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Saturday, February 27, 2010

A sacred trust dissolved

I had a really hard birth the other night, and I'm having a hard time processing it, so I thought I'd write it out here. Sorry for the semi-rant upfront:)

I came on to shift with the nurses talking about one particular patient and moaning and groaning about it. She was a hypnobabies birther and had come in with a birth plan. Usually those will solicit groans from nurses:) So, I immediately spoke up and said I would take her, to the surprise of all present. I think many were grateful:)

So I read through the plan, which seemed perfectly fine to me, but some of it was drawing comments from the other nurses. Here's the two things that bothered me of the doctors there started talking about how some of her patients who start requesting things like what this couple was bothered her, because she didn't feel like that was her job and it shouldn't be the job of her nurses. Mostly that just bothered me because what some women request is just the right to have labor support, and move, and receive help to make it through it. I certainly think that's in my job description along with making sure the mom and baby are safe.

Another thing, though, is what really bothered me. The mom's water had broken, and so of course infection is an issue. The midwife that I was working with sat down with them and talked to them about what she felt they should do. I felt like she did a very good job with this and the decision to use pitocin was well thought out and discussed with the patient. So, we started pitocin, but the patient wanted it to be slow. I walked out of the room to tell the midwife this. When I called the midwife, she kind of balked at that. She did not want to do the pitocin slow. So she told me to just turn it up without them knowing.

And this is what bothered we have the right to force a woman's body to do something against her will, without even telling her...NO! We have no right to assume that responsibility. Regardless of the reason. I choose to disregard this counsel and let the woman know everything I was doing and why, and asked her permission, but the idea that this medical professional would take a woman's trust like this and throw it out the door just tears me up inside. It tears me up the way people judged her and her decisions and it tears me up the way her decisions could have easily been tramped over without her knowledge and without her consent.

This is not the first time something like this has happened. I have seen episiotomies given without consent or knowledge until after it is done. Pitocin is started and increased without a woman understanding why, or the doctor even taking the time to discuss it with her. I think this is the first time I have been blatantly asked to do something behind a mother's back, though, and this is what is so hard for me to process.

Because what we are doing, is tearing down a sacred trust between caregivers and patients. A trust that a woman gives to us. She says I am placing myself, my body, and my baby in your hands, and we have no right to lie to them. We have no right to talk about them behind their backs or discredit them, or make fun of them. Even if we feel like their decisions are wrong and we are right. We have no right.


Pam said...

I am fortunate enough to have an OB/GYN who when I told him almost 8 years ago about hynobirthing, took it upon himself to get the book and read about it. He then educated those in his office and then the nurses on the Labor and Delivery floor. We moved away for about 2 1/2 years and were in a small rural town, in which all the OB's balked at my request and told me it was impossible to delivery this way. I had 2 children when were were there and I think I help change their outlook on that womens bodies really do know to do when it comes to labor. When we moved back to Michigan my OB/GYN had initiated an education course for our hospital to offer to women so they could take hypnobirthing classes. So when I had our last child it was very exciting to have nurses who were educated and excited to be do their first hynobirthing birth. They even used the same terms used in this method. There is hope!

Linds said...

I think this is a great post. As a first-time pregnant woman I am curious about what things would be considered inconvenient for medical staff and what is welcomed.

Handsfullmom said...

That IS disturbing, especially when it is the midwife who wanted to sneak in the intervention without explaining it -- the very person the woman trusts to help her navigate the birth and options safely.

Sheridan said...

Wow, thank you for supporting this mom in an honest way. I think that it is a real shame that this moms request to turn it up slowly were met with an instruction to do it behind her back. You are right it violates that trust.

Rachel said...

Linds-I'm going to save my answer to you for a new post:) Hopefully tomorrow.

Mickelle said...

Yup. Makes me wonder how many times things like this were done with my prior OB/GYN. He was totally that kind of man.

Anonymous said...

I found your blog through another and I must just say that this is one of the huge reasons I felt it necessary to birth at home. I felt I could no longer trust my birth team and my hospital to provide me with the care and respect (ie honesty) that I requested. Thank you for remaining honest and respectful of birthing women.

Birth is a Journey: Does it have to be life changing?

  • One woman might have to climb on an overfilled boat, risking her life and nearly dying as she escapes over the ocean to come to this land. This experience could certainly be life altering. It may very well color the rest of her life, positively or negatively. (I overcame this amazing struggle and here I am triumphant! OR Holy crap, that was SO hard I don’t know if I can go on! By the way, neither response is “right”. No one would judge the woman with the 2nd response.)
  • One woman may buy an airplane ticket, sit on a comfortable 747 and fly to America with a nice smooth flight and landing. She is happy to be in America. Those welcoming her are glad she is here safe and sound. She may only travel by plane 2-4 times in her life, so it is pretty memorable. But the journey itself probably wouldn’t be life changing; it would simply be a journey.
  • One woman may learn to fly an ultra-light plane to lead a flock of geese into America teaching them to migrate. This experience could certainly be empowering and life altering.