Saturday, August 07, 2004

A Different Kind of Pain in Childbirth

Note before beginning!

This can be seen as a VERY negative post. Even in that light, there absolutely is a balance... a mirror image of the goodness and love and kindness I have seen in birth, too. But this blogspot isn't the space for that. I will do that another time. This is for enlightenment of a different sort.

As most who are reading this blog know, I am also processing issues surrounding birthrape and how midwives (not just OBs and nurses) facilitate the birthrape experience for women.

(a definition in the making)

Birthrape: The experience of having fingers, scissors, and/or tools put/pushed/shoved inside a woman's vagina or rectum without her direct (or indirect) permission.

Being coerced, manipulated, or lied to regarding the health and safety of the baby or themselves so the midwife is able to do something to the mother's vagina, rectum, cervix, or perineum, usually with excuses; rarely with apologies.

Some find the definition expanded to:

The midwife taking the woman's Power by using disparaging comments, unsupportive expressions, speaking around her as if she is unable to hear or process requests or information.

and

Even though consent forms are signed in the hospital, birth center, and at home, consent for care does not include the manipulations or coercive words to get women to obey the caregiver.

I thought it was time I shared some of the thousands of comments I have personally heard that have facilitated birthrape over the years.

I share them and am writing about them and speaking about them and nearly screaming about them in the hopes that midwives will hear what they are saying that is sending their clients into therapy, pushing them to depressions that require medication and alternative therapies, keeping them from coming back to the midwife at all because of her Power Hunger and covert misogyny. Too many women (in my opinion) find Unattended Birth their only acceptable option after their experiences with professional caregivers in birth.

You see, most midwives talk a good game. They will say any number of things in pregnancy to lead the woman to believe she (the mom) is in control. I have sat through hundreds and thousands of prenatals with midwives and listened to the party line about how they believe in a woman to know, how they will "let" them labor how they want, how they will limit vaginal exams, etc. And then, when labor is in full swing, I sit by (or participate) in the amazing disregard for the woman's prenatal wishes and dreams of an unhurried, unfettered, un-directed birth.

I am not a part of the delusion or lies anymore.

Common Beliefs
* Women in labor don't really want to use their birth plan.
* Women in labor aren't able to verbalize their needs.
* Women in labor don't know when they need to pee or drink or eat.
* Women in labor don't know when to change positions.
* Women in labor can't make decisions.
* Women in labor want an epidural.
* Once labor kicks in, they all want epidurals.

Directives That Disembody Her Being

* Lift her leg.
* Move her to the bed.
* Grab her knees.
* Put her feet in the stirrups.
* Put her hands on the grips.
* Push her head to her chest.
* Push her chin to her chest.
* Put pillows under her head.
* Put pillows under her butt.
* Pull her down to the edge of the bed.
* Push with her so she knows how to do it right.
* Count for her so she knows how to do it right.

(while these next phrases end in periods and question marks... almost exclusively, the following words have been shouted at women... an exclamation mark is more appropriate, but there aren't enough in the computer to add them all)

Comments That Negate Her Intelligence
(spiritual, physical, emotional, and intellectual)

* You aren't pushing right.
* Push like this.
* Quit making noise.
* No, push longer.
* Push like you are having a bowel movement.
* Push the watermelon out.
* Push the bowling ball out.
* Don't push in your chest, push in your butt.
* Push like you mean it.
* What are you doing?
* Can't you push harder?
* Have you ever been raped? (asked in labor)
* Are you an abuse survivor? (asked in labor)
* Have you been abused? (asked in labor)

Coercive and Manipulative Remarks


* I need to get in there.
* pressing knees apart - I need to do a vaginal exam.
* C'mon, just let me see what is going on.
* I'll do it quick and fast, I promise.
* I promise to be gentle.
* I just want to feel the baby's position.
* I just want to see how dilated you are.
* You asked me to be your midwife, now let me do my job, okay?
* I'm a woman, too, I know how it feels... I promise to be gentle.
* I remember how vaginal exams felt in labor, I promise to be gentle.
* Do you want the baby to come out or not? Just open your legs.
* Are you sure you are ready to be a mom?
* You had no problem opening your legs 9 months ago.
* Just let me break your water, it will speed things up.
* If I break your water, the head will be applied better on the cervix.
* If I break your water, prostaglandins will stimulate things nicely.
* Here, drink this. (as Gatorade with cytotec is given to the mom)
* You might feel a pinch. (as pitocin is injected into the vaginal vault)
* I am just wiping up some stuff. (as pitocin on a gauze is pushed inside the vagina or rectum)
* Here, drink this. (as blue and black cohosh are given without consent)
* Here, put these under your tongue. (as homeopathics are given without information or consent)
* I'm just feeling your cervix... it might hurt a little. (as manipulations to the cervix are done... from stripping the membranes to manual dilation)
* I'm just feeling your cervix. (as cytotec is put onto the cervix)
* Do you want your baby to die?
* You don't know the seriousness of the situation.
* You have been a martyr long enough.
* Just take the medication.
* Just get "your" epidural.
* Would you like something for the pain? (in the middle of a contraction)
* This will take the edge off.
* It doesn't do anything to the baby.
* If you were my daughter/sister/mother....
* I have had three scheduled cesareans myself! I don't know what you are complaining about. (being wheeled into the OR)
* Stop whining.
* Why are you crying?
* What is wrong with you? Are you trying to hurt your baby?
* In this day and age, no one needs to suffer in childbirth anymore.
* Mothers and babies died without hospitals 100 years ago.
* Let me call the anesthesiologist... just talk to him about your options.
* No, you can't eat... just in case you need a cesarean... and your labor is rather slow moving.
* No, nothing by mouth after 7 centimeters. (or any number the caregiver randomly pulled out of her ass)
* Only ice chips.
* Oh, Bradley... they always have cesareans.
* You wanted a homebirth? That's child abuse!
* Are you one of those La Leche League people who nurse until the kid dates?
* Do you vaccinate? (after discussion of no erythromycin in the baby's eyes)
* You want your baby to go blind? (after refusal of erythromycin in baby's eyes)
* Your baby might bleed to death. (after refusal of Vitamin K injection for the baby)
* It's just antibiotics.
* God, you have terrible veins!
* Where are your veins?
* (to the Licensed Midwife during a transport, a nurse asks) Do you know how to take a blood pressure? Did you do any?
* Why did you wait so long?
* Why did you get here so early?
* You aren't in labor.
* How would you not know if your water broke or not?
* Can't you stop moaning?
* Be quiet!

* Oops, your water broke! (while using fingernails or fingers to break it on purpose)

Whispering to Other Birth Attendants
* My god, I wish she would hurry up.
* I am so bored!
* She is going so slow.
* I wish she would let me break her water.
* My baby needs to nurse, I need to go home.
* My boobs are going to burst if I don't go home and nurse. She needs to hurry up.
* I am so tired.
* I want to go home.
* I am going to talk her into letting me break her water so she will hurry up.
* I am going to talk her into letting me manually dilate her so she will hurry up.
* I need her to hurry up.
* She's holding back. There must be some emotional barrier we haven't found yet.
* I bet she was abused. Look how she: keeps her legs together/cries with exams/doesn't want us to touch her/doesn't take her clothes off/won't take her shirt off/won't relax enough to let the baby out/is afraid to be a parent/hasn't worked through her issues/has body image issues/has eating issues/is fat/is thin/lives in her head/isn't in touch with reality
* She is so noisy.
* She is too quiet.
* She needs to let go.

---------------------------------------------------------------

I am exhausted writing this much pain. I know there are hundreds of thousands of remarks that have been said that I haven't been witness to and I encourage women who have had them said to them to email me privately so I might start a list that lets caregivers know what not to say to women during pregnancy, labor, birth, and postpartum.

Email to: Barb Herrera - msgardenia@cox.net

Your names, of course, are completely private. Your words, however, need to be heard!

Let's shout together!

15 comments:

Kya said...

Oh yeah, I remember "Here, drink this". To this day, I have no clue just what "herbal tinctures" I was repeatedly given during my first birth were. Cohoshes? Maybe... sure tasted like crap but I didn't feel like I had any say in the matter. "I know it's nasty, but it will help". Help who? You or me?!

Bless you for speaking out Barb. You're an angel to fight for those who don't realize they are being abused by the people they hire to protect them.

Anonymous said...

"Your blood pressure is too high- this can cause you and/or your baby to die".

"You might as well just slap the handcuffs on me if we go to the hospital" (after being told that AT HER OWN RISK she would go with us if we needed to go)

"I don't want to get your birth tub for you, because I don't think you're going to have a homebirth" (she didn't actually say this, but it was implied- despite the fact that being immersed up to my neck would have helped tremendously with the BP issues)

"I don't know if it's stubborness or immaturity, or something else, but I just can't trust you to listen to me to get your baby out if something happens! I'm not sure I want to do your birth anymore (said to me on the phone two days before due date- I fired her after that phone call)

Anesthesiologist in hospital we ended up in after firing midwife and being too scared to birth alone- "I'm just looking..." as he swabbed my arm with alcohol. I looked him in the eye, and said, "No you aren't". He took off the tourniquet, and left the room in a huff. I cried and said I wasn't trying to be difficult. I just hate being lied to.

Navelgazing Midwife said...

I'm so sorry.

I'm so sorry.

Katherine said...

"You can't change positions so much, you're shifting the monitor out of place."

"Walking around or changing positions won't make a difference, you just 'think' you're getting better contractions."

"Please just let me do my job."

"We need to strip the amniotic membrane and put an internal monitor in to make sure the baby's okay."

"You can have a normal birth next time." (Convincing me to sign for a caesarean. Also when I asked during postpartum appointments. Now with number 2 I find out three things: no hospital in the area allows VBAC, the OB/GYN made a vertical incision, and licensed midwives aren't allowed to attend VBAC attempts in this state.)

During caesarean, another doctor came in and started telling the OB/GYN to "hurry it up if you can, Dr. (don't remember) needs this OR for his next patient and I need this anaesthesologist for an emergency downstairs." Funny, I ended up with infection along the suture line...

My new OB/GYN now: @We're just going to go in along the old incision, your weight disqualifies you for transverse caesarean." "We're scheduling the caesarean at 38 weeks, the baby will be fine." "You're not a doctor, you can read studies but you don't really know what they're saying. Leave that to the folks who went to med school, ok?" "I usually just...why does what your mother (who, btw, is an advanced practice nurse) thinks matter?" "I don't think your husband would like it if...you gain weight/you rupture during VBAC/etcetera." And yes, sometimes he tries to say this with my husband in the room. I have tried to change doctors without success, nobody will touch me this far along.

I love my children and intended to have 3 or 4 but I don't think I can handle going through another pregnancy knowing what's at the end of it.

Anonymous said...

I'm so glad I read this. I'm not a mom yet, and my husband really wants children. I've always been afraid of what could happen to me during labor, and from reading all this, I'm glad that women have the strength to talk about when they were wronged. Because of their speaking out, I can ensure that none of this will ever happen to me. Thank you all so much, and I hope that time can heal the wounds that cruel others have inflicted upon you.

Anonymous said...

i am a nurse by profession and during my labour i asked what was wrong with my baby and was told
"you are a nurse, you stick to your job and let us do ours"

"you will NOT be being reviewed by a registrar"

18hours later my son was born almost stillborn and needed resus for 10minutes he went to scbu for monitoring and i was left in the delivery room alone with a midwife and because i was shaking i was asked if i
"was usually of a nervous disposition"

my son had seizures for 24hours due to hypoxia and has a loose diagnosis of GDD

Anonymous said...

Thank you for this article. Yes, I heard one of the statements in your list--"Why are you crying?"--verbatim, in a tone of decided annoyance, from the midwife who was stitching up my torn perineum well after the novocaine had worn off. Okay, to her credit, she stopped and gave me another injection when I told her it hurt, but her whole attitude was that I was inconveniencing HER delivery somehow.

I could go on about my first labor and delivery, but right now, I'll share just one part of it. After I got to the miltary hospital (the military clinic never told me I had the right to deliver in a civilian hospital), I was in bed, in pain, with monitors and an IV. While I was lying there trying to deal with contractions, a strange man in scrubs (a doctor? anesthetist? random medical tourist?) walked into my room and stared at me. Without introducing himself, he looked at me jovially, smiled, and said loudly, "You look like you're having a baby! Are you having a baby?"

My first thought was, "My God, there are idiots running loose in this hospital." But, wanting to express my annoyance somehow, while being afraid to be too direct, I glared at him through my pain and said angrily, "I'm really thirsty. I want some water." His face fell, he looked at me icily, and announced with apparent satisfaction, "Well, you can't have that!" Then he turned on his heel and stormed out of the room, offended (I suppose) at my unwelcoming attitude. Fortunately, I didn't see him again. Not that my midwife was any friendlier, as it turns out.

Maybe later I'll share more about the humiliations and little cruelties my trusted caregivers inflicted on me. I just wanted to write this down somewhere, so I can release it once and for all. It was nearly 25 years ago, but I still remember it vividly.

--pegatha

Anonymous said...

Doctor "These (I can't remember what he said but the things they pull the stitches through with) are broken" Midwife "Can I g and fetch some new ones" Doctor "No she'll survive."
That was just one of many many many things that evil man did to me.

Anonymous said...

I'm sorry but this sounds like the biggest bunch of crap I've ever heard. If you girls are so smart that a Dr. shouting direction at you is "birthrape" then go have your babies in the woods by yourself.

What are you going to do/say when some young girl reads this and is given instruction by a doctor that sees that the umbilical cord is wrapped around that babies neck and she rebels cause she don't have to have intelligence demeaned and that's birthrape blah blah blah while her child dies and then her placenta rips a hole in her uterus and she dies too?

If you don’t want direction shouted at you then that’s fine the olden women had dead babies all the time trying to do it on their own go follow in their footsteps, maybe it’ll prove how independent you are, ya never know.

Jenna said...

"Well,that's why they call it labor! (giggle)" said my L&D nurse when I said that the back labor pain was really bothering me.

Thanks - I'd never heard before that having babies might hurt.

Anonymous said...

My doc was fine but the nurses were terrible.

"She's a great nurse" - After I complained to another nurse about the extremely rough cervical exam I just had. I was in tears and begging the nurse to stop and she wouldn't, I felt like they thought they had the freedom to do anthing they wanted to me. Next day the nurse who violated me said "I'm sorry you felt that way".

"Stop breathing like that"

"Stop asking questions"

"If it were up to me, I wouldn't let you start pushing for at least another hour" (I was 10 cm and had the uncontrollable urge to push)

"Here this will help with the pain" (It didn't help with the pain at all, it just made me so loopy I couldn't even understand what people were saying to me and I was no longer able to stand)

"Don't let her stand up!" (I stood anyway, no one was able to hold me down. But right after I stood is when they gave me that drug to "help with the pain.")

"I don't know" (When I asked if a catheter hurt)

shanoneil said...

At about 2 cm dilation (was admitted at 1-2 due to gbs+), a female resident came in with her crochet hook, "checked me" and as she was checking me said "I am just going to break your waters to get things going", I said, "I'm not sure if I want you to do that..." she said "don't you want to see your baby sooner?" - talk about manipulation! this led to pitocin, which led to epidural, which led to cesarean due to "failure to progress" (gotta love that term)... planning to vbac with a midwife/doula team in a few weeks... wish me luck!

Anonymous said...

I remember during my last prenatal appointment. Even though I did not want to get a sweep she did it anyways. They were always so negative saying things like ain't you tired of being pregnant? That baby can't stay there forever! and "Let's schedule that induction." I was not even past my due date! That night my water broke and so I had to go to the hospital where they did not let me leave instead they put me on Pitocin. I delivered the next day.

Jami said...

Wow. Thank you for this post. I'm reading it late, but better than never. So many of those things were said and done to me in both of my births. I'm in awe. My first was a brutal forced csection. (I'll link the story here http://www.facebook.com/note.php?saved&&suggest&note_id=400834439280 if anyone wants to read) and I was repeatedly talked down to, examined roughly, talked about, and eventually forced against my will into a csection, tied down, head held down, not adequate anesthesia so I FELT the whole thing, ignored when I begged to see my baby.. sent home with an infection, told I was imagining things... so many horrible things. My second birth, I thought I was fully prepared. I hired midwives who I grew to trust and thought cared about me. They listened to my previous trauma and promised over and over that THIS birth would be different and told me all the things they would do to make it better. I also hired a doula, and read a TON, talked to other midwives, doulas, birthing advocates, took a vbac birth class, etc. Like my first labor, it started naturally at home with my membranes rupturing and then contractions following. I labored at home for about 7 hours with my husband and doula until the midwife wanted me to come in to the hospital. Within minutes, the midwife who I felt lucky was oncall the day of my labor since I had liked her so much during the pregnancy, turned on me. Started talking about a csection. Forced all kinds of interventions. Talked about protocol and did rough exams, telling me he was too big and my pelvis too small and he'd never fit. Brought in a consulting OB without my permission to try to scare me into a c/s. She betrayed and hurt me in so many ways. I finally kicked her out. The next midwife was better, but not good. My son was born by very traumatic vbac on her shift, delivered with foreceps by the consulting OB after they failed to talk me into a csection (they had definitely tried, had encircled me in the bed and used every scare tactic possible but I refused!!). After my son was born, roughly, with 4th degree tears to me from the foreceps and screams I will never forget.. the OB pulled on the cord, trying to hurry out my placenta. He tore it and had to do a D&C right there, which I fully felt but gritted my teeth and had to bear or else they told me I'd be under general in an OR. Another HELLish birth. Thank you for speaking out. I am coping with PTSD years after my births. And afraid to birth again.

Anonymous said...

My husband was military when our first baby was born, so we had our baby in a military hospital. I was never told that I had the option of taking CHAMPUS (military health coverage that was available back then) and having the baby in a civilian hospital.

When I showed up at the hospital in labor, I was in too much pain to read carefully. I ended up signing a Consent to Surgery ("in case anything goes wrong suddenly") that apparently included permission to allow observers at my labor for teaching purposes. I am extremely modest, so I would never knowingly have permitted a group of strangers to line up against the opposite wall and stare at my crotch. Once they were there, I was too intimidated to ask them to leave. It was so embarrassing and shameful I have tears in my eyes writing about it, over a quarter of a century later.

My perineum tore when the baby came out. As the midwife-trainee slowly stitched me up, the anaesthetic started to wear off. I started to cry from the pain, the disappointment of the labor, and the emotion of finally having my beautiful baby. The midwife-trainee angrily asked my why I was crying. Apparently she thought I was making her look bad in front of her instructor. I was amazed that she didn't understand the strong emotions of a woman who'd just been through labor, so I meekly mumbled something about the stitches hurting.

I truly believe that this experience (combined with too-early, too-intrusive visits from demanding in-laws) started me down the road of a postpartum depression that lasted nearly two years. And it was so unavoidable. I did not deserve to be treated so shabbily.