This set me off down an unhappy memory lane.
Doctors fighting over a labouring woman, déjà vu. Baby with a poor outcome, mum without a womb.
"Police were today questioning staff at a hospital in Sicily where a child was born with suspected brain damage after two doctors attending his mother allegedly came to blows over the need for a caesarean as she went into labour."
I had a doc and three midwives with raised voices, one midwife came in and sottovoce told my husband "for the love of god if you love your wife and child go and insist they do a C-sec, she (the doc) won't listen"
So he did, the doc came back in, examined me and yelled, "but this cervix is changing !"
Yeah I'd gone from three cm to three and a half cm in 24 hours of unrelenting, unmedicated agony and when they ran a check on my heart not an hour earlier there had been some very unhappy faces muttering at the main doc.
Sock Dropper won the argument. I have reason to be grateful for that.
I had been chatting in the nearby bar almost daily with the owner, who was almost as pregnant as I was, for the last six weeks or so before our due dates.
I went to see her at work with my few week old new baby as promised. She wasn't there. But was on her way and her husband asked us to leave before she arrived. Their baby girl died after they turned off the machines. Her husband told us that it had been chaos, with one doc insisting on going ahead "naturally" with the other screaming for an emergency C-sec now. The C-sec doc had been ejected from the room. The baby was born vaginally an hour later with devastating brain damage. Later on I saw in the local paper that the doctor underwent disciplinary procedures because all the evidence pointed to a C-sec having been the only reasonable conclusion far, far earlier in labour.
Then I moved here. There are three children around Son of Thor's age with not so mild to extremely severe disabilities, I know their mothers in different contexts, one is the daughter of a neighbour, one was a mum with a kid in the same year group, one is a friend of a friend. In every single case the unifying factor is rows between medics during labour, where one held out for "natura"l and somebody else pushing for a C-sec that either didn't happen, or happened too late. They all 3 received substantial damages as the system concluded that the hospital was at fault.
So I hate all the angst over "C-sec rates and percentages".
By all means challenge unnecessary C-secs performed on women who neither need or want them.
But don't make it numbers game or all about a philosophical revulsion for them.
Look at the individual in front of you and think about what she and her baby needs right here, right now. Cos if that isn't the priority then examples like those above are going to keep on happening.
I joke about how I only have one kid because he was an insomniac, and it is not without some foundation. But the real reason why I couldn't face the thought of another baby was the birth. I have no issues with having had a C-sec, I was so desperate at that point that if you had told me that hurling me out of the window from the 8th floor would stop the pain and make sure my baby was born safe and sound I'd have signed off on it.
My problem with risking another birth is that I have "flashback" issues at being scared to death that both of us were going to get hurt or die, because at no stage in my labour did I feel like we were the point. We were most decidedly in the back of the queue behind birthing philosophy and hospital statistics.
I am pro more choices for women in birth. From HBAC right through to chosing to have a C-sec from the onset. What I am not up for is swopping one hard line in the sand for another and pretending that humans are carbon copies of each other so it will work out just fine for everybody.
Women and their babies should not have to risk being collateral damage for somebody who has picked a one size fits all approach to all their patients.
If we want to change birth to make it truly a feminist deal where there really is a choice and genuine, unbiased guidance and information is available from the onset as well as during labour, then we need to make it about women and their babies and not about loaded labels like “natural” v “unnatural” or lists of statistics that may bear no relation to an individual with so very much to lose.
Birth should not be a “political” arena where medics wrangle about their preference for “lifestyle” choices.
This is a timely post. I have just written about changing doctors in Italy. I cannot write about my birth experience in Italy, as I just do not want to remind myself of what happened. Suffice to say, as a result, I had my second child in Australia. Then we moved back to Italy, and are near the same hospital, and I live in denial about ever needing to go there, because I do not want to. Many doctors here just seem to totally lack a bedside manner, or just general interest in you, when it comes to patient care.
ReplyDeleteI totally understand why you don't talk about it. I talked about my birth in detail for the first time in years a week or so ago. constant flashbacks ever since.
ReplyDeleteBig, fat, hug love, cos this isn't a club I'd want anybody else to be shoved into.
I agree with Cathy that many, many doctors here completely lack bedside manner. I am terrified by the prospect of giving birth here on the basis on pervious care I've received. I have never been made to feel like such a burden as a patient. They really don't give a damn, and it's disgusting.
ReplyDeleteStories like yours and the recent episode in the news are absolutely appalling. I agree that the method of birth must be determined case by case, patient by patient, but I have to question why Italy has one of the highest, if not the highest Cesarean rates in the western world.
I agree with Cathy that many, many doctors here completely lack bedside manner. I am terrified by the prospect of giving birth here on the basis on pervious care I've received. I have never been made to feel like such a burden as a patient. They really don't give a damn, and it's disgusting.
ReplyDeleteStories like yours and the recent episode in the news are absolutely appalling. I agree that the method of birth must be determined case by case, patient by patient, but I have to question why Italy has one of the highest, if not the highest Cesarean rates in the western world.
Oh my goodness Sarah your post and then Cathy's words do nothing to inspire confidence should we ever need hospital treatment! I also hope that somehow Leanne misses this post.
ReplyDelete"but I have to question why Italy has one of the highest, if not the highest Cesarean rates in the western world"
ReplyDeleteI think in part due to the high number of elderly primas. I was one of the youngest giving birth on the ward, at 32. Many of the others were in their 40s, first child and assisted concpetion. I'd guess that rightly or wrongly there are believed to be additional risks for that group and C-sec is chosen to avoid trial by labour.
VBAC is virtually unheard of, so the people who have one will then tent to go on to have another if they go against the tide and havea second (or shock horror, third) child.
No epidural on demand can be relied upon. So many who would see labour through if they had pain relief may show signs of distress and exhustion that is believed to preclude (rightly or wrongly) a sucessful vaginal delivery.
Some women go and get certificates climing phsycological barrier to vaginal birth so they can avoid being on the wrong side of a not very pleasant doctor. That will account for another few percentage points.
Plus you have the older primarios with mega god complexes who just go around pronouncing "times up" and heading for theater because they have some kind of stop watch theroy about you blocking their labour beds. I walked (well crawled to be more accurate) out of the first hospital I went to because of one such doc. He was in a hurry and didn't believe in wasting words on mere immigrants so indicated to two nurses to spread my legs in front of 14 medical students without so much as a warning let alone permission. He was in a hurry godammit, being so important and all.
I don't even want to talk about the shock involved in the unanounced emnema that happened just three hours prior to God-Doc doing his rounds.
And look what I ended up with, overheated frying pan to more overheated frying pan.
If I could do it all again I would do my homework so much more carefully and be very pointed about my questions. Avoiding anybody who had lines in the sand.
I gave birth back in the 1980s when c-sections were done only if the mother or child were at risk. Some mothers went through 24 to 36 hour labors. I lucked out. I delivered vaginally (with no meds) after 10 hours for each of my children (I was living in an old Hippy town). Now, it seems that c-sections are done much more often. I don't think it should be either/or. If the health of the mother and child demand it a c-section should be done. Since, it is a bad time to have to advocate for yourself I am all for fathers or family members speaking up.
ReplyDeleteYikes. I'm so glad I hadn't heard any stories like this before showing up in Italy 6 months pregnant with my younger daughter. I had a scheduled C-section (because Sophie's enormous head was preventing my contractions from counting where it mattered), and while one of the attending doctors at the hospital was a complete jackass with no regard for either the mothers or the babies, my OB was great. He refused to tie my tubes like I wanted (on religious grounds), but he was otherwise very attentive and concerned about our well-being. On the other hand, recovery was distinctly difficult because I was not given any pain medication after the spinal from the C-section wore off. The first night especially, fresh from surgery with regular nursing sessions and postpartum contractions, was horrible. (I didn't know I could be firmer about getting pain meds... even bringing my own if need be.) However, we all went home healthy at the end. Your point about individual situations vs. statistics and medical politics was well-said!
ReplyDeleteMy God. Every story I hear makes me more and more sure that, should I ever be in the position of giving birth, I'll make sure it's not in Italy. Thank heavens for your midwife and the Sock Dropper, Sarah - it's just so, so sad that others haven't been so fortunate.
ReplyDeleteIt's utterly dumbfounding, in this day and age, and in a fully developed country, that medical care should be quite as abysmal as it appears to be in Italy. It's not as if childbirth is an out-of-the-ordinary experience for doctors - they should be able to get it right for every single woman.
Oh Sarah - I am so utterly saddened that this happened to you. Thank goodness that your husband was so incredibly strong
ReplyDeleteThis level of ego and lack of care is just disgusting in the modern world - I may moan about over medicalisation of UK birth but that should never compromise the safety of a woman or her baby. Better in fact to be overly cautious and save lives surely?
I agree with you so much! It should be decided strictly based on the mother and baby's health, not on any statistical data!
ReplyDeleteThis is such a great post and such a timely article. It is amazing to me how almost anything can be turned into a political debate. What I think is true though is that birth has become over medicalized and that's probably why there is no this backlash against medicalized births and toward natural. However, the reason there are hospitals is because people need them. And modern medicine is not the enemy. Instead of making decisions based on ridiculous statistics doctors need to do good work and do their best to care for each patient in her individual situation. I'm sorry that your friend lost her baby. That is devastating. Thank you for posting this. It is an important conversation. I hope it continues.
ReplyDeleteThanks for writing this post, Sarah. Had to be said. And I'm sorry for all the people who had such terrible experiences. I, too, was horrified when I heard the story from Sicily, but not surprised. Even though I was prima gravida (two kids at ages 40 and 42), I gave birth both times more or less 'naturally' with no pain relief (the first time after 32 hours it wasn't for want of screaming). The first experience was not good - the ward was full and with the emergency C-secs lined up on wagons along the corridor no-one had time to mollycoddle a foreigner with little Italian and a cervix that wouldn't dilate. I ended up screaming for the knife, but eventually popped him out 'naturally'. The second was totally opposite. A quiet Saturday morning, a near-empty ward, a quick labour and smiles all round. My point is that it was clear that demands made upon the system stretch it at times to the very limit. This must happen both on the individual level as well as on the team level. Perhaps as well as disciplining individual doctors who make the wrong choices, authorities should also be looking at the stresses and strains in the entire system that lead to these events taking place.
ReplyDeleteAs a mum who lost her first baby boy ten years agoI would like to say
ReplyDeleteWHO CARES HOW THE BABY COMES OUT AS LONG AS BOTH MUM AND BABY ARE SAFE!!!!
We had a normal pregnancy, a 6 hour (full term) natural labor on Easter Sunday and our little boy swallowed meconium and on Easter Monday he died.
It is impossible to put into words, our next two children were delivered by elective C section. My heart goes out to your friends who lost their little girl...RIP
-Lisa
Wow, I thought I was the only woman who noticed the lack of bedside manner in Italian hospitals.
ReplyDeleteIn fact, when on the day I gave birth, I got into a verbal scuffle with a doctor who insisted that I sign a C-section consent form.
I refused and he insinuated that if I didn't consent, they may allow me to carry for anther two weeks, despite being two weeks overdue.
Well......I told him fine, just grant me authorization to get back on a plane to New York. Nonetheless, I won.
However, the nasty condescending attitudes were overwhelming and I lost it....New York style.
I couldn't speak a lick of Italian at the time, and I think I dropped so many F-bombs until someone thought I was French.
Why, because I chose not to breast feed and my daughter needed an eye examination. The pediatrician wasn't available so they discharged me, kept my daughter and wouldn't allow me to see her.
Oh no hell no.......You don't separate a woman from her newborn! Those who breastfed were allowed to visit, and I felt as if I was being punished for making a choice.
I still sort of cringe when I think about how evil I was, but it was necessary.