No matter if it’s your first time, or you’re a seasoned professional, the only things certain about having a baby are – you will have little or no control over how it happens, and it will hurt, probably a lot. So it’s no surprise really that many women feel anxious, even disenfranchised in their medical treatment.
Personally, I have a chequered obstetric history. When it comes up now, I just say I had a “bad birth experience” with my firstborn. It seems impolite to elaborate, I don’t want to share the gory details with men, or scare potential mothers. My baby was healthy and outwardly I seemed fine, so there is and was no evidence that anything went wrong.
It’s taken me five years to process the experience and I’m by no means finished. The emotions I can’t seem to resolve are guilt and embarrassment at my decision. I feel foolish for choosing my OB. He was dismissive and patronising from the very first consult. But I was naïve. I wanted the best for my baby and the best for my body. I had read he was OB to the stars, with ‘the best stitch-work in the business’ – that turned out to be a cruel irony. I didn’t trust my instincts.
I told myself he’d thaw, maybe when I was further along, when my pregnancy became more of a reality. Because although it was my reality and consumed my every thought and feeling, I knew it was merely another routine job in his schedule. Although an OB should treat every woman, every foetus, every birth with the same respect, I speculated he had treated enough women who had lost babies to keep a distance until the pregnancy was deemed more ‘viable’ (that callous medical term). I tried to establish a rapport, asking after his wife, his holidays. I received only perfunctory replies; although he was going to be well acquainted with my vagina, he felt no need to get to know me any better. This was to be nothing but a business transaction for him. Perhaps my vagina was just not famous enough.
Despite the exorbitant fees I was paying, I was always relieved when he was unavailable for my appointment and I saw his midwife instead. Her natural warmth was the antidote to his gruff, impersonal manner. She made me feel like I mattered, like my baby mattered. It was she who diagnosed me with anaemia after I almost passed out in the street. She was the one who noticed I had abdominal muscle separation and sent me for physio treatment.
When I asked questions about pregnancy and delivery my OB all but scoffed in derision. Like many women, I just wanted to establish some sense of control over what was happening to me. My questions were not ill-informed. But even if they were silly or paranoid, what I needed was information, comfort, reassurance. From an OB, what I would consider a ‘duty of care’. Yet somehow, I still trusted t it would ‘be alright on the night’.
The hospital staff let me down too. I was aware that my baby was in a posterior position, with his spine aligned to mine since my final trimester. I had been using all the techniques I could to move him and I was feeling anxious about it, I knew the birth would be far more painful if he hadn’t turned. During labour, every time a midwife checked my cervix I asked if he’d turned. They all remained non-committal. After I’d been in labour for about six hours with little change, they sent me to the labour ward, gave me an epidural and put me on a Syntocinon drip.
The machine that was strapped to my abdomen to monitor the contractions was not working. The new midwife grumbled about it and adjusted it constantly, but did not do anything to report or replace it. When her shift was due to finish she tried to hurry me along with pushing.
When the registrar came in to monitor the changeover she noted the records showed my baby’s heartrate dropping periodically. They argued over this in front of me, with the midwife insisting the results were false due to the faulty machine. I had the distinct impression both were concerned more about how this affected their stats than me or my baby. You can imagine how this might have made me feel in the state I was in.
By the time my OB arrived I was pushing. After a brief greeting he moved in and had a look. He gave me no direction. I remember asking if I should keep pushing. I got no answer. Within a few minutes though, my baby made the decision for him. He got fed up of being stuck in my birth canal and shot out in what is called (delightfully) an “explosive birth”.
Thankfully, in one of the few mercies I was dealt, my epidural held up. I did not feel it and was unaware of the consequences initially. For a few ignorant moments I was allowed to enjoy the fact that I had a healthy baby. As I held him on my chest my OB tried to stitch me up. He made no eye contact as he threw his hands up in exasperation and uttered the words: “I can’t fix this, we’ll have to get a colorectal surgeon in”.
Leaving me in a state of increasing panic he made the arrangements and returned with the surgeon. The surgeon explained in a highly clinical way that (they believed) I had a 4th degree tear, meaning my vagina had torn right through my perineum to my anus. I required emergency surgery. The surgeon advised me quite mildly that he might have to redirect my bowel to a stoma for a period of 5 or 6 weeks while the area healed. My OB stood there mute, offering no words of comfort or reassurance.
The memory of this is burnt in my brain, and yet as I type it sounds ludicrous. Surely no healthcare professional would act like that. Had he taken any time to get to know me in our consults he’d know that I had just nursed my mother through treatment for stage 3 bowel cancer. I had seen a stoma firsthand and, for non-medical folk, it is extremely confronting. To think that I might have to deal with a colostomy bag, to keep a stoma clean and care for it, as well as looking after a newborn was terrifying. I had seen how hard an adjustment this was for my own mother. My life was already changed forever, this was a shattering blow.
The next hour was mentally torturous as I waited for them to prep the theatre. I was supposed to be enjoying my first moments with my son, but I could barely think of him. I was overwhelmed with fear for myself. I did not want to have a stoma.
As it turned out, I didn’t have to. My OB was wrong. I didn’t have a 4th degree tear, rather a 3rd degree tear. That means it was bad, but it didn’t go right through the rectal wall. My bowel didn’t need redirecting so I was stitched up by the colorectal surgeon and sent back to the maternity ward. I had been away from my newborn for about 4 hours.
I was very woozy from the general anaesthetic. I don’t know if this had any impact on my milk coming in, or if the delay in skin-on-skin contact affected my bonding with my baby. Feeding was difficult, and he was a terrible sleeper so I dealt with my physical recovery in a state of stress and sleep-deprivation.
In the weeks and months that followed I felt like a survivor of war. My baby was healthy but he didn’t sleep well and breastfeeding remained difficult. I loved him dearly, but it seemed more of a mental love rather than the deep physical bond people speak of. I knew as a human being that I should and would do anything for him. Emotionally though, apart from feeling sorry for myself, I just felt kind of numb. I have pondered my relationship with my son in light of this a lot over the years.
I cried all the time. I saw a psychologist who cleared me of PND and said I was ‘just tired’. I knew I was suffering from post-traumatic stress disorder, so I saw a counsellor. Her advice was to write it down and then do something like burn it or bury it ceremoniously. I found this idea insulting. As if my problems, my complaints were too troublesome to share. I know she believed it would be cleansing, cathartic for me. I knew it would not.
I briefly considered making a formal complaint against my OB. Then I learnt someone had filed a complaint against him that resulted in no more than a slap on the wrist. Apparently he was ordered to check his bedside manner. Clearly it had no effect and I knew the process would only cause me more grief.
In a subsequent pregnancy, I suffered a miscarriage at 19 weeks. I discovered this at the ultrasound and had to be induced. The OB I had chosen to deliver this baby apparently cried when he was informed. The midwife who helped me through it was also in tears when I eventually got to hold my stillborn baby. These caregivers showed me empathy and compassion. This was obviously a deeply traumatic experience. But while I carry a lot of sadness about this, it is the experience with an uncaring OB that haunts me.
So I have a message for that OB.
You are in a position of great power. You handle women at their most vulnerable, you witness their fear, you see them in great pain, and you are tasked with helping them overcome it. And you failed me. You should know that, and you should not fail others.
If you don’t love what you do, stop doing it. Because the health and wellbeing of mothers and their babies are too fragile and too precious for you to treat like a ticket to your next golf junket.
I may not ever forgive my OB, but I hope I forgive myself one day. And I dream of a future where empathy is a non-negotiable standard for professionals in the health and medical industry.