn’t given me that ultimatum. It was dehumanizing.

I had waited forever for you, LK. I was hungry and angry at the thought of my birth being dictated to me. I didn’t even know you, we hadn’t met. You came to check my dilation when I was ready to walk out the door after so many hours. I never do that, by the way. I’m a good and obedient patient, to my own detriment. But you arrived just after my husband told them we were leaving… I guess that prompted you to drop whatever was keeping you and check me out. What I thought was just a dilation check became you stirring my membranes. I remember you saying, “I’m just going to stir things around down there,” with your fingers inserted already. I remember the pain, and I remember I said, “Okay,” not yet understanding what that meant, as it was happening. I thought you were being rough, because cervical checks were not always this painful. Then it was clear. You were doing me a favor, supposedly. You were trying to stir the membranes to manually induce labor, to “give” me the homebirth I wanted in time, before being coerced into a hospital induction.

I was furious after I left, when I understood what was happening to me. I didn’t want your “help”! I didn’t want to be induced at all! I wanted this baby to choose their own birthday! Don’t any of you get that? Why would you ever do that without making sure the person gave their full consent? I felt violated. You had done something to my body in a position of trust that was against my will. Later I was spotting blood and losing my plug. Even though membrane stirring is not proven to start labor (and is proven to introduce bacteria, cause pain, and create spotting), you did the practice on me anyway without my agreement in an act of trying to be *merciful* to me. You were wrong.

On the way home I called you, D, to tell you. I was out of breath, struggling with words, but obviously upset. I said that LK’s “help” was “not cool”. You agreed… because you had just been to a birth and were so tired, you wanted a chance to catch up on your sleep first before my baby came! D, that’s not at all the problem. I felt like an animal while everyone but me manipulated my body and made choices about it for me, without my consent.

The rage I felt that night, I cannot describe to you. I paced. I ranted. I processed. I confided in you, I trusted you, so I brainstormed out loud with you on the phone my plots. “We could just say I went into labor, and that the homebirth was still on, and that later on we figured it was false labor. We could just keep doing that until it’s the real thing, and they’ll never have to check or admit me or try to induce. ” After all, “false” labor happens all the time. As much as I hate lying, I was willing to do it to save myself. You told me D, that we couldn’t do that, and that if I tried to do that you would no longer be allowed to care for me.

No longer allowed! I would be completely without assistance for labor, simply because I told the hospital something which could or could not be truthful and no one would have any way of knowing. Except you, D, of course, if you were privy to this confidential choice by me. But you would admit it, or tell. I guess you would be scared… scared if something went wrong, it would come back on you, I would blame or sue you. Well, I wouldn’t have. I wouldn’t. I know you don’t know that, but I wouldn’t. I’m honorable. All I wanted was a healthy birth, and one that didn’t traumatize anyone, but that isn’t what I got. You were lawsuit-free but it broke me. It changed my life and caused a giant scar inside of me. It almost altered the future of my family. The consequences of these things are so much more severe than legal troubles or even job or money loss. It’s so much deeper than that. What was at stake for me was greater.

So that night, as more of an act of protest, I had sex to induce labor. I didn’t want even THIS manner of induction, but I had to take matters into my own hands. I had to feel in control again. Other people would NOT tell me what to do with my body, would not put their hands in or on me to make anything happen that I didn’t consent to. I did it because I wasn’t going to let anyone push me into a corner. I did it because if anything was going to induce me, it was going to be me. Immediately after, contractions began. I’ll never know for sure if it was the stressing rage I felt, the membrane stirring, the intercourse, or any combo of these, or maybe even none of these at all… but it seems like labor was indeed “induced” and that I may have been the one to effectively create it. That is bittersweet, because I will never know, and because I was put in a position to do something I didn’t want, but at least I was still in the driver’s seat and not going to let them take it away from me. I was going to have this baby naturally and at home. I would NOT be going to the hospital this time!

But that didn’t happen. I called you D, in the early morning, to let you know I was excited to be contracting all night and this was the day. I was feeling good. Sleep was nice. Labor so far was easy. I called D first because I was scared that you, L, would be too hands-on even though you were my primary. You were closer to me and you had asked to be called before D and we went against that. At the time we thought that D would give us more choices and more time. D after all had been the “fade into the woodwork” one, which I truly sensed I needed. When you were both here, it was intense. I was in hard labor. I needed to be alone but you wouldn’t leave me alone! Getting on my back for a check was excruciating but you “made” me anyway. Why? I was *this* close to having the baby! Let me do my thing, please. I was stripping off my clothing right in front of you, didn’t you notice I was almost there? If I tightened up, I’m sure it was the tension of being around people, being in painful positions, and submitting to checks.

Then that damn meconium showed up (possibly normal, possibly due to the stress), and you “had” to transfer me. Ugh! Legally, maybe you did, I don’t know. But it sucks. I know now that it is NOT an emergency, and while I know you would not want to be held liable if anything were to happen as a result, or maybe you’d get in trouble with the state or the hospital if anyone found out, this was even worse for me. This was the worst day of my life. I had to put on clothing, because the ambulance was coming. You might as well have asked me to tap dance. I had to crawl down the hall covered in piss, fluid, and blood because you thought the paramedics couldn’t fit the stretcher down my hall. If that’s true, DAMN, it still was an ordeal. Twenty minutes felt like an eternity. Could you have dragged me? Maybe you thought this was my last shot to be alone, my last shot to have the baby at home, and if so, I do appreciate that. It felt like I was in Hell, it was torture, and I’m not being dramatic. I wish you would have left me alone completely and let me labor in peace. I would have had a great birth and produced a healthy baby for you in no time. I wouldn’t have lost faith in myself and carried recurring memories with me to haunt me.

I needed quiet and solitude, and trust in me and my body and my instinct. I hope you can give more of that to other women you help. I hope you will take that away from my story. Some women don’t need to be encouraged or touched or told how good they are doing. Some women need to just be left the fuck alone, or it is like you are killing them just to be there. But that’s just the labor aspect. We do not need to be held hostage by the legalities of an archaic maternity system. We don’t need to be threatened into submission.

To the female paramedic, thank you so much for honoring my wishes and being a gentle spirit. You were so respectful and I could feel your mercy, and you let me lay on my side like I needed. I felt your kindness and gentleness. I wish I was in a position then to say so to you. I wanted to write you a letter and I did send a message to the hospital, so I hope it got to you. You made a huge difference.

To whoever covered me with a blanket when we entered the hospital doors, THANK YOU. My eyes were closed but I still didn’t appreciate my ass hanging out. That was very considerate and meant a lot.

In the hospital, the baby was right there. He came right away. No meconium aspiration, of course. Good fluid amount. Everything okay. He was perfect, sturdy as an ox (is that an expression?), and as angry as I felt inside. Just as soon as they were taking him away to check him, they were giving him right back. My husband and daughter missed the birth. My husband missed the birth of his first son.

I had a million strangers around me holding my legs, prepping the room in a hurry, and LK, you were there to deliver. You told me (ha!) to put my chin to my chest and push, and not to make any noise. As if you had any control at that point! Had you never seen the involuntary fury of a woman delivering without drugs? I did the opposite. I couldn’t have listened to you if I wanted to. I couldn’t have even tried. I DID make noise and I put my chin away from my chest, and I wasn’t pushing on your command, I was pushing because my body could do nothing else. You and your nurses were rough with the matter of placenta delivery and subsequent uterine massage. Your pitocin afterwards for bleeding was bullshit and unnecessary and only added to my pain. The aftershocks were hard. If you thought my blood loss was excessive, don’t do things that make people bleed. Please read more about a relaxed and natural third stage delivery. Thanks for not sewing me up too tight, even though I could feel you stitching me. You are an example to me of how just because a practitioner is a woman does not mean they are delicate.

Midwives: I know you have lives of your own and professions to protect, but you are supposed to be “with woman”. Who knows what I need better:  me, or the state of Florida? I needed you to believe in me and without you I no longer believed in myself. I gave my body and my trust over to you, and I deserved your trust in return. To understand horror truly and deep in your soul is a rare thing and should be rarer.

Hospital — please teach your staff how to handle with courtesy the patients. After what for me had been a horrific day, I needed sleep. I was in a lot of pain and trying to find the right meds to let me breastfeed but also sleep, and baby occasionally woke to be nursed. People calling me to demand I choose something from the menu waking me and the newborn up is not necessary. Please train your staff in appropriate behavior or hire people who are good with people.

I get shit for this one occasionally. People who’ve read my book or an excerpt act like I’m some diva slapping a tray out of someone’s hand, thinking myself precious.  No. Talk about missing the point because you feel like it. Like I’ve said before, I’m a timid patient and customer. I’m the type that can’t even send food back at a restaurant if something is wrong with it. All things in perspective. Those people don’t really deserve a response, but in the spirit of defending myself, let me clarify.

So– I’m in tons of pain with a newborn, and we are both trying to rest after the worst day of my life. It’s 6 am or so and still pretty dark when the phone startles me out of an already fragile sleep. Groggy and worn, I can barely detect the mumbling on the other side of the phone that I fumbled just picking up. “Huh,” I was like. And the lady on the other end, with an obvious chip on her shoulder and I’m guessing no clue what my state of health or mind was, yelled back, “Watchoo WANT for breakfuss??” I was at a loss for words. “I don’t even know what you have.” I said. Then she started listing shit off a menu. I had to interrupt her. “We’ll just get something to eat later.” I said, and hung up. That’s all paraphrased of course, ’cause that was like 3 years ago, but I trust that’s pretty accurate (albeit condensed).

Now, I’ve given birth at a hospital before. I’ve never had someone call me up at the crack of dawn just to ask me about food (and, it didn’t happen again, during my stay there), and with an attitude like I was inconveniencing them. People quietly enter and exit your room, to check on you and your health, to check on the baby. People don’t loudly make fusses or wake you out of needed sleep. Maybe my previous hospital was better, had more of a clue. If people want food, they’ll go get it or fill out a little paper or something, or call for it by phone or by nurse. If they’re in recovery, they don’t want to be dialed up over cheerios. That was all I meant.

Some have said, “it’s not their job to know what you’ve been through.” Oh, isn’t it? But apparently it is their job to call up every room and take orders? That’s an odd job duty. In fact, part of the reason I always thought nurses took care of our food for us was they knew how we were doing, what kind of allergies we had, what kind of medication we were on, etc. It’s not their job to know? So you mean to say if they call up a room with a coma patient, and the phone rings endlessly but no one picks up, that’s a smooth running operation– a hospital that really has their shit together? Whatever. The point is, if hospital staff (including cafeteria workers) have access to any recovering patient, yes they absolutely should know the patient’s status or condition before trying to engage them in anything. Don’t have access to reach me or affect me if you don’t know my condition or needs. That seems reasonable. And nothing they do should be jolting or disturbing, in the hospital, of all places! That’s how people get better.

So yeah, I was pissed that I got woken up and pissed for my baby too, big deal. (lol) And for the record, I never bitched anyone out about it, I just described my frustration over it in my book about my births, so excuse the hell out of me for recounting the memory. >:) *End rant*.

One more thing, Hospital. You “let” me go home early, because, you know, I wanted that homebirth, after all. How kind, right? Let me tell you something. If you have a hospital experience, the recovery and being taken care of is sometimes the best part. I think that very concept is what keeps some people from homebirthing at all. In my mind, how I felt, I needed that recovery. I had a scary and painful experience and had already had the lesser parts of the hospital birth experience; the upside was supposed to be the “vacation”. It was well earned, that’s for sure. Even though this hospital was sub-par compared to my last, I’ll be honest… I was reluctant to go home. I was hurt. I was sensitive. I needed the rest, the break, needed to be babied, and you cut me loose. Leave it up to the patient next time. They might actually want or need the standard stay.

Everyone, overall the fuss made over me was unnecessary and the commotion gave me an excruciatingly painful labor like nothing I would ever wish on anyone, and the psychological damage I am still astounded today that I had the strength to heal. Birth became my enemy that day, not just because I didn’t get what I envisioned, but because the pain itself was felt in the most terrible way as to test the very limits of what one thinks they are capable of enduring (and has no choice not to). And now I know it didn’t have to. The damage that implies is so utterly tremendous I cannot convey this with words. Birth doesn’t have to be anything at all like that. That birth was not special, not dangerous, but it was made so.  I know you feel you help a lot of people, but the standards and procedures are so very flawed. Care needs to be individualized to the woman, not based on arbitrary bullshit. Attentiveness to up to date science (not to be mistaken for “medicine”, which is its own category and a business) including acknowledging that we are mammals with specific needs and responses in labor is critical! Those MUST be honored and worked with, not against, or we are hurting women and babies. Please know that even if I’m only reflecting 1% of those you see, of every 99 women you help, you may be brutalizing 1. I have a feeling my story resonates with more than 1%, though.

I don’t want you to think I hate you, because I don’t. We’re all doing what we have to do and what we think is right, right…? Things have to change, though.

Sincerely, Elizabeth

What Will You Take Away From Your Lessons In Birth?

26 07 2012

Everything that we are and have been through… the culmination of our experiences, our education, our choices, our good and bad luck, our destiny, and yes, even our intuition… what has it taught us? Do we understand it and direct the flow ourselves, or are we tossed back and forth in choppy seas, like clueless pieces of debris?

I had a dream last night.

I was pregnant again with Eve. Eve is 8 right now. In the dream she was a baby again just for the sake of being pregnant with her, as if she had to be inside of me temporarily to be protected. I was in a hospital room holding baby Eve, giving her a pacifier– something I’ve never done with any of my kids– but

these circumstances were different. I just needed to keep her happy for a moment. I had no fear of dependence or long term effects or how pacifiers are just ways to get babies to shut up without feeding them, because this wasn’t going to impact anything for the future. And then suddenly she was in my belly and I was 9 months pregnant.

That very day, I knew, I was scheduled to have a C-section. When it was just me and my husband in the room, I started to cut into my abdomen myself, but I stopped when I realized she wasn’t ready yet. I left just shallow, non-bleeding wounds. Totally unrealistic, just dream-stuff.


My husband and kids were there, and even my parents and maybe my sister, which was weird. It was a large hospital suite for birth with plenty of room, and an attached bathroom. Staff would occasionally come in and out. It was a sunny day and light was coming in from the windows. I went to go use the bathroom and as I closed the door, I heard a nurse come in talking about she was going to need a urine sample. I opened the door and tried to make myself available, because I just barely had to pee as it was… if she was going to get a sample from me, it was going to be now or never. When I opened the door, she was talking to my family, empty handed. I looked on a nearby tall cart for any signs of a specimen cup, but could only find a plastic cup with some water at the bottom. I picked it up questioningly, and glanced up at Dr. W. Dr. W. has been my kids pediatrician since Eve was a newborn. In this dream, I suppose he was the obstetrician. He quietly commented some words to let me know that he had no idea if the nurse intended me to pee in this cup. I was frustrated because I did have to pee and I didn’t feel like waiting on these people to get their shit together. You know how it is when you have a full term baby right on your bladder. Even a little bit of pee can sometimes feel urgent. I might have closed the door and decided to pee, anyway.

Eve at age 5

It is at this point that the thoughts start to creep in… is this what I am supposed to be doing? Yes, this situation is very different, but I was here to have a C-section? Was I sure that was the right thing to do? Was I about to submit to multiple unnecessary hospital treatments, or could I finally this time keep some control over the situation?

From in the bathroom I could hear another person enter. He was there to insert something or place something in me. I had the feeling it was like a catheter, but they were calling it something else. I exited the bathroom and faced him to hear what he was telling the others. He was irritated. It was the end of his shift or something and he wanted to do this quickly. I started to get twitchy, because this attitude was the last thing I needed right now, and I wasn’t sure I even wanted this thing. When I was in labor in the hospital with Eve (who was an induction at “41” weeks, for fear of placental deterioration) I had a catheter placed, but I had had the epidural and was close to delivery, so I didn’t care and I felt nothing. At this point in the dream, I hadn’t even had any sort of anesthesia. I’ve never had a catheter-type thing placed without it, and this guy was the last person I would want doing that– if I needed it at all.

Apparently I had been crying in the bathroom, because I realize that my face is streaked with tears, but my manner is firm. I interrupt him so as to not waste his time. I ask, “Is this thing totally necessary?”

He answers me with unexpected kindness, “No, it’s totally up to the charisma of the patient.”  Dreamspeak for “discretion“? If it’s up to charisma, I might be in trouble! 🙂

“Good,” I reply. “Is this something I can reject now?”

“Yes, just sign here,” he said as he handed me just a couple of forms. I gladly did and handed them over. I noticed I signed yesterday’s date on them. He left the room. My son Cian (who is 3) shot imaginary Spidey-webs at the man as he left, like he is prone to do in real life. I hugged my son and laughed with him and thanked him for being a good protector.

There was a feeling of a change in the air, the room was quiet, and everyone was looking at me. I sat in a chair by the window. Next to me was a man I don’t know in real life, but he felt important to me in the dream, like a guide or a father figure. My face was still wet with tears but I wasn’t crying. He said to me, “Now that was a very different Elizabeth from what we saw before.” And I nodded. There was a feeling of satisfaction and accomplishment. He said, “You’ve come a long way.”

It may sound basic, but I’ve learned and grown a lot from that 21 year old girl who gave birth the first time. Trusting, submitting to authority, naïve.

This led to a whole new realization, and I pondered it aloud to all within the hospital room– should I really be getting a C-section? I was happy they were not inducing. That I wasn’t going to allow. They were just going to go straight to a C-section. But, perhaps I was wrong!? If I let them give me a C-section, would I be missing the opportunity for getting it right? “This isn’t like the last time,” I said. “She’s already been born!

This time, I really was worried that letting labor come naturally could be too late. Would labor even come? She’d already been born. This was not like a natural pregnancy and labor. This was unnatural. I was worried that not doing the C-section might actually kill her. Or, was this my chance to finally get it right, and by doing the C-section I’d be missing it? I was pacing and saying all of this and crying, trying to figure out what to do. I sat in the hospital bed and cried and talked some more, but no one really offered their input, only listened. It was so sudden to make a choice. I hadn’t had a full 9 months to consider the significance of this and figure out what the right choice would be, and it was just suddenly thrust upon me in one day.

In the midst of my tears, my open hospital room door was approached by a large group. “Heeyyyy!” I heard a loud friend of mine who I am barely friends with in real life say as she entered with her posse. She had been acting as a nanny for a Japanese family, and for some reason this entailed her bringing in several full grown Japanese women with her. She came to me and hugged me, as if unaware I was in the middle of a personal crisis, and started making light jokes about pregnancy and birth. Hardly the time! Now the room really was full, of people close to me and strangers alike. I feel like it was a coincidence she found me here, but I totally didn’t invite her, and now she’s making herself at home. Soon after they came, I said, “Hey. This is too chaotic. I am really just looking for peace. Can we maybe move some of the people who are right behind me to somewhere over there?” I motioned towards further into the room, closer to the door. A couple of the Japanese women got up from behind me and sat over there.

I went into the bathroom. I am not sure if I really had to go or if I was just trying to get away. Over and over again this whole time, trying to find my center, I am mulling it over in my head to try to arrive at the right conclusion. What am I going to do? The bathroom doesn’t look like a private bathroom anymore, it looks like a public restroom (even if it still isn’t… it’s my private bathroom). Over at the sinks, a girl is putting on heavy make up. Was she part of my friend’s posse? She is all done up as if she is getting ready to go some place special. A friend of hers is in the room with her. I’ve had it with all these people and I need to start getting people out of here, so I decide I’m going to start with her.

“Hey, I’m about to give birth soon, and there are really just too many people here. You’re gonna have to go,” I say.

“No.” She ignores me and keeps doing her make up in the mirror. She has this really elaborate metal compact, with multiple mirrors in it and compartments for various cosmetics.

“No, seriously, get the fuck out,” I say. I’m pretty sure her friend has left by now, but this lady isn’t taking me seriously. I take the compact and throw it. Glass shatters on the floor. I immediately see the glass as a weapon, which is a threat, and I’m not going to let it get to that point. She doesn’t get to turn to confront me– I grab her by her weave and escort her out the door. Finally, a moment of peace. But then she sends a male friend in. He’s playing with a lighter. I don’t know what exactly he thinks he’s going to do, but he’s not going to win. For a moment I marvel at how weird it is, to try to hurt a pregnant woman. I have a piece of glass in my sights. Is he going to cut me? How weird, to inflict a wound on a woman who will give birth soon. It’ll be superficial, unnecessarily messy, and pretty thoughtless… as if pregnant or laboring women need any additional problems.

This part gets fuzzy and I’m not sure how it resolves, but I think I scare him into leaving. When I exit the bathroom, the room is busy with people. There are at least two long cafeteria dining tables in the room, people seated at them, and some walking around. I don’t recognize most of the people. I see an ex-boyfriend sitting at the table, looking longingly at me. I wonder if I am especially pretty to him since I am pregnant. I pretend I am looking for something under the table to avoid making eye contact with him. The room is so busy, and night is here, and I’m still feeling unsure of what I’m going to do, but surely someone will be in the room soon to begin the procedure, or try to offer some other unnecessary medical intervention that I will likely reject.

Like so many of the people who are locked in some kind of opposition with me over my beliefs, I would not dare not learn from my life lessons, lest they be in vain. When put to the test and faced with an unexpected choice, I would be a fool to relive the same pain and prove to the universe that I had been no better or wiser for it… that I hadn’t learned anything. Forced the replay the same roles, again and again. Not me.

Elizabeth and baby Eve

In waking life, had this been a real-life scenario, I might have gone with the C-section. Unnatural circumstances cannot be counted on to be worked out through natural means. Forcing a baby who has already been born to stay inside the womb could lead to death (I would imagine), and the price of that is more heavy than if I were to miss my chance at redoing the first birth right. In other words, I would gladly repeat my mistakes if it meant my child lives. Would it mean the same thing in the dream? Is that the real test– to see if I know enough to separate life’s patterns from a unique life or death choice?

The dream never concluded one way or the other.

So, what about you? Do you have dreams about previous (or future) labors that haunt you? If you had to do it all over again– literally– what choices would you make?