In September, I was the midwife at the birth of a 23-year old black woman and her 24-year old black husband, both of whom are veterans of the Gulf War. The labor was rather long and I was assisted by my apprentice (who is white) and my assistant (who is black) and the dad's mom was also there. The other person there was a Home Health Nurse (HHN), a white woman who was about 58 years old, that the mother had gotten to know during the pregnancy. When mom (I'll call her Mary) wanted to invite the HHN, we had a session of exploring why she wanted her there and Mary said she was a sort of surrogate mom and she really wanted to show her what a home birth was like. In the first part of the discussions, that was the true reason that had come out... that she'd seen hospital births, but the prospect of being able to see a homebirth was fascinating to her.
At the home visit, we let the HHN know that birth wasn't just walking in and the baby dropping out. She nodded her understanding, but she still looked at us with a glazed semi-smiling look on her face.
When Mary was in labor, the HHN was bored shitless. Originally bounding in at 3am, by 20 hours later, she wanted to go home and wasn't shy about letting us know with her body language. She had gone home at one point to sleep, but when things picked up, we called her back as she'd asked us to. (Oh, if we could only go back.)
During labor, we laughed a lot. Mom spent time in the tub, wandered around the apartment and we listened to a lot of different types of music. One of the most amusing and memorable parts of the earlier labor came when dad put Sade on the cd player. I learned the pronunciation of the artist was "Shar-day" and when I, who was extremely tired anyway, said I knew every word of that particular cd and loved "Shar-day" so much, it set off howls of laughter from the black folk in the apartment. My apprentice and I, baffled by the cackles, didn't understand until they explained the pronunciation was actually "Shah-day."
An entire separation of cultures began, lovingly and humorously, as, over and over, differences were pointed out or given friendly winks and any word that could be twisted around, was to cause gales of laughter. One of the funniest was when mom got out of the tub and I got some Shea Butter to rub all over her very dry skin. Almost in unison, the black folk in the room said, "You mean the 'Sharrrrrrr' butter?"
Interestingly, once labor got really tough, mom coped really well with my assistant, so she spent most of the time doing the support. Having done labor support with several different cultures, I have often seen the most welcome support come from someone of the same culture and/or language. I was not of this mother's culture and my assistant was.
Mary started pushing and she really didn't like it one bit. Loud, raucous and wiggling, mom fought ever contraction and we, her support team, stroked, loved, cajoled, teased, directed, ordered, laughed, barked, whispered, waited, sat quietly, and offered her whatever we could as the head showed itself with a palm-sized amount presenting at the vagina. Thank goodness, the heart tones were holding their own during this one hour plus experience, but we didn't know how much longer that was going to be the case.
Mary screamed over and over that she was done. She was not going to do it anymore, to just pull the baby out. No amount of explaining could convince her the baby wasn't coming without her help and finally she exhausted herself and her body stiffened, her eyes rolled back in her head and she began to faint. To the uninitiated on-looker, it would probably look like the beginnings of a seizure, and surely could have been, but she shuddered slightly and when we took her blood pressure immediately, it was absolutely normal, her pulse fine and she was merely unresponsive verbally.
The HHN had her fingers on her cell phone and had already dialed 9-1 and I looked at her and said, "Call 9-1-1" and she hit the last 1 of the number, stepped out and within 2 minutes, two police officers were in the room. A few minutes after that, EMS was there and mom was a little more responsive.
All vitals remained normal as I explained the situation to the paramedics. We could still see the same palm-sized amount of head when she had a contraction and the EMTs were delighted that they might get to see a homebirth. Everybody was very respectful with each other and as the mom said she did want to stay home and birth there, the EMTs asked if they could stay and watch. Mom said, "sure" and the guys hung out and cheered behind me. I had to stop them from hollering at her to push (maybe I shouldn't have!) and they remained excited to possibly see the baby born. I explained things quietly, so they knew what was going on and the discussion in-between contractions was quiet and respectful between the Captain and myself. At least one of the young guys hadn't ever seen a baby born before and a couple of them hadn't seen a homebirth. He was giddy with excitement.
Then Mary started screaming again and no amount of trying to calm her down was working. In front of the EMTs and the HHN, the screaming wasn't going to go over very long so the EMTs asked if she wanted to go to the hospital and she cried, "Yes!" When I asked her what the hospital was going to do, she cried, "They will take it out!" I tried to explain that she would still have to push and I don't think she heard me as she began a mantra of "No, no, no, no..." and the EMTs brought the gurney into the room that had been sitting in the living room waiting the whole time.
If none of these people had not been there, we would have put mom in the car and gone to the hospital by my office. Instead, she was taken to the hospital the ambulance took her to.
There's this thing with midwives and EMTs around here. When we did In-Services, we asked about going in the back of the "rigs" with our clients and some of the guys said they would never let us in and some said it depended on the situation, but they all said to never ask... that they would pick who got to go. So, even though I had made it distinctly clear in speech and actions that I was the Licensed Midwife and Mary's husband was right behind her the whole time, the EMT in charge pointed to and said to my assistant, "Do you want to go?"
In a 5-minute conversation that lasted 20 seconds with our eyes (and just our eyes), the assistant and I looked at each other and said:
She: May I go?
Me: It'll be a great learning opportunity.
She: Shouldn't you go?
Me: But they asked you.
She: But maybe if you asked to go.
Me: Then no one will be with her; they'll get mad and she'll be alone.
She: I want to go.
Me: Then go!
She: I'll go!
And off she goes in the ambulance with my client. Dad and grandma follow behind in the car. My apprentice and I, having 2 other women post-dates, have to put the birth kit back together exactly correctly, but it doesn't take more than a few minutes and then we dash to the hospital ourselves.
What I learned later is that in the ambulance, the EMTs were terrified Mary was going to deliver and kept asking the assistant to look under the sheet to see if the baby was there. Praying the baby would be there each time she looked, it wasn't and the assistant had to tell the guys it was fine, the baby wasn't there yet. Mom was screaming with contractions and it sounded like she was pushing, but the baby wasn't progressing past the same place as before.
When one EMT tried to take mom's BP during a contraction, the assistant suggested they might want to wait until a contraction was over. When he was able to do so, he merely obtained the systolic and the person writing on the chart said, "That's enough for me!" It was certainly an odd ride.
Getting to the hospital, they were taken to L&D and the EMTs pointed to the assistant and said, "She can tell you what happened," and gave vitals before leaving. My assistant explained the labor's beginning, rupture of membranes, vitals throughout labor and mom's decision not to continue pushing at home - hence the decision to transport to the hospital.
Instead of continuing in narrative form, I diverge into a more official capacity. Follow along if you will.
Below, you will find the letter I wrote as the official complaint sent to JCAHO (pronounced jay-coh) - the Joint Commission on Accreditation of Healthcare Organizations - an organization that hospitals voluntarily join because it looks so great on their records since JCAHO supposedly is an outside organization providing an objective view of a hospital's performance in a variety of areas. From JCAHO's website:
Joint Commission evaluates the quality and safety of care for nearly 15,000 health care organizations. To maintain and earn accreditation, organizations must have an extensive on-site review by a team of Joint Commission health care professionals, at least once every three years. The purpose of the review is to evaluate the organization's performance in areas that affect your care. Accreditation may then be awarded based on how well the organizations met Joint Commission standards.
Coincidentally, within 2 months after I wrote my letter, the hospital in question had their review. This gets confusing, so please follow the bouncing bureaucratic ball.
First, about The Letter.
I was implored (by the Powers That Be That Shall Remain Nameless) to keep as much emotion out of it as possible. I had to write about 10 versions before I got to this sterilized version. No words can explain the amount of anger I felt during the recovery with this mother and trying to help her while having no one hear any of us screaming for help. I chose to use the mother's first name in the letter (not here, the name used is not her real name - anything in italics has been changed, not to protect anyone, but just because at this point) because I felt it would make a much more personal impact... that she was a real person and not just some "patient," but a woman with a baby and a husband and a life. I chose each word very carefully. It took me about 3 weeks to complete the letter.
So, here is the sterilized version and I will continue below the letter after that.
October 11, 2006
To All It May Concern:
I am writing to notify you of a serious breach of care in That Hospital on September 11, 2006 between the hours of 2:00pm and approximately 6:00pm. Because this is a long and convoluted story filled with emotion, I will attempt to bullet point where the neglect occurred with the hospital staff and try to curb the intense amount of anger and disgust I feel towards those that interacted with and were supposed to care for my client Mary Morris and her newborn baby. Having attended well over 500 births in hospitals around the United States and Germany, I am well aware of the standards of care for a maternity patient and a newborn. I have also attended births in eight other hospitals here in Our County so understand the standard of care for this county in particular. What I experienced at That Hospital was anything but the normal standard of care.
• During the birth, I was, apparently, being summoned by Dr. Colon (quite loudly and angrily according to my client and my assistant), yet I was forbidden from entering the labor and delivery suite. I identified myself to the nurse at the front desk twice as Mary Morris' Licensed Midwife and she summarily dismissed me saying, “No visitors. Sit over there,” and pointed to the waiting room. I was permitted to enter approximately twelve minutes postpartum and never saw Dr. Colon.
• Dr. Colon stood against the far wall with his arms crossed as the baby was being born forcing the nurse to do the delivery. No explanation was given for this behavior. While I did not witness this, my assistant, the baby’s father and grandmother did witness this happening.
• Dr. Colon approached the delivery bed after the birth of the baby to pull the placenta out, causing excruciating pain for Mary. She still, many weeks later, remembers the pain in detail.
• Dr. Colon, while raising the bed, stated that he was sure Mary tore (in her vagina), but upon inspection, stated surprisingly there wasn’t anything but a skidmark (a common term for a slight abrasion). He then stated that he was going to suture it anyway and sutured her perineum without any Lidocaine or medication of any kind. Mary did not have an epidural. He placed one stitch in the lower left inner vagina. While the records state it was a first degree tear, his words in the delivery room stated otherwise. In 24 years, I have never seen even one suture placed without anesthesia.
• Dr. Colon never introduced himself to Mary, never addressed Mary, never asked permission to touch her nor even congratulated her for the birth of her son. He merely pulled her placenta out, sutured her without medication and then threw the gloves in the garbage and walked out of the room.
• No vitals were ever done by your staff on Mary during the time I was in the room which was approximately 3.5 hours.
• No one on your staff checked Mary’s fundus or her blood loss during the time I was in the room.
• The baby never went to the warmer.
• The baby never received Erythromycin eye ointment despite the parent’s desire for it. The hospital never offered to place the ointment within the first two hours of the baby’s birth despite it being the law. The parents ultimately signed a release that I would give the ointment at home, which I did, but they had not been offered it within the legal time frame.
• The baby did not receive a Vitamin K shot despite the parent’s desire for it. The hospital never offered to give the injection despite it being the law to give it very shortly after the baby’s birth. The parents ultimately signed a release that I would give the injection at home, which I did, but they had not been offered it within the legal time frame.
• The baby had his temperature checked twice – once at birth (which I did not witness) and once again about three hours postpartum. This is not the correct standard of care for a newborn.
• The baby had his heart and lungs listened to twice – once at birth (which I did not witness) and once again about three hours postpartum. This is not the correct standard of care for a newborn.
• The baby did not have his identification band placed on his ankle. After obtaining Mary’s medical records, it states in the records, “parents refused placement” which is incorrect since no one ever tried or came near with a band. The mother is a Licensed Practical Nurse and absolutely knows the vast importance of security in a hospital, especially of a newborn baby and would never have refused such an important detail.
• The parents were not told the baby’s birth time and only learned it when they went to fill out the birth certificate four days later. We had to piece it together via cell phone logs and were two minutes off for those four days. No one considered it important enough to tell the family the baby’s birth time, something that is a normal course of events in a typical hospital birth.
• The baby was given one hat. When asked for another hat, we were refused and told another would be given on the postpartum floor.
• The baby was given one blanket and it was wet from the birth and the baby had also had a bowel movement at the birth (meconium), so the blanket was covered in that, too. When we asked for another blanket, that request was ignored. We cleaned the baby with a chux pad as best as we could and used the sheet Mary was wrapped in (bloody and wet from the birth) to keep the baby warm until we found a blanket in the isolette tucked under a chux pad. We’d searched the room for a towel, washcloth, sheet, gown – anything – and there was nothing. I’d used my skirt at one point, too, to keep the baby warm. Once we found the blanket, we used that until my apprentice and the grandmother went home and got the baby some clothes.
• The baby was weighed only after the parent’s requested it several times.
• Mary was never given a gown.
• Mary was given one pad to wear during the entire time in her bed. The only time she was offered another pad was when we were leaving and the nurse brought a postpartum pack in and set it down by the sink in the room, not helping Mary, who was in the bathroom, in any way.
• Mary was not offered a frozen pad as women typically are after a vaginal birth.
• Mary’s sheets were never changed. She never received a blanket change despite our asking for something that wasn’t bloody and wet.
• Mary and her husband wanted to leave the hospital with the lack of care they were receiving, but I explicitly told them I felt it was important to at least stay the night and make a decision in the morning. And then the next event occurred that ruined any chance of their consideration of staying in That Hospital.
• A woman who never identified herself entered the room yelling and proceeded to demand Mary’s chart from me. I identified myself and explained that HIPAA regulations forbade my being able to give the chart directly to her, but I was glad to share the information with the mother’s permission. She became increasingly agitated and her voice escalated and the father and grandmother all began yelling together. At a birth! My best guess was the woman was the Charge Nurse since she, at one point shouted, “I’m in charge here!” She had a Caribbean accent (the baby’s grandmother was from the Caribbean so recognized it easily). The woman stated she needed information from the chart and for me to give her the chart immediately and I once again said I could not and said I had the lab information and flow sheet of her prenatals I was glad to share with her and if the mother signed a records release I was glad to copy the chart for her. The mother shook her head no and the woman left the room very angry.
• As she left, Mary said she would crawl out of your hospital before being subjected to the lack of care she was receiving by staying in. I could no longer disagree with her decision to leave.
• A woman entered the room and said she was a neonatologist, but she never stated her name. She said she was there to examine the baby. The parents said they did not want an exam and that was when the doctor left the room and left the door completely open with the mother naked on the bed and the curtain open. Those in the hallway stood staring inside the room until we realized the doctor was not returning and my assistant went to close the door. At no time did the doctor state risks of leaving Against Medical Advice or any concerns she had regarding the baby’s birth as has occurred with other clients who have opted out of routine hospital procedures in any other hospital over the last 20+ years in my experience.
• When Mary went to the bathroom for the first time, no nurse accompanied her.
• No final vitals were done on either Mary or the baby before leaving the maternity floor. This is in direct conflict with standards of care in my experience.
• When we left the maternity floor to leave, no nurse checked to make sure Mary had the right baby – in fact, no acknowledgement was made whatsoever of her presence and that she was leaving the floor with a newborn baby. No nurse accompanied her from the room to the elevator, from the elevator to the ground floor or from the inside to the outside of the hospital. She left the hospital unattended completely. No nurse was there in case she was bleeding or felt faint.
• When the baby was put in the car seat in the car, no nurse checked to make sure the baby was put in the car seat correctly.
• When we arrived home fifteen minutes later, the Local City Police were blocking the family’s garage and said the hospital asked that they come and check on the baby’s health and well-being. We were quite surprised considering how little That Hospital seemed to care when we were IN the hospital. They asked for proof that I was a Licensed Midwife, which I showed them immediately and they quickly left. I am not sure why Dr. Colon, the Charge Nurse or any number of others at That Hospital did not ask me for my identification while we were still at the hospital instead of sending the police to hinder the safety of the mother and baby; I would have complied happily.
• Child Protective Services was called on the family and came to visit on day two postpartum as well as have a lengthy phone call with me regarding the Morris’ parenting style and choice to leave That Hospital Against Medical Advice. She also stated there were issues with meconium staining the hospital mentioned. No one at the hospital had mentioned the concerns the day before. Her quick assessment that That Hospital’s accusations were “unfounded” speaks volumes regarding the lengths That Hospital went to discredit a perfectly respectable young married couple.
As a Licensed Midwife in Our County, I understand circumstances might not always be the most comfortable for me when I have a transfer or a transport to a local hospital. However, never have I seen a client punished in the way Mary Morris was punished for wanting a homebirth. And she transferred without any complications! I shudder to think how she would have been treated had she come with a life-threatening complication. It is beyond comprehension how human beings can treat a birthing woman and a newborn baby with such disdain and cruelty. There is no excuse for this type of behavior in a hospital in any city in America. For God’s sake, I recently returned from working in a hospital in New Orleans and their care was so tender and so loving - Hurricane Katrina had changed their emotional lives so dramatically that those nurses and doctors have found renewed spirituality in their care-giving skills. Does That Hospital need a disaster to re-awaken to human kindness? I pray not.
I will continue to work diligently in my profession to maintain the utmost in integrity. If any doctor, nurse, board member or staff member has any questions, please do not hesitate to call and ask me to answer it for them.
My Name, Licensed Midwife, Certified Professional Midwife
Ph# My Number Email: My Email
So, I know it sounds unbelievable. If I read it, I would blink and have a hard time believing it, too. My apprentice and the assistant for that birth will look at each other all these months later and still shake our heads wondering if what we saw was real. It was.
It was so real, the hospital staff had to lie about it all.
When JCAHO was in town, we discovered we had an ally in the hospital. That person (whom we will call The Mole) became our inside information about the JCAHO hearings going on and tried to help us get into the hearings so our side could be heard.
You see, this is the interesting part about the JCAHO hearings, they are public, but unannounced. Well, The Mole let us know when they were, but the segments where the public can speak is minimal and specifically scheduled - and UNscheduled - if that makes any sense at all. (It probably does in bureaucracy world.) So, the parents and I called the JCAHO and hospital people in charge of the hearings asking to speak and we were told, over and over, that the hearings were unscheduled for the public. At one point I asked if I just needed to come down and sit 24 hours a day because I would. It was then that, of course, the public hearings were completed, so it wouldn't be necessary to come at all.
So, JCAHO never heard our version of the story beyond what I wrote and what the family wrote and an extensive interview done by some government man who didn't understand birth one iota.
JCAHO did, however, get to hear the entire story from each of the players involved on the hospital's side. Weren't they lucky? seething even now
The doctor, the head nurse (yes she was the head nurse), the "nice nurse" (whom I will speak about later), the bitch nurse, the neonatologist and every bit player involved got to have a say. And did they ever have their say.
The nurses said the mom was so out of control and so crazy, they couldn't get near her to give her a gown or to take the baby to put him in the warmer. BLESSEDLY, we have pictures (thank the Universe for my apprentice taking pictures!!!) of mom serenely holding her baby and the "nice nurse" holding the baby at one point on the way to the baby scale - gee, 3.5 hours postpartum, the baby still had meconium where we couldn't wipe it off of him... wonder why that was. Anyway, the nurses said we were SO mean and SO snotty to them that THEY CRIED at the nurses station!!!!!!!!!!!!!!!! They could hardly wait until we left because we were so mean. They'd hardly met any group of people so horrible. blinking in utter disbelief
If they cried, and I hope they did, it was from the amazing realization of the cruelty to another human being that they inflicted - TWO human beings. I hope they are crying right this minute.
Mary and her husband came to the hospital with a camcorder. When Mary was in the bathroom before she was leaving, I was in there with her as was her husband. My apprentice and assistant were getting the baby dressed on the bed. The "nice nurse" came in, gave us a "going home pack" by setting it on the sink in the room... not giving it to us in the bathroom (where we could have used it since it had pads in it) - and she walked out without saying a word. I had to walk out to the sink to go get a pad for mom.
It was days before we realized the camcorder, which had been sitting at that sink, was gone. The "nice nurse" had surely been instructed to kindly remove it from the room lest there be evidence on it. I am sure she is crying the most. She tried to be nice, but it was obvious she was told to give only the most cursory of un-care and words to us.How did this end with JCAHO?
The hospital received a brand new Gold Seal of Approval! None of the nurses, nor the doctor were disciplined for their horrific behavior, BUT, the one thing that was found was the doctor had not explained the risks and benefits of lidocaine to the mother before suturing her (he claimed she refused the lidocaine). The hospital was fined a delightfully hefty fine from what I hear, but other than that, my mom is left out of any anything.
- No one to listen to her side of the story that would be able to do anything to the doctors or nurses directly.
- No lawyer will take her case because she can't show permanent damage to her or the baby (apparently fear of sex and the excruciating pain of being sutured without pain meds isn't worthy of a lawsuit - not to mention utter neglect in a hospital) .
- No restitution for her bills, pain and suffering or therapy she has needed to work through this experience.
HOWEVER, a New Mole has come out of the hospital steering mom into a new direction that might lead to a better sounding board than JCAHO. We'll see if it works out.
So, dear readers, you who know me can understand why I was so traumatized in September when this birth occurred.
Although I couldn't say it in the letter, in the investigation, we did state that race and socioeconomic status had a very big part in Mary's care. It was apparent they thought she was a single black woman coming in with her sister, when, in fact, the woman who accompanied her in the ambulance, was my assistant (who happened to be black). My client was having a hard time keeping control initially, but my assistant was able to calm her periodically and once the mom realized she was going to have to push the baby out in the hospital without assistance, she began to push in earnest and the baby was born within a few contractions.
(This brings me to the interesting concept we espouse about babies coming out even without a mom's active pushing. Apparently, this mom fought so hard against the baby, she maintained a location of homeostasis as far as where the baby remained in the vagina. The uterus, during the entire 90 minute pushing/un-pushing production remained extremely active and we could see the baby's head presenting more at the entroitus, but the baby receded each time the contraction ended. The thought that something might be holding the baby up crossed our minds, except there were none of the tell-tale signs of decelerations that would occur with a short cord or a nuchal cord. The whole thing was so odd.)
Immediately upon arrival, a nurse said to mom, "We're not nice like those homebirth midwives. We're gonna get that baby out." This was the Bitch Nurse. She continued being snotty and curt with Mary and was rough with her body and then with the baby as he was born. My assistant has an amazing capacity for recollection and I am thrilled she was allowed into the ambulance so she could make meticulous notes of every single thing that unfolded while I couldn't be there.
The doctor did, indeed, stand in the corner of the room yelling about me, asking where I was, why wasn't I there, that he knew there really was no midwife, that I had just ABANDONED my client and what kind of midwife is that. The whole time, the nurse is asking him to come to the table because the birth is imminent and he stood in the corner of the room with his arms crossed, not budging, in his street clothes. The nurse "delivered" the baby and the doctor strode to mom, shoved the nurse aside, put gloves on, yanked the cord so hard mom screamed until she nearly fainted, pulled the cord out, shoved his fist so hard down on her abdomen she had tears streaming from her eyes and then raised the bed to look at her while commenting that he knew she tore. Surprised, he said she just had a skid mark, but he was going to stitch it anyway. He grabbed the suture, placed the stitch while my mom screamed to the heavens and then he took his gloves off, threw them on the floor and turned and walked out the door.
That entire time, I was in the lobby trying to get in and was not allowed in. The nurse placed a faux call to the room and turned back to me and said, "No visitors," and pointed to the waiting room and told me to sit down and wait. I called my assistant's cell phone, but she didn't answer. Brilliantly, my apprentice called the hospital and asked to be put through to the patient's room. My assistant answered and she told me the baby had just been born (this is the way we pieced together the incorrect time of birth until we saw the hospital birth certificate work sheet 4 days later) and that mom needed her, she had to go. This was right when the doctor walked up to the table to yank the cord out and the assault began. It's too bad we weren't on a cell phone to be able to tape it.
12 minutes after the answering of the phone call, dad came out and brought us into the room. I walked right past the doctor, but he didn't say a word to me; I didn't know he was her doctor or I would have said something. Nobody ever asked me who I was, but I introduced myself each time a nurse came in, even the screaming nurse. Incredibly, I remained professional and civil (perhaps I should have gone berserk and run around the hospital floor screaming my disgust at their behavior? they would have kicked me out, surely.) and was very proud of my behavior with the staff.
I believe I would have been more demanding of "things" next time. Even though we asked for things like towels and gowns and washcloths and blankets and were turned down each time, something in me thinks I could have been more aggressive. I look at myself and wonder what I could have done to not have my client be punished in this way and in my heart of hearts know they were treating her this way because they just have an evil place in their heads for people of poverty.
When mom's husband came in during the delivery, he was shell-shocked, so didn't speak until after the birth and once he started speaking, the nurses started taking notice... the couple is extremely well-educated and don't "sound black" (according to how our society would consider blacks to sound). It threw the nurses off. And what was even more shocking to them was when, 3 hours into the horror, the insurance chick came in and snottily said, "I suppose you don't have insurance either, do you." Dad said, "As a matter of fact, we have Famous Great PPO Insurance," and the insurance chick about swallowed her tongue, threw the papers at them and rushed out of the room embarrassed as hell.
Having mom sign the papers to leave was our biggest mistake. Mom just wanted to get out of there and she didn't look at anything she was signing and signed too many things that ended up saying she didn't want this (Vitamin K) or that (Erythromycin). If you all are ever in a similar chaotic situation, do not EVER sign anything without reading it first - even if you can't wait to get OUT of there. It isn't worth it in the end. And, for the record, it isn't any of those papers that are keeping a lawyer from taking her case. The papers are the least of it in the grand scheme of it all legally, but because they are a legal document, in these investigations, they meant a lot. And it sucked to give them anything at all.
I am exhausted from writing this for 2 days and I know I could continue writing for 3 more because the 5 of us have picked this apart ad infinitum - we have considered and re-considered every nuance of this case. I have played and re-played every detail over and over, asking myself what I would have done differently.
You might wonder, what happened to the HHN? When the ambulance took mom out of the apartment, she left and didn't call for 5 days. She was "tired." The mom is very sorry she ever invited her to the birth and very much feels she had a hand in the demise of her homebirth, or at least, a peaceful birth in a location that would have treated her with respect and dignity.
Mom will have a homebirth next time. She says she will never be afraid of that pain of pushing again. She will find strength in that experience and not be afraid of most things in her life that are seemingly unbearable challenges. She has found enormous strength in her birth experience. Her husband loves her and while he was extremely sad to not have the homebirth he wanted so badly, he has supported and protected her in this healing in ways many men would never have known how to do. His words, his deeds, his tenderness and love ooze from his heart and cover his family in a way I don't see coming from most 40-year olds, much less someone of his young age. I am honored to know them both.
The assistant and apprentice have found healing easier than I (or so it seems to me) and they continue loving me through my pain. Is it always so different for the midwife herself? I want to erase the experience. I wish I could turn back time and find the magic words to make her push that baby out in her bedroom. I wish I never knew there were nurses and doctors who were so evil and cruel in my own city. I wish I still believed people could never be so evil to a birthing mother and a newborn baby. I wish I had never been witness to such horror. I feel like my illusion of hospital care has been raped... and my illusion wasn't even all that glamorous! I hate that I might have to go back to that hospital and have to find a way to work with a liaison to make the experience better.
Because those nurses can sit in front of the investigators and boo hoo and say this and that about us, but the absolute truth is - they know The Truth. They know who neglected whom, who assaulted whom, who stole what from whom. And I will stand with them, toe to toe, staring them in the eyes, also knowing The Truth.
I know The Truth.
And today, I finally speak The Truth for you all to hear.