09/09/2020
I'm going to get a little personal.
Ten years ago today, my life changed in ways I’m still trying to understand. My last baby was born, after a home birth transfer turned cesarean section.
Yesterday, a Facebook memory showed me complaining about contractions that we annoying and not progressive. All my friends were supportive and commented that I might still have weeks to go. They were right. It wasn’t even my due date yet. But that night, right after I went to bed, my water broke. Big. I flooded the bed. Contractions started right away, every five minutes. I labored all night and into the next day. I knew something was not quite right. Baby was fine. We were listening with a Doppler. That wasn’t my worry. It was her position. My chiropractor came to my house to adjust me in case that was the problem. No change. I finally decided I needed to go to the hospital and get an epidural so whatever the issue was could relax out and I could have this baby. I’d been 7 cm for hours so the drive was not pleasant. But off we went.
When I arrived on the L&D unit, I immediately asked for an epidural. Was told it would take a bit to get me admitted. Asked if I could have something in my IV. My nurse laughed at me. The on call OB came into my room, shamed me loudly for attempting a home birth. Shamed me for having my labor take so long with baby number 8. Threatened me with a c-section if I didn’t hurry up and have this baby.
Once I was half blocked, because it didn’t work all the way, my nurse stood at the computer, ignoring me. She literally said not one single word to me as she charted. I said I needed to push. She ignored me. Some time later (no idea on passage of time), the OB came back. She checked my cervix. I was fully dilated. She told me to push even though I wasn’t having a contraction. Baby didn’t move. Commence the c-section coercion. But the epidural wasn’t fully effective. That’s ok. We’ll just put me to sleep. Let’s not redo the epidural or try a spinal for a non-emergent c-section. We will definitely need to go the more dangerous route of general anesthesia. Who does that? Well, I know who.
Baby is born. One minute Apgar is 1 due to general anesthesia. Full resuscitation is needed. OB later told me she hadn’t been sure baby was going to make it. Both my uterine arteries were torn during the surgery. I bled. A lot. My hemoglobin went from over 13 down to 7.1. When I got up to the bathroom for the first time and saw myself in the mirror, I looked mostly dead. I was symptomatic for weeks. I wasn’t even given a prescription for an iron supplement. I got my records. My day of discharge physician note stated everything was dandy. It wasn’t.
How my practice changed, because no one should ever experience what I did:
I now believe every single birthing person needs a doula. I am as strong as they come. I am an expert on the birth process. At that point, I’d been a birth worker for 13 years. I knew my stuff, even then. Despite all of that, I could not withstand the weight of the OB bullying I experienced, from my nurse laughing at me, judging me as a home birther, to the physician bullying me and coercing me. If I can’t stand up under that pressure, how does a woman without my knowledge and strength of will?
As soon as I was exposed to Spinning Babies, I worked, giving of my own time as a volunteer, to bring classes to Wichita to educate all the nurses I could convince to attend. Spinning Babies has revolutionized the practice of L&D nurses across the country. Had I had those tools available to me, my birth 10 years ago would have been very different. It likely would have happened within hours of my water breaking, at home, in my tub, as intended.
I am committed to advocate for every patient I care for. It doesn’t matter to me what kind of birth she wants. I don’t push women into any certain thing. Just because I made certain choices for my own births, does not mean I try and steer women in those same directions. However, whatever she tells me she wants for her birth, I will do everything within my power as an RN to make that happen for her. Sometimes that has meant standing up to doctors. That has earned me a reputation. It’s made certain nurse-physician relationships strained. I’ve been accused of not being a physician advocate. Which is fine, because I’m not. I’m an advocate for birthing people. Their safety and health, including mental health, are my top priority.
As a home birth transfer, I know exactly what it feels like to come in the system and be judged harshly. So, as the local AWHONN leader, I decided to have a meeting discussing home birth transfers and how to care for them in a respectful way. I’d scheduled this for a local hospital. When my topic was released, I was told I couldn’t hold the meeting there. So I scheduled at the other hospital. Friday afternoon, before the Monday evening meeting, I received a phone call from the COO telling me that due to emails he’d received with concern about my meeting topic, I couldn’t have it there either. What was happening? I wasn’t promoting home birth. I wanted to talk to nurses about the importance of caring for these women and understanding their needs. I had a panel with a local OB, a local home birth midwife, and two moms to share their experiences with being a home birth transfer. How as this a bad thing? Clearly what I was doing as an RN wasn’t enough.
I became a certified nurse midwife. This allows me to provide the kind of care for birthing people that I wish I’d received myself. I needed to feel heard, respected, and honored in my birthing space. I knew I could do that for others. But even now, it’s not enough.
Let’s talk about maternal mental health I mentioned above. Because no one wants to talk about it. Birth trauma is a thing. Obstetric violence happens. I’m not just talking about stories on the internet. I’ve witnessed it at a nurse. I experienced it 10 years ago. I suffered from postpartum depression. The scary kind, where I had thoughts of tossing my baby out the window. I’ve personally experienced secondary birth trauma. This is the trauma felt by those who witness. This includes birth workers like doulas, nurses, and even physicians. It also includes support partners of the birthing person. So now, I am working toward my psych mental health nurse practitioner certification so I can help those with perinatal mood an anxiety disorders and those experiencing birth trauma/PTSD, both primary and secondary.
Elena’s birth changed my life. Her birth is also changing the lives of the people I care for and those I’ve worked with.
I love you, baby girl!!
Photo by Gina Dreher Photography
