Recently, a nurse left a lengthy comment on my website in response to an article where I had encouraged women to recognize their value, and demand that others respect them for it—and especially in their maternity care. The comment, posted in full below, is one peephole into an operating system that tells traumatized women, over and over, “Surely what was done to you was out of medical necessity. You can’t understand what was happening; there’s more to the story. You should just be grateful you have a healthy baby. Stop talking.”
I know Mary doesn’t represent all nurses, so I reached out to some other medical professionals who work in maternity care, nurses like Mary and a physician’s assistant, for their views on whether women are “fabricating” stories of birth trauma and abuse. If Mary, and others like her, don’t believe childbearing women as a group, maybe they will listen to other medical professionals.
The statements from those medical professionals are published here.
In the meantime, I encourage women, once again, to keep speaking up. Do not be silenced.
Comment from Mary:
* Trigger Warning *
These stories have been around as long as I can remember. As a multi-graduate level prepared L&D certified charge RN having been a nurse for 20 years I have never witnessed such horror, yet I have clearly noticed an underlying pattern with each of these claims.
These stories, presented only from the subjective view of the birthing mother, presents a one sided view of these situations. I would like to find a responsible journalist who is interested in taking the stories back to the medical institution and incorporating the viewpoint of the medical staff involved in the exact delivery having been discussed by the birth mother. I honestly feel this approach could give readers a more balanced perspective on these types of recounts.
From each story there is usually an initial claim that stands out as “impossible” to a medical professional which instantly discredits the story. For example, claims that patients have been accosted by their nurse with unwanted pitocin. Pitocin is an order from their own provider, not their nurse. An order that can easily be discussed with their chosen provider and even declined. Perhaps there has been prolonged rupture of membranes and the chance of infection is now present, therefore there was the unanticipated order for pitocin. Claims that a scalpel was used to do an episiotomy. Scalpels are not used to perform that procedure. Or the claim that a resident struggled to apply a vacuum to the baby’s head… No woman has to be delivered by a resident…ever. It’s a choice they have allowed for a teaching opportunity. Every woman can decline a resident in favor of their own established provider. If a woman has allowed the resident and there is a need for a vacuum it can be trusted that the situation is under control and going well. In the case of a more urgent need for a vacuum, the primary would not allow the resident to perform the task and do it themselves quickly and safely as the resident observed. A woman is free to decline anything. Yes, for legal reasons they need to sign a form acknowledging informed consent and personal choice to decline, but every woman has the right to decline anything. Truly, the list of examples could go on for quite a while, my point is that it is usually easily recognizable by any medical professional that was not present for delivery to know that the personal recount of the mother is not accurate and that she truly doesn’t have a full understanding of what had occurred.
This lasting misconception is not entirely their fault. There truly should be an immediate debriefing, especially in emergent situations, for all mothers who may not understand or be happy with what has occurred. This would present an opportunity for questions, for explanation, for clarification, for effective communication, for delivery satisfaction, and most of all true understanding of what happened and exactly WHY it happened. If this were to occur immediately during the time period where memory is most clear then there would not be so many seemingly fabricated traumatic birth stories.
It is a known and studied fact that even eye witnesses of any account will all recall something different. And even the very same person will remember less and even something different with each passing day. All people’s memories can be altered without them even realizing it. This is a fact for people in a normal state of being. People experiencing life altering events such as childbirth are even more susceptible to tainted memories in the absence of understanding.
A great many of them from the beginning have sought out a nurse midwife for their care and delivery. This appears to be due to their reception of the stories found on these types of websites that they have heard and believe, or because they have a preconceived plan for the way they want their birth experience, or perhaps they simply have an intense need for control which would be evident in other aspects of their lives other than their child birth experience. A large number of them present with a written birth plan. Birth plans are wonderful and encouraged. It is a sign of engagement in their pregnancy and their participation in delivery. Medical staff try to do everything that is possible, reasonable, and safe for patients. A birth plan however is truly a tentative request. The true “plan” is dictated by the acuity and current events. Looking back it seems that many of these woman had many similarities in their early OB choices all the way up to their tragic event.
The fact is this…. Childbirth is not something that is predicable or controllable. It is a manageable state of being that can be completely free of complication or be an extremely high risk situation. There is always risk incurred when any person gives birth. I think that down deep all of these dissatisfied birth mothers know this as well or they would not seek prenatal care or birth in a medical facility. They aren’t willing to delivery alone because they do understand there is unforeseeable risk. Unforeseeable risk and unforeseeable outcomes do not equate to foreseeable blame on professional medical staff with years and years of education and experience dedicated to helping these exact people.
Anyone who really wants the truth knows that the truth doesn’t reside in a one-sided emotional testimony. The truth incorporates everyone in the room to provide perspective and understanding. These websites, books, videos, and posts are a disrespectful escalated explosion of a conglomerate of embellished misunderstandings. If you want to know what to expect just ask questions, read medical books, talk to OB specific medical professionals about the stories you have heard, take video. Your video won’t lie. You won’t be permitted to film the actual birth expulsion, however you can film faces and audio record the dialog. (Note from Cristen: how’s this for a video?)
Again, just once, I’d like to see an article that considers the perceptions of every person in the room at the time of delivery, a memory specialist interviewing each of the people involved, as well as the history and background of the person claiming mistreatment. I know for a solid fact that that article would read entirely differently. Perhaps then the respect the medical professionals deserve will be restored. I challenge these stories to be filmed live throughout the event and then hear what they believe really happened. I promise you, even the patients themselves will be enlightened.
[End of comment]
A former communications strategist at a top public affairs firm in Baltimore, Maryland, Cristen Pascucci is the founder of Birth Monopoly, co-creator of the Exposing the Silence Project, and, since 2012, vice president of the national consumer advocacy organization Improving Birth. In that time, she has run an emergency hotline for women facing threats to their legal rights in childbirth, created a viral consumer campaign to “Break the Silence” on trauma and abuse in childbirth, and helped put the maternity care crisis in national media. Today, she is a leading voice for women giving birth, speaking around the country and consulting privately for consumers and professionals on issues related to birth rights and options.