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Saturday, November 13, 2010

The loss of trust-

I feel like I need to write this experience down because if I don't it will pass me by like a brief shadow. If I do that I'll forget that I don't want to do this again...or at least that I should do something more than what I did this time.

I came onto shift to a woman who had been stuck at 7cm for 6 hours. The baby looked like it was doing fine but the mom had developed a fever which means she could have an infection going on. The epidural she had was beginning to wear off and she did not want to be feeling any pain.

The doctor I was working with was pretty patient in waiting but because she was getting a fever he was more worried. After 7 or 8 hours at the same dilation it was decided to do a c-section. I actually think the mom was wanting one way before that. I could tell she was tired of waiting and did not like feeling any of the pain she was having. Because the doctor kept putting it off though the decision to have the c-section came much later than she would have liked(I'm just guessing this by how she responded when it was finally if she was breathing a sign of relief).

Everything was going pretty fine until they started pulling the baby out. She started say that she could feel that. I could hear the panic in her voice. We asked if it was just pressure or the pain. I didn't hear the rest of the conversation but it sounded like it was mostly the pressure of the baby being pulled out that scared her(it can be a pretty intense feeling). Right after the baby was born I glanced at her and saw tears in her eyes. I came over and told her how beautiful her baby was. But she just nodded a sad little nod.

As soon as the baby left the CRNA called me over and told me he was going to put her under general anesthesia because she was starting to feel everything. He had me hold the oxygen mask on her as he was getting other things ready. I looked in her eyes and she looked terrified. Things had been explained to her but I'm not sure she really understood what was happening. The CRNA gave her some medication to put her to sleep and as he did so she began to shove at my hands to get the mask off. At this point if I had taken the mask off it could have harmed her but I hated holding it on her when she was so frightened and obviously didn't quite get what was going on.

Everything turned out ok...sort was healthy baby was healthy. But psychologically I'm not so sure. This was a c-section that might have been prevented(she was induced early used an epidural was not able to move around to help dilate her cervix). These kinds of things are all so iffy though. Things might have turned out exactly the same. Her wishes were respected...she wanted this c-section...I guess she thought it would be easier.... Did she really understand the implications of a c-section...did anyone talk to her about the We never do. We shove a paper in their face and ask them to sign it. There is no discussion of the pro's and con's.

We didn't do such a good job of being with her through this particular journey. I think this journey turned into a bit of a nightmare for her....and I don't want to forget that....I don't want to forget that this hurts women psychologically...and while I did a horrible job of being there for her I want to do better next time. So I don't want to forget her fearful eyes or the horrible feeling of forcing the mask onto her face when she didn't want it or didn't understand(even though it was what she needed to stay alive). I hated that feeling...I don't want to feel that again....I'll have to decide what I need to do so that next time my own feelings of distaste for my part in this can become something better. I want to become something better than this...and I sorry a woman had to be hurt at my ineptitude.

I'm sorry for all those who've had to suffer at the hands of those they once trusted.


Cherylyn said...

Oh Rachel, I'm so sorry for both you and her! This is so touching, and it choked me up just reading it. Thank you for sharing the hard things along with the good. We do grow and learn from every experience, and there are times when we need to see the darkness more closely so we can embrace the light more fully. (hugs)

Alina said...

Thank you for your post. My C-section was medically fine but it was very difficult emotionally. My hospital's policies only allowed my husband there during the birth and I was alone on the table before and after (my husband had to leave with the baby while they closed me up) I was so alone and scared. It didn't even feel like I had given birth and the nurses gave a cursory "are you okay?" and that was all the emotional support I received. I did call back and told the charge nurse what happened. She was very supportive. The reason I'm telling you this is because even though my nurses didn't apologize it is healing to hear your desire to be there emotionally for your patients. Thank you.

Enjoy Birth said...

Oh, that is so sad. I am sorry that had to happen. I hope she finds the peace she needs. Do you guys let moms know about ICAN and other cesarean resources?

Rachel said...

This was from Susan Alexander but I couldn't post it for some reason...

"Recognition of a problem is the beginning to fixing it.... I think this all should've begun with better informed consent I would say "true" informed consent, but I know that's a touchy subject for medical professionals. Is there a "true" informed consent? I don't know. But at least we can strive for better. So do what you can. You are not the OB, but you can strive to input your own information to women when a choice is being presented to them that is not an emergency and you are there to here that choice. When you aren't there, you have no control, so try and let go of that."

Rachel said...

Thanks for all your comments...I'm working on a follow up post to this one on how to address the psychological issues surrounding birth and c-sections. Any input would be great:)

mjb said...

Thank you for caring and being aware that psychological health outcomes matter.
One of my care providers apologized to me and I can't tell you how helpful that was for healing.

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.