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]
Here are the responses to this comment by three medical professionals [link].
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.
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I am honestly stunned and very perplexed with this blog Cristen.
“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. ”
I find this statement quite demeaning, as if the birthing mother, doesn’t have the better memory or the truth of what happened on her side….I find it troubling because for the longest time, I thought I was “just being dramatic” as I was dismissed by others. Surely what happened to me wasn’t the case, it couldn’t have possibly happened at the hands of well respected midwives?! For the longest time, because of their high esteem, I carried around the weight of what happened as “if only I had taken a childbirth class”…”if only I had a doula”…”if only I didn’t let her break my water”….”if only I hadn’t______________” and carried around the pain and the trauma from what I DIDN’T DO…blaming myself for the terrible birth I had…UNTIL….until I saw the medical records…..all of these things I remembered, WERE ACTUALLY RIGHT! I wasn’t being dramatic! I remember all these things like night and day, and I even have **SOME** notes to back it up! In fact, not only that, I have a video where I was told that I couldn’t use the tub to labor in…yet the medical records stated that I declined it!! So, now, not only do I have these medical records that are in allignment with what I perceived to happen (which was true), I also have in video the lies that were told to me….so, then I ask you, at what point would the opinions of these supposed professionals have had? They obviously were not practicing evidence based medicine in the first place, they lied in records….I clearly had the memory that I thought I did…so what good would it be interviewing these very people who were not acting in my best interests?
Trish, Cristen didn’t write most of this blog. She was re-posting a comment that was left on another article she wrote.
“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”
The statement is demeaning. And many of us feel the same you do. I hope that this helps you understand that it isn’t Cristen making that comment you had mentioned.
Hi Sheila,
Let me go back and clarify: when this post was first posted last night, when I posted, there was no plot or any other information, it was just the nurse’s comment, which of course, would have found anyone perplexed. Glad to have the context and the commentary added in to give better perspective. Keep up the good work IB and Birth Monopoly 🙂
And one last thing, this is troublesome as well to me:
“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. ”
The history and the background of the person claiming mistreatment?! Again, I’m having a really, really hard time with this….as if their history or background discredits their testimony? This eerily sounds like what we do with rape victims and muddy their reputation while trying to acquit their offender.
This is one blog that I really had a hard time reading. I’m trying to be objective, I promise. But being on the receiving hand of the abuses and lack of evidence based care, this sounds all too much like victim blaming….
Hugs to you anyway! 🙂
Trisha, it IS victim blaming. And that’s the point. Almost the entire blog is a comment a nurse named Mary left on an Birth Monopoly article. Cristen is posting Mary’s comment during blog post one and will post rebuttals in further blog posts.
I’m feeling exactly what Trish said. “Why should we believe her? Let’s first make sure she is a law abiding, church going citizen before we deem her rape account credible.”
Misogyny is so intertwined in all parts of our lives that women don’t even realize when they are doing it to each other and continuing the pattern for their daughters.
This post was not written by Cristen. It was written by a nurse called Mary. Cristen is showing us a view point of some nurses that do not believe women suffer at the hands of these so called, birth professionals. She will post another view tomorrow. She is simply showing what we are up against.
Let me go back and clarify: when this post was first posted last night, when I posted, there was no plot or any other information, it was just the nurse’s comment, which of course, would have found anyone perplexed. Glad to have the context and the commentary added in to give better perspective. Keep up the good work IB and Birth Monopoly 🙂
I’m sure the nurse who slapped me after my first baby was born had a great medical reason. I was touching my own breast trying to nurse. I was told “don’t do that.”
I’m guessing the OB who screamed at me to hurry up so she could go home also had a good medical reason.
I’m guessing the nurses who told me to “shut up” and that I “wanted it” when I cried and was having a 4th degree tear repaired also had excellent medical reasons. I’d sure love to read an journalistic account of those events to show me the medical reasons behind only part of the trauma from that birth.
A midwife and doula caught my second baby. It was a healing experience filled with compassion, respect and dignity.
This isn’t Cristen talking. This is a long quote from a nurse. Please read everything before getting upset.
I am sure there are people and places where bad things happen. Those bad things could be anything from the nurse being rude, the doctor checking a patient after she said no, pitocin being hung without consent, etc. But these articles you post are as though these scenarios are expectations of the medical professionals and that you as a patient need to watch out because we plan on mismanaging your labor and delivery. It causes patients to lose trust in the good nurses and doctors who really want the best for our patients.
I can only speak for myself but I have spent a lot of time with patients going line but line through their birth plans answering ever question and trying to go over all details and scenarios, and sometimes it’s still not enough. So if you are not going to listen to the knowledgeable educated medical professionals because you still think we are out to get you, i dont know what I’m supposed to do. It makes some of us wonder why you chose to give birth in a hospital. I know the security of being in a hospital is most likely what you are looking for, well then you need to listen to some of the things we tell you. We are not all mean, bad, or for sure out to get you.
“These articles you post are as though these scenarios are expectation of the medical professionals…” NO, “these articles” are traumatized women finding their voice and telling their story because they need to be HEARD to heal, and because they want other women to know that they are not alone. “These articles” are here because we are tired of being told that our concerns aren’t valid. It *doesn’t* “cause patients to lose trust in the good nurses and doctors…” The fact that these things REALLY HAPPEN is what causes patients to lose trust in the good nurses and doctors.
Maybe going over their birth plans “line by line” *isn’t* enough because what WOULD be enough and what is NOT an unreasonable request is that women are not subjected to non-evidence based care that sets them up for the complications that then necessitate intervention. What WOULD be enough is if, prior to every proposed non-emergency intervention, a woman and her support people (because plenty of THEM get traumatized too) were presented with the rationale, risks, and alternatives to the intervention, without being made to feel like the decision they want (or may not even know is theirs to make) is frowned on because it makes things inconvenient for the staff, without experiencing scare tactics and pressure to choose what the “knowledgeable educated medical professionals” want. This is not saying that all nurses, doctors, and hospitals are bad. This is not saying that you are “out to get us.” This is saying we deserve respect, we deserve to be informed, autonomous “patients” treated as though WE are the decision-makers, and that in the instances when we DON’T get all of these things that we deserve, we deserve to tell our stories without being told that they are not true and that our feelings about them are not valid. Because we’re not “knowledgeable educated medical professionals.”
You wonder why these women “chose” to give birth in a hospital. 99% of the time it’s because: A) “Knowledgeable educated medical professionals” tell the public that home birth is unsafe despite evidence to the contrary and medical authorities outside the US making recommendations that most women would be safer delivering OUT of the hospital. B) Most insurance doesn’t cover home birth and most women can’t afford to pay $3000 out of pocket for one. Why should we have to pay $3000 for a respectful birth where our wishes are honored, and when they can’t be, we are left feeling informed and supported and emotionally accepting of that fact because it was handled in a way in which we don’t feel coerced or as if things should have been done differently.
You can be a good nurse, and there can be good doctors. None of that negates the fact that birth trauma exists. This is not “us against you” or “us against them.” This is wounded women against obstetric violence and against the denial that it even exists.
I 100% believe that women feel traumatized during their birth experience and for that I am truly saddened. An experience that should be enjoyed, happy, and remembered for a lifetime as a joyous one should never be marred as such. This is a field that professionals should work in because it is truly a miracle and a life changing even for all Involved. I love my job, my patients, and the people I work for. I am thankful for being able to be a part of so many happy times.
I just feel that there are many days that a patient comes in and thinks that we are going to suggest medications or interventions that are not appropriate to their individual care. I work hard to make sure that for example pitocin is only suggested if truly needed (in which I do get into some heated arguments when I disagree but it’s whats right for the patient), or that if a cesarean is needed that it’s truly needed. I have in one case in perticular been asked by the patient if I felt she truly needed one and I did not think so–the provider was misinterpreting the strip–new monitors at the time and they did some wacky things. As a nurse, and educated professional our core is to advocate for the patient and in a case such as labor and delivery we are so vital with mom being at her most vulnerable. We are the second line of defense- after patient and dad and when they won’t fully understand we need to ensure they do and tell them that they have a right to refuse things. I’m sure there are nurses that take the easy way out–they push the pit, they drag their feet to give a patient an epidural because they want to save it for the next shift, they dont advocate for a patient because they don’t want to do the work they need to for that. It’s very sad and I hate to think that I work with people that feel that way.
Most hospitals have some sort of patient boards where experiences such as these should be discussed. As a patient you may not want to speak or feel looked down at for doing so but you shouldn’t. It may seem like nothing will change in doing so but I can tell you that it does truly make a difference.
AWHONN continues to recommend that the safest place for mom and baby is in a hospital, so we should ensure that moms feel safe not only physically but emotionally as well.
**I am a mother of 4 so I do understand what it’s like to be a patient–I had my first 2 before I graduated nursing school and worked in L&D**
Thank you so much for commenting. There are so many wonderful nurses out there who advocate for patients and their families. I wonder about the patient boards you mentioned? I don’t think I’ve ever heard those mentioned before by women who have complained. Do you know what they are called, more specifically?
Every hospital has something in place that handles negative patient experiences (good ones as well). Most hospitals call them patient advisory boards. There is usually a panel of people from various medical departments and some higher ups. They listen to patients re tell their story bad or good. This is vital in changing the way things are done or reprimanding someone for something they did that was wrong or for mistreating a patient. I would encourage someone who has had anything negative happen to them to contact the hospital or speak to someone there and bring it to their attention. Even those after hospital surveys are very important. Patient satisfaction is very important to the hospital and we see ALL those comments every couple months from every department. You can never change everyone and fix everything but you should try. Unfortunately there will be bad doctors nurses and midwives all over and it’s hard for a patient to pick based on a name and even another’s experience. Everyone perceives the circumstances differently and we should be aware and respectful of that.
I know I may no always be the best nurse out these and I have off days too–the kids were tough on me in the morning the husband and I had a fight and so on–but I do my best to leave everything behind and focus solely on my patient and their needs at that moment in time. Because their needs may change as time goes on as well. Nothing is static especially in obstetrics.
Another thing ANY patient can do at ANY time is when they feel uncomfortable, unsupported, judged, or have any qualms or negative experience is to ask for the charge nurse. This nurse is the acting manager and can help correct any injustices, whether that means assigning a new nurse, speaking with the doctor or the doctor’s higher up, or any other issue ie anesthesia. They can also answer any question and are an extra resource. If you still feel you are unheard, you can ask to speak the the Manager of the unit. I assure you, they do not want you to have a bad experience and do not want any of their staff to cause trauma to the patient! They also have pull with the doctor and anesthesia’s boss as well.
L&D Nurse, thanks for speaking up for the rest of us. Those of you who have had a traumatic experience, my heart hurts for you and I really feel pain for you. I agree with L&D nurse in saying that you won’t always find empathetic, caring nurses dedicated to working their tails off for you, to ensure you get what you want. I encourage everyone to speak up, ask for clarification, and to deny things! Nothing is more painful as a L&D nurse than to watch your patient let the doctor do whatever they think should be done without the patient getting much explanation or options. It kills me when that discussion is a hurried one and the provider is pushy, the mom is so tired that she sometimes simply agrees. I will go to battle for my patients, and try to gauge what they want their labor to look like before things really get going. I try to educate about every scenario early so that these women are more equipped to make educated decisions.
But the sad fact of it all is that not every nurse takes the time to sit with you and learn what you want, to truly get to know you. Not every nurse educates you early, tells you what is going to help or hinder, advocates for you. Not every nurses is willing to battle for you, physically to help support you through a natural labor and professionally to disagree with your provider. I URGE every new mom I know to do their research on epidurals, c sections, natural labor, to look up reviews on their providers, their c section rates, pitocin rates, induction rates. And I URGE everyone to know that have the right to say NO, to ask for a DIFFERENT PROVIDER and/or NURSE.
When things tend to go south in labor and delivery, it is very hard to find the time to explain to the patient what is happening and why it is happening. I try very hard to do so, but I will tell you we have a million thoughts going on about how to save both you and your baby. That does not mean that we shouldn’t explain anything to you, it just may mean you get the cliff notes version until we have you and baby stable enough to explain what happened and what is going on. So EDUCATION is a huge thing, and if you are educated about the possibilities of what could happen during labor, it might make things less scary as you will know what is going on and why before the nurse can tell you.
Again, I am sorry to all of you who have had a traumatic experience, from the bottom of my heart. I truly pray that if you ever go through labor again, it is a healing, wonderful experience for you.
(If you are pregnant, I am serious about looking up the statistics of your provider and their practice on c sections, epidurals, ect. Also, if you want to labor natural, get a doula or call the labor unit and ask for a list of nurses who are great labor support. Unfortunately, not all of us are. And if you forget to call, you can always ask in triage before you get admitted to the hospital. Also, make sure to check the hospitals policies on laboring in the tub as there are many exclusion criteria where I work)
Good luck to everyone, I pray for healing and happiness!
God Bless.
Samantha -L&D RN and future doula
You left out the reason that in many states, home birth with a midwife is illegal!
Some people “Choose” a hospital birth because they don’t see any other choice because of insurance or family peace or homebirth availability.
Raising these very real and common experiences is as vital as discussing domestic violence. It may seem that it’s only here to injure the relationship and reputation of good and caring professionals but this isn’t any more true for you and hospitals than it is for husbands and marriage. These accounts are real and need to be validated for the well being of mothers, marriages, families, the Healthcare community as a whole, to improve subpar moral and ethical treatment and to celebrate the beautiful miracles events and care that reach the optimal ideal.
There are, indeed, very skilled and tender nurses, doctors, midwives, PA’s, and NP’s in labor and delivery. We cannot overlook this fact, but I submit this is the very reason these accounts of abuse are so heartbreaking, good care is expected to be the norm, experiencing abusive betrayal like this goes beyond almost anything.
Considering the load of hightened hormones, the intensely emotional design of birth, the significant need for trust and honor, the level of intimacy involved with other people being involved in not only a life shifting moment for a woman and her family but also entering her most private and sacred spaces, these acts of brutality and control are earth shattering for women. Yet. Women are denied the right to be wounded and silenced. They are told by everyone their body is nothing more than an incubating machine and any horrors or trauma experienced is simply their lot to pay without complain because the ONLY thing that matters is their baby. Surely every woman would pay any price to have a healthy baby but why should that be taken advantage of by others? New mothers are expected to waltz or if the hospital and slip on their size 5 jeans, get back to the fields, smile a glowing perfect smile, and be ready to allow their mate to enter them at the earliest convenience as if it were a mere dentist appointment.
I get why as a nurse who had made a real and purposeful effort into being present as a human being with care and concern for your patients you’d be frustrated at reading account after account love this, but where do women go to be validated? Where and what do they do to wake up society so or community demands more and better? How do they make it known they deserve to be honored as an individual who’s having an all encompassing moment more important than their provider’s steak dinner, sweet dream, or golf game? When do other professionals or pressure on their colleagues to stop doing crappy vial things to women than demean and dismiss them as intelligence, honorable, sentient beings who matter? When do we arrive at point when other health care professionals say enough is enough to those who are acting outside of ethics and morals at demand they cease to devalue the profession and smear your reputation?
It’s a difficult tight row to walk, I know. Some people you wish you could make decisions for because they choose things that seem very clearly dangerous but we don’t get to take a person’s autonomy away just because of a clock, a preference, or ego.
I would agree that there are many good doctors, nurses, and physician’s assistants practicing, but even they can do things that are traumatic sometimes. I had one of the best OBs possible when planning my 2VBAC this spring, and overall had a great experience with her. However, she caused me a great deal of pain when she decided that she HAD to check and strip my posterior positioned, firm cervix because she was worried about me going overdue. I had initially given consent, but revoked my consent because of her rough handling. I asked her to “please stop” several times. She ignored me and pressed on in spite of the fact that this was not a necessary procedure. I will tell you that after that I was not willing to let her check me again. This was a my third child, and I have never had such a painful check in my life. Honestly, it was reminiscent of the OB who stopped to have a nurse pull up his sleeve mid cervical check, then told me I needed to have an epidural because I seemed “tense”.
Would you say the same thing to a rape victim? “Telling your story of what happened is as though these scenarios are expectations of the male population and that you as a woman needs to watch out because men plan on raping you.”
Sharing the stories is important! Even if only 1% of men commit all rapes, just as perhaps only 1% of all obstetric care providers commit all the bullying…
As a doula, I’ve seen the bullying. I’ve seen the procedures done without consent, medications administered without consent, and even worse, AGAINST the expressed desire of the woman. And yes…I’ll put my real name on this, because I don’t feel a need to hide behind anonymity.
I do not use Labor and Delivery Nurse to HIDE behind anonymity, I use it because I love my job and I don’t wish to lose it. I have a VERY uncommon name and I have to protect myself from being bullied at work for my opinion (which I don’t think would happen BUT you never know), and to continue the work that I do because I love it. As a doula, you probably don’t have to worry about being fired for your opinions on social media or blogs, but as a Registered Nurse I do. I stand by all my comments both on here an in my place of employment and I think that most nurses where I work would agree with me. It’s the older nurses that have been around since the 70’s and have seen times changing that have a hard time. Nursing is all about change, policies and procedures and patient education levels are constantly changing and you have to be willing to evolve with them.
I hope you understand where I’m coming from here.
As I have stated previously this is a terrible thing that happened to this mother during the birth of her child, and I hope that there are other nurses, residents, doctors and such that can learn from stories like this. We should ALL want what is best for our patient.
Regardless of whether the mother has “embellished” or “tainted” memories, her feelings are STILL VALID because she is a HUMAN BEING DESERVING OF BASIC HUMAN RESPECT. if she comes out of her birth experience feeling traumatized, she needs help, not told that her (human and capable of error, arrogance, and abuse) doctors are innocent by default simply by virtue of their doctor-ness.
As a registered nurse, I find this response appalling. This is exactly what’s wrong with medicine and why it’s important birth professionals hear the stories of traumatized moms. Medicine can be so task oriented that I feel like we forget we’re helping PEOPLE. These moms have feelings, hopes, desires that extend beyond just leaving the delivery room alive. And on that note, the moms don’t need to be “debriefed”; they need to be ASKED. With no coercion. Informed about what is happening and what ALL of their options are, so they can make a truly informed decision. Shame on you Mary. You’ve lost touch with the heart of nursing.
Trish, read the post more closely. Those statements were not written by Kristen. She is sharing a long comment that Mary, a labor and delivery nurse, posted on a previous post.
Hi Stacia,
Let me go back and clarify: when this post was first posted last night, when I posted, there was no plot or any other information, it was just the nurse’s comment, which of course, would have found anyone perplexed. Glad to have the context and the commentary added in to give better perspective. Keep up the good work IB and Birth Monopoly 🙂
I would just like to throw out there that during my first son’s birth, I was given an episiotomy with a scalpel. I saw it, I wasn’t hallucinating, it was a scalpel. Maybe not every hospital has the same protocol? And for her to say that these traumatic birth stories are just fabricated out of false memories??? Are you kidding me? So during my second son’s birth at home, I felt totally respected and cared for. Am I fabricating those feelings simply because I was in labor? I don’t think so. Labor and birth can be a whirlwind, but you still know how you were treated and what was going on. This nurse is acting like any woman who is in labor just has false memories or something. I agree with Trish, this whole article sounds like victim blaming.
I am married to a high-risk obstetrician, had three previous birth with midwives that were satisfying, and was traumatized by my fourth delivery in a traditional maternity care unit led by an obstetrician and labor and delivery nurses. All my births were drug-free, uncomplicated vaginal births, so it was not the birth itself that caused my negative reaction. Trauma can occur not just when a complication arises but because of how a mother is treated during her birth! This nurse should visit Penny Simkin’s website http://pattch.org/resource-guide/traumatic-births-and-ptsd-definition-and-statistics/ to learn more about the reality of birth trauma. I went into my fourth delivery experienced, educated and with my husband’s support all to discover that some of traditional maternity care’s basic practices can cause trauma. My husband was not even aware that how he’s been trained to treat women could feel traumatic to me. Trauma, too, is not a decision on the mother’s part; her ancient brain or limbic system registers events as trauma if a real or perceived threat to her safety or survival has occurred.
As a labor and delivery RN for 17 years and then a CNM for 17 years I can tell you that women don’t have to make this stuff up. The main reason I became a CNM is because of the uncaring, patriarchal ideas, disregarding evidence based info.etc..
Women do not have to make this stuff up!
This nurse must live a very sheltered existence to believe this. My recall of my traumatic birth experience was backed up by the nurse’s handwritten notes- the doctor’s notes were very different in many areas. Oftentimes when one lives a certain truth, the person cannot see that other people’s experiences are quiet different. Personally, in my job I have switched locations many times. Each time doing the same position for the same company. When working with a new staff they are often unaware that just because they do something some way that others do it differently. I would recommend that this nurse starts to go to work at different locations out of her current area, maybe then she will get a better perspective on what is actually happening.
I find it interesting that she thinks there should be an “immediate debriefing”. Really? You think? Of course there should be communication after. Even more important, there should be “honest” communication BEFORE anything procedures are done.
Many of the interventions ‘done’ to laboring women may appear to be okay or medically indicated to ‘everyone in the room’. This in NO WAY proves that a women in labor has not been significantly traumatized. If she says she has been traumatized, she has been. Period. The amount of dismissal and patronizing in this comment is incredible. I am a midwife and have seen many incidents of women being bullied, intimidated, frightened, threatened, and having procedures performed without their consent. It is not up to spectators to decide what a woman’s ‘truth’ is. If she says this is how she feels about her experience, this is how it is. This is her truth. She is not wrong. She is not dramatic.
“or perhaps they simply have an intense need for control which would be evident in other aspects of their lives” Not the birthing women and their families but the some of the staff like the woman who wrote this.
It’s quite curious to me that a nurse with as much education and experience would dare to assume her experiences must be the standard. I have had the honor of attending births as a doula in three states, and I have been witness to some troubling births at the hands of nurses and doctors alike.
I find it almost funny that she says the laboring mother has a choice about Pitocin, when most often the bag labeled “Oxytocin” is hung without the least bit of mention. A laboring mother has a choice about having a resident? So a laboring mother, with her legs spread wide open, with an oxygen mask on, exhausted, now looks down to see a strangers face peering down into her vagina and it’s her job to now ask for her doctor? This is what happens, I’ve seen it over and over and over again.
In my experience it is a “If you don’t ask, we aren’t going to tell you…” situation in prenatal appointments and in the labor and delivery room. My job as a doula isn’t to scare my clients, but to inform them… many of them have no idea that they’ll not see their doctors until baby is +3. They don’t know that if they chose a certain hospital and opt for an epidural everyone, including their partner must leave the room. They don’t know that unless they specify on their Birth Preferences Sheet, they could have 4-6 people standing in the back of the room observing (read: talking) during their birth.
Perception is reality… if a woman says her birth was traumatizing then it was… No certification or graduate agency allows you to negate that…
I’d implore you to change your perspective, connect with the mothers you take care of, you just might see things a bit differently.
Wow, that is all important information. thanks for the heads up!
I had a horrible delivery with my son. He was vacuumed 5 times by a resident but the attending doctor was there next to her. My son was about 10 days early and ended up being about 10 pounds. I should have a c-section but it was not offered and I was in no shape to request it. I had 4 nurses trying to assist me before the vacuum- one telling me not to sream. My angel was my attending nurse Heather who said “look at me and we will get through this together”. The resident was wrong to vacuum my son 5 times and yes it was 5 times-she admitted it. My son suffered a brain hemorrhage due to it and had seizures. When having children we have to remember that there is human error. I know that no one meant to hurt my son. He is 13 now and has minor issues from the hemorrhage. I don’t care what any nurse says about what happens or doesn’t happen in the delivery room. I know my story-I lived it.
Personally a nurse who “hasn’t seen this in 20 years” has to have her head in the sand!! My memory is not one sided I talked to those in the room they saw the same things. Heck I didn’t even KNOW about my episiotomy I was told about it by my husband and friend with me! So she can forgive me I didn’t know they don’t use a scapal I was not aware I was being cut by a doctor who told me it would only happen if absolutely had to and she would tell me. I had only had my water broken for 10 minutes when the nurse (at the Doctor’s orders… Who was not my OB) brought in some fluids to give me. I asked what it was and was told Pitocin. The nurse wasn’t even going to tell me!! I said I don’t want that and I was told I didn’t have a right to decline it! I told her to call my OB who agreed with me I didn’t need it. (I was an induction for fast labors and my prior induction for
The same reason was 2 hours…) the nurse came in to get the bag to “give it to someone that wants to have their baby today.” My daughter was born 2 1/2 hours after my water was broken to induce.
So Mary knows it was these experiences that caused me to seek out midwifery care not stories from others. I sought out a better OB after my first birth and she was amazing with my 2nd birth and my issues in my 3rd birth were caused by her partner not her…. But when she retired I wasn’t risking get an OB like her partner or my 1st OB.
Care providers like to point out birth is unpredictable and things can happen. Yes very true and that is why women need to feel they can trust their provider. My favorite OB if she said I needed something I wouldn’t question her because she treated me with dignity and respect.
1. When my doctor upped my pitocin to twice the hospital’s normal limit, a limit I’d specifically asked her about during my 40-week appointment, my doctor hadn’t seen me at all at any point in the 8 hours she’d been on shift. She didn’t examine me before writing the order, discuss it with me, or ask for my consent, and the nurse who upped my dosage never told me what was happening or asked me if it was okay. I only found out about the dosage change because 15 months later, I ordered my chart from the hospital and found the order from the doctor. I was stunned, since she’d said she never ordered that dosage of pitocin and that it was against hospital policy.
2. And keep in mind, that high dosage was prescribed in what was essentially a voluntary induction at a little over 40 weeks with neither baby nor me experiencing complications or distress. I’d already been told if the induction didn’t work, sending me home would be an option. Why give me such a large dose, when it was outside hospital policy and what my provider had told me she herself believed unnecessary and ineffective, for a non-emergent situation?
3. When I asked my nurse if it would be possible to pull the cervidil on my second round of induction, because I’d started having 4-minute long contractions with no breaks between and my baby was experiencing late decels that kept me on oxygen most of the night, my nurse’s response was a flat no and an insistence that I wasn’t even having contractions. (I could feel them and see them on the monitor. She recorded them as occurring as I remember them in my chart.) When I asked if I could talk it over with the doctor, she told me, “I’m not bothering the doctor with this.” This went on for 9 hours. Should I have been able to talk to the doctor? Yes. Could I talk to the doctor? No.
4. Yes, I could have asked for a different nurse, something I found out over a year later. No one at any point had told me it was an option. No contact information was provided for a charge nurse. If you don’t know something is an option, how are you supposed to take advantage of it? And furthermore, if the nurse was simply acting on the doctor’s instructions not to bother him, if I’d had a different nurse, would it have made a difference? I don’t know. Possibly yes, possibly not.
5. What difference does it make if an episiotomy is performed with a scalpel or scissors? The point is not the instrument used, but that it is done without a woman’s knowledge, consent, and at times without anything for the pain. If anything, the fact that she didn’t know what instrument was used to perform the episiotomy is just a further demonstration of how the doctor utterly failed to inform her of what has happening, much less give her the opportunity to consent to the procedure.
6. How many women do you know who are trying to push a baby out, and when the resident attending them is concerned enough about progress to suggest a vacuum, is actually going to stop the process and say, “You know what? I’d actually prefer my doctor to be here. Yes, my baby might be in trouble, and yes, it might take several minutes for you to track down my doctor and get him here, but my baby and I can wait.” Just because theoretically a woman has options doesn’t mean they are always actually available to her.
7. You acknowledge that informed consent should happen, but sometimes it can’t, usually in situations where there’s an emergency and a certain amount of danger involved. This is a recipe for trauma, even if it is unintentional on the part of providers, even if it is done in the best interest of the woman and baby. Then you further acknowledge that this sense of trauma could be ameliorated if care providers sat down and talked to the women about what happened, but quite frequently it doesn’t. (Certainly no one ever thought to talk to me about what happened with my daughter’s birth.) So: you admit the circumstances that cause trauma happen, that doctors and nurses often make little effort to mitigate that trauma, but when women complain about the situation, it’s not because they experienced something they shouldn’t have, but because they’re just silly women who don’t have the knowledge or emotional distance to truly understand what happened. As if the fact that they don’t understand what happened to them–because no one ever thought it worthwhile to discuss it with them–isn’t a huge component in what made the experience traumatic.
8. You keep harping on the fact that these women don’t know what happened to them, so their stories shouldn’t be listened to. It’s been 3.5 years since my daughter’s birth. It’s true that there are large chunks of my daughter’s birth that I don’t recall correctly or remember at all. I fully admitted I didn’t know what had happened even a few hours after she’d been born. My lack of knowledge frustrated me so much, when she was a little over a year old, I ordered my full chart from the hospital to try to fill in some of the blanks. I discovered all sorts of things about the birth I’d never known had happened. I also discovered a lot of the things I had been worried about during the birth, which my doctors and nurses had assured me were not happening, but that had actually happened. They’d just lied to me. Even with this additional information, I still don’t have the full story. If I thought I could, all this time later, pull all the doctors and nurses involved in the birth into a room and find out from each and every one of them exactly how they experienced my birth and why they made the decisions they made or said the things they said–assuming they themselves can reliably remember what happened and assuming they would be completely honest about it–I would absolutely love that. I would love to know how it happened for them, even if it doesn’t exactly line up with my memory or experiences. That’s not possible, though, and even if it were, that STILL wouldn’t be the whole story. No one can give me that, because no one KNOWS that. Part of coming to terms with my daughter’s birth has been letting go of the idea that I will ever know exactly what happened or have reasons for some of the things I experienced.
9. What I DO know is this: I was not given the opportunity for fully informed consent at multiple junctures during my daughter’s birth. At times, some of the doctors or nurses did not tell me the truth. One of my L&D nurses repeatedly rolled her eyes at me and huffed sighs when I told her I was in pain, and at one point when I told her I was in too much pain to move myself into a position she wanted me in, she rolled her eyes, grabbed my arms, and roughly jerked me into the position with no concern at all for the pain it caused me. I experienced an emergency at the end of my labor. Without anyone having enough time to explain what was happening, I was told point blank by the doctor to sign the c-section consent papers or my baby would die. I was moved off L&D and to the recovery ward as soon as my surgery was over, and at no point did anyone involved in the last several hours of my daughter’s birth come talk to me about what had happened. I’d had a baby. I was in a different section of the hospital. I was no longer their responsibility or concern.
I don’t need to know everything that happened down to the minute in excruciating detail to know that what I experienced was wrong. Just because it should not have happened based on hospital policy and professional best practices and medical ethics, just because it’s not what is supposed to happen, doesn’t mean it didn’t happen. And when you tell women “You were too emotionally close to the situation, you don’t have medical expertise to truly understand, you were too out of it to know what was going on so you can’t possibly know you experienced mistreatment and trauma–and since all doctors and nurses are professionals and trustworthy and not emotionally involved like you were, everything they did must have been correct,” this is textbook gaslighting, which simply adds another layer of abuse.
Why is everyone calling the mother a “birth mother”? That is really insulting. “Birth mother” or “birthmother” is a term the adoption industry invented to assuage adoptive mothers who objected to their adoptees’ mothers being called “natural mothers”. The implication is one of little more than a walking uterus who is on this earth to make babies for other people. I have also seen stepparents use it for the children’s actual mother and it’s just as insulting then.
She’s a MOTHER. Call her a MOTHER. This conversation is difficult and, from some directions, insulting enough without throwing in hurtful terms to pile it on.
Did she actually say that no resident has ever delivered a baby? WTF? I am a nurse in a teaching hospital where ONLY residents deliver babies. Nurses also deliver babies sometimes. In some rural hospitals it is mostly the nurses who deliver.
RE:Birth Monopoly | Nurse: Women are “Fabricating” Traumatic Birth Stories Валок KТС-10 Сатка