Editor’s Note: Erin Shetler is a birth trauma survivor recovering from PTSD. This is the story of why she’s attending this year’s Improving Birth rally, and what the movement to improve birth can do to help reduce the rates of birth trauma. Visit www.rallytoimprovebirth.com to find a rally near you this Labor Day.
Want to reduce birth trauma? Start with demanding respect this Labor Day
When I first saw the Labor Day news coverage of last year’s Rally to Improve Birth, I thought the people standing outside the local hospital and waving signs about childbirth and C-section rates were nuts. “Why are these folks so upset about other women’s choices?” I thought as I watched them talk to reporters about the high rate of interventions and surgical births. I was seven months pregnant and trusted that the hospital would be the smartest, safest place to have my baby. “These people need to mind their own business,” I said. “The only thing that matters is having a healthy baby.”
Then I had my first baby, and it changed everything.
Leading up to her birth, I did everything I could to be a good patient. I didn’t care about natural childbirth and couldn’t relate to people who wanted candles and yoga balls and inflatable birthing tubs in the delivery room. I took four hours of hospital childbirth classes. I told my doctor I planned to go with the flow and see what happened. I considered tattooing “epidural at 4 centimeters” on my forehead. I went straight to the hospital when they said I should, signed the consent forms mid-contraction and happily did everything they told me to do, even when I learned my doctor was out of town. I knew a lot could happen during delivery, but I trusted I would get through it and make good decisions with the help of the on-call doctor and nurses. After all, I was in labor, and a little scared, and I knew the hospital would be my partner in delivering a safe, healthy baby.
I was wrong. During my fast but medicated delivery, the on-call doctor lied to me, hid things from me and secretly performed surgical procedures on myself and my daughter without my consent. While I was numb and unable to feel anything below the waist, he draped my legs with surgical paper so we couldn’t see what was going on. While I pushed, he and the nurses told me things were going great. I learned later that was a lie. My baby’s heart rate had dropped, something I would learn only after complaining and ordering my medical records. Under that surgical sheet, the doctor was secretly cutting an episiotomy and vacuuming my daughter out of my body with a suction device. He literally hid my legs, cut open my vagina and sucked my baby out by the head, all without my knowledge and certainly without my consent. My first memory of my daughter is seeing a blue and purple ring on her head from the suction machine and panicking about what was wrong with her. A blood vessel in her eye had popped during the procedure, and there was a ring of blood around her pupil. As the nurse nonchalantly told me these were normal because they had to use a vacuum on my daughter’s head, I realized that all of these things had happened to me – and to her – without my knowledge.
Well-intentioned people asked me later about the first thing I noticed about my new daughter. Was it her fuzzy red hair? Her sweetly long fingers and toes? The sad answer is this: The first things I noticed were her bruises. And when I saw her, I realized that in my very first moments as a mother, I couldn’t protect or care for my child because I didn’t know what was happening to her.
(Vacuums are used in less than 5 percent of deliveries, usually when a mother is exhausted or a baby is in distress. Vacuum attempts sometimes fail, and if they do, an immediate C-section is necessary. Every clinical standard of care – the hospital’s terminology for acceptable behavior from a healthcare provider – says the physician should address the patient before using a vacuum during delivery and obtain her verbal consent – not just a signature on a hospital admission form, which covers permission to treat a patient. In fact, the American College of Obstetricians and Gynecologists lists “failure to obtain informed consent” as an absolute contraindication (translation: a deal breaker) for use of a vacuum. Though he and the hospital later apologized after a firm complaint letter, I never got an answer from the doctor about why he felt I did not deserve respect for my consent rights, why I wasn’t important enough to be part of the decisions about my body and my baby. There was no indication from the hospital or the doctor that any emergency existed that prevented him or the nurses from communicating with me. To perform the vacuum procedure, they first had to place a catheter. So they had time to cut me and catheterize me, but the only thing anyone took the time to tell me was that my pushing was “going great” and we were going to have this baby quickly. In my medical charts, the notation after the procedure was this three word sentence: “Procedure well tolerated.”)
Later, the doctor said he was surprised that I was upset and he “wished he knew I wanted to be so involved,” making me realize I was probably not the first or the last woman he’d treated this way. He actually said in a follow-up meeting in front the head of the hospital’s obstetrics department that he believed “most women don’t really want to know what goes on down there.”
I wasn’t against using medical intervention if it meant helping my baby arrive safely. But I trusted that the doctor would involve me in my care. Had he taken 15 seconds to say, “Baby’s heart is telling us she needs to come out quickly, I’m going to use this vacuum and I might have to make an incision, OK? Alright, now 1, 2, 3, push…,” I probably would have spent the first weeks of my daughter’s life writing thank you notes to the hospital instead of complaint letters.
Instead, I was treated like I didn’t exist, like I didn’t matter.
But it did matter, certainly to my health. In the hospital I was treated for high white blood cell counts attributed by the doctors to stress. When I got home, the flashbacks and nightmares started. For weeks I woke my new baby and her father each night, screaming. It was the same dream, over and over. I was having a baby. I could feel her coming out of me, first the head, then the shoulders. There were a lot of people in the room, but no one could hear me shout for help, no matter how loudly I screamed.
I was diagnosed with post-traumatic stress disorder about six weeks after my baby’s birth. I was still having the nightmares, and my normally low blood pressure was sky high. Typical sounds, like the quick honk of a car locking on the street, made me jump. For the first time in my life I had no appetite, and I lost 40 pounds – all the baby weight and more – in less than two months.
To top it all off, my episiotomy was taking its time to heal. Imagine, with every single step you took for six weeks, being reminded that someone violated you without your consent. And that you were supposed to be happy about it because you had a healthy baby.
I complained to the hospital and two medical boards. Then I fired my OB–the one whose partner had treated me so poorly. A few weeks later, her office sent me a bill for the remainder of my delivery fee. Instead of a check, I sent her a note daring her to sue me for the money so we could talk in open court about her partner’s negligence and the PTSD it caused. I never heard from her or her billing office again.
Thousands of dollars in treatment later – and hundreds of hours of lost bonding time
with my little girl – I am feeling much stronger. But the trauma caused by my mistreatment during delivery has had a major impact on my family’s life.
During labor I pushed for a very short 13 minutes. All those hours crying on the bathroom floor, all those dollars spent on a counselor, all the stress on my husband from caring for an ill wife, all the stigma of having a mental condition that I now battle every day – it all could have been avoided if I’d been treated like a human being for 13 minutes. Every mother deserves that, no matter what kind of birth she has. Respect for our bodies, our babies and our rights is never too much to expect.
That’s why I’m joining forces with the folks I thought were nuts. Remember the ones waving the signs? The ones I thought were nosy, yoga-ball bouncing doctor haters? Turns out, they are none of the above. They are a smart, growing global coalition of people who recognize that we have a problem with the way many women are treated while giving birth. Nine out of 10 women give birth in a hospital in the United States. Through rallies and advocacy, ImprovingBirth.org is making sure everyone knows that all those women do not check their human rights at the door.
Birth trauma and PTSD are several times more likely to occur in women whose rights are violated during delivery. And they can adversely affect women and their families for years after birth. There are many people in the Improving Birth movement, and each has his or her own reason for fighting so hard for change. Women like me, who don’t deserve to suffer from avoidable birth trauma at the hands of their doctors. They are my reason.
Let me be clear. There are thousands of wonderful medical professionals out there who treat their patients with respect during labor. They should be applauded.
But let me be clear about something else: My case is not an anomaly. While the situations are not always as egregious (many are more terrible; many are less), cases like mine happen every single day. I guarantee that in your city or town, at your local hospital, a woman has felt bullied, uninformed or ignored during childbirth. It’s not always the hospital’s fault, and it’s certainly not the patient’s fault. But it is our responsibility to fix it – together. All those great doctors and nurses I mentioned need to join the movement for better birth. They should stand up with us at this year’s Labor Day rallies and say they are not going to put up with colleagues who treat women like they don’t matter. And all the people like me, who know firsthand that birth matters to the health of our bodies and our families, must stand up as healthcare consumers and Americans and make it known that we won’t take it anymore.
Thousands of women give birth in the hospital every day, and too many of them suffer undue trauma because of outdated procedures or providers who don’t respect their rights. We are not candle-loving, yoga-ball bouncing natural birth advocates. We are your mothers, wives and sisters. And if we don’t fix this soon, we will someday include your daughters. My family deserves better. Doesn’t yours?
Join Improving Birth and hundreds of other supporters this Labor Day to show the world that birth matters to you. Visit rallytoimprovebirth.com to find a rally near you. See you there.
Article author Erin Shetler is a graduate of American University and a communications executive in St. Louis, Missouri.