Yesterday I talked about the “Why” and shared a story about a mama who barely survived birth after an unnecessary induction that ended in a c-section. I also asked you to share a story with me, and I'm floored with the incredible stories you shared. I am honored and heartbroken all at the same time. Today, I’m going to share one of my personal stories that lead me to start ImprovingBirth and answers one of the questions from yesterday – why do I get up in the morning to do this work?
. . .
I worked as a doula for nearly a decade before I understood that I was an activist.
For a particular client, I had already attended two of her previous children's births. This would be her third. We knew each other well, and I certainly knew her in birth.
She was texting occasionally throughout the day to tell me that she was having mild surges while they were at a family birthday party. My doula bag was packed. I was just on standby waiting to hear when they wanted to me to join them at home.
She texted to tell me things suddenly picked up just as they returned home from the birthday party and that I should come -- only to have that text followed by a phone call minutes later with her husband saying that I should meet them at the hospital since it was suddenly very intense. I agreed to meet them there.
I only lived a couple miles from the hospital, so I arrived very quickly, expecting to be wait several minutes as the client lived a bit farther away. To my surprise, this car came screeching into the parking lot just moments later.
Dad was at the wheel. He pulled up in front of me, flung the car door open, and started hollering that the baby was coming.
I opened the mom's door to find her frightened and wide-eyed.
She had unmedicated births for all her babies, but having the baby in the car was not her plan.
I used the calmest voice possible, encouraging her that everything was fine, that she was where she had intended to birth. I asked dad to go get someone to help us.
A surge started, and she just kept saying, "The baby is coming out." I knew that the pressure of baby coming down can seem much closer than the reality, so I asked if I could gently feel between her legs to see if she was bulging from the babies head crowning.
She was fully clothed and agreed that it was okay.
I confirmed what I thought, the baby was not crowning and that we likely had time to get inside.
The chaos that ensued for the next 20 minutes or so is where the real problem began.
Once inside, a nurse checked mom's cervical dilation to announce she was only 3cm.
I actually laughed out loud and said, “There is no way!”
I knew this mom. I had labored with her more than once. Her eyes were rolling back in her head. I was so sure that she was complete with an overwhelming urge to push. How on earth could she be 3 cm??
Another nurse came to check.
This time, complete…..BUT...
Something wasn’t right. “It’s a hand,” she said. "STOP PUSHING!!"
The fearful wide-eyed look on the mom's face was back.
“Your baby is transverse [IB note: lying sideways]. If you keep pushing, you could break its arm.”
All I could do was encourage her and help her blow out her breath instead of push.
The head nurse then came in, and checked the mom again.
“It’s not the hand. It’s the face,” she said. “And you’ve got plenty of room to push her out.”
A portable ultrasound machine enters the room, and they confirm that it is in fact the baby's face, meaning that instead of the top or back of the head coming out first, the baby's lower face was coming. (Hence the 3cm estimate that was first given: the nurse had her fingers in the baby's mouth.)
Then enters the doctor. This is where the real trauma begins.
Before then, it was a bunch of incredible nurses doing their best of figure out what was going on.
The baby had been on the monitor the whole time, and it was showing no signs of distress.
The doctor arrives and does an exam without even speaking to the mother. He is only addressing the staff in the room.
He suggests she give a push and says that the baby could come out like this.
Then moments later, while his hands are still in her vagina, he says, “Stop pushing. We're doing a c-section!”
Mom says, “Wait - why? I just want to push my baby out!”
His response still rings in my head clear as a bell.
“If you keep pushing, you are going to snap your baby’s neck!”
With pleading eyes, she looks at me, and we are back to trying not to push - all while she is begging me to help her and just let her push her baby out.
“Please, no, I just want to push my baby out!”
The doctor just stands there waiting for her to say yes.
He continues to tell her that she "is going to kill her baby.”
She unwillingly agrees to a c-section, and everyone dispersed to go prep the OR.
Side Note: This is the part of the story where I have to tell you that I stepped way over the line of doula and into the activist role. There is a lot of debate about this kind of situation and where a doula should and shouldn’t go. I didn’t even stop to think about those things. I was running purely on instinct. Some would call me a “Rouge Doula.” I call it being human.
The thing I had noticed through this entire process was that according to the monitor, the baby was not showing any distress.
Side Note: There will no doubt be critics that say that I have never had training to read the monitor. But let's be realistic. After 7 or 8 years doing this work, you know some things.
The urge that she had to push was overwhelming and uncontrollable. I took a deep breath, leaned down, and whispered in her ear. I encouraged her to watch the monitor. She could see on the screen that the heart rate stayed in the normal range, even when she was pushing.
I told her to trust her instincts. She stopped fighting the urge and kept her eye on the monitor as she pushed.
The young nurse that had originally checked her and reported 3cm was the only one in the room with us now. She suggested that she could go ahead and place the urinary catheter to save time. At first, my client started to object, because she was unmedicated and was afraid it would be painful. But I encouraged her. I had seen in many births before that when the mother emptied their bladder, it gave the baby more room.
As soon as she placed the catheter, a massive surge came on. The urge to push wasn’t even something mom could begin to fight. She pushed with all her might and started saying to the nurse, “The baby is coming. I can feel the burning.”
The nurse lifted the blanket and said under her breath, “Oh! The baby is coming.”
She opened the door and yelled into the hallway, “I need help in here!”
I thought she was bringing everyone back in for a vaginal delivery, but instead when they all came, they were unlocking the wheels on her bed saying they were taking mom to the OR. She was begging. I was begging.
The doctor came back. “What the hell is going on here?”
Mom and I together are begging. She saying “Please check me. I can feel the burning.”
Me saying, “Please check her.”
She begged and pleaded with him 5 times. “Please just check me!”
He finally yelled, “NO! WE ARE DOING A C-SECTION!”
. . .
I’m sure some of you are wondering, where is dad in all this? He was there, scared as scared could be. He didn’t know what to do, and there was so much chaos that I couldn’t help him. I could only focus on her. He is a very calm and passive person by nature, so he kind of melted into the background not saying anything. That is, until a crucial moment.
. . .
As they are wheeling mom down the hall, I am beside myself. Dad is looking at me as he followers her bed. And I’m yelling now, “YOU DEMAND THAT THEY CHECK HER BEFORE THEY CUT HER!”
The head nurse comes to me, because I’m yelling and says “Hey, hey, whats going on?” I tell her that my client said the baby was coming, that she could feel the burning, begged the doctor to check her 5 times, and he refused.
The head nurse promised to go in the OR and find out what was happening. I had hope - only to have it dashed a couple minutes later when she came out shaking her head and apologizing to me. “I’m sorry. There is nothing I could do.”
I collapsed into sobs right there outside the OR.
A few minutes passed, and the doctor came out of the OR. He said to me condescendingly, “It won’t be long now,” as he walked to the doctors' lounge.dHe returned immediately and he asked which one of us was the doula. (The mom's sister was now standing there with me.) The doctor knew full well which one of us was.
I lifted my chin and acknowledged my role.
He put his finger in my face, and said “You better watch it young lady. You don’t know what you’re talking about.”
I responded by telling him what he just did was wrong. He then threatened to have me removed from the hospital, and he went back into the OR.
Again I began to cry. I felt helpless. I couldn't protect the mom no matter how hard I had tried.
What seemed like an eternity passed. I waited to hear the baby cry, but...nothing.
Suddenly, the doors to the OR opened. The doctor assisting in the surgery came out and said the most incredible thing I could have ever heard…..
“She did it all herself.”
“What does that mean?!” I asked him
“She pushed the baby out right on to the table.”
Her sister and I grabbed each other and started crying, hugging, and jumping up and down like we had just won the World Series.
I learned later that mom never stopped pushing. She pushed as silently as she could, not to alarm anyone. Then after the doctor came back in from reprimanding me, which dad had heard from the other said of the OR door, the dad demanded that the doctor explain to him why they were about to cut his wife open.
During this explanation, the doctor suddenly ran across the room in an attempt to catch the baby before she plopped right onto the table, where mama was laying flat on her back. But the doctor didn’t make it.
What felt like elation at first quickly turned into trauma for us all. Mama and baby were physically fine, but the emotional trauma that had been done was substantial.
Severe depression for the parents and signs of PTSD ensued for months after the birth. The parents had planned on having a 4th baby, but decided that going through another birth and postpartum period like that just wasn’t an option.
I didn't come out of it unscathed. I would find myself thinking about it in the days following, my blood pressure would rise, and I would have significant feelings of anxiety. I (at least) had the benefit of my doula sisters to share the story with to help me heal.
. . .
This is just one story of many that I unfortunately carry. It’s stories like this that make many of us quit.
It's my personal “Why," well one of them anyways.
The violation of informed consent and right of refusal was substantial.
The mom never filed a complaint.
There were so many things that went wrong in this situation, the most important one was that we ALL forgot who the authority was in the room: the mother.
The fact that we ALL felt that we needed to get permission from this provider for her to just push her baby out,makes me feel sick to my stomach now.
This mindset is a dangerous one on many levels and just one of many reasons we must improve birth.
I’m asking you again today, if you didn’t share your story with me yesterday, please consider it. It doesn’t need to be as detailed as this, but I believe there is healing in sharing our story. Just visit our contact page and be heard.
In love and service,
PS. This coming year is going to be a BIG year, but we need your help. Your donation will directly impact our ability to reach families in their communities this year. We are working on a comprehensive community toolkit so that local advocates on the ground can reach families with current information and empower them to have better births. Please consider ImprovingBirth for your year-end giving. You can visit our donation page here.