17 December, 2008

obstetric rape at Rush

sad story about a woman who suffered needlessly during the birth of her fifth child.

the doctor, who was not her regular OB:

-belittled, intimidated and verbally abused everyone around him: residents, nurses, colleagues on the phone, and the patient and her husband.

-chatted loudly on his cell phone about abortions and a woman who "has no business being pregnant", while in his laboring patient's room! I have heard countless nurses and midwives make unnecessary side chatter during labor, even midwives who claim that they never talk during labor, but this guy wins the insensitivity prize by a mile.

-deliberately withheld pain medication after it had been requested by the patient AND the anesthesiologist had already been called to the floor

-deliberately placed the patient in an uncomfortable position, causing her great pain and stressing a preexisting injury

-performed a rough and painful vaginal exam despite her pleas for him to stop

-artificially ruptured membranes without patient consent, and then lied to the resident that they had ruptured spontaneously

-repeatedly told the patient that she was going to hemorrhage (based on zero evidence) and that she and her baby would die

-inserted a catheter during a contraction, ignoring her requests to wait until it had subsided

-continuously exhorted the patient to "shut up and push" after he determined her cervix to be 8 cm dilated, rather than waiting for it to open completely and a spontaneous pushing urge to develop (I would wager he has rarely, if ever, witnessed a spontaneous pushing urge!)

-nearly dropped the baby

-would not allow the mother or father to hold their healthy baby immediately

-called for a larger-gauge needle than is normally stocked by that hospital's L & D for injecting local anesthesia into her perineum. periurethral repair was performed in a very painful manner. requests for more anesthesia were ignored.

-told a nurse he had denied this patient any analgesia because "sometimes pain is the best teacher."

I am 'trying real hard to be the shepherd', i.e. trying not to proclaim that what this doctor needs is a hefty dose of his own medicine. An eye for an eye makes the whole world blind.

This, folks, is why some women will not set foot in a hospital to give birth. Is anyone listening?!

note: some of these details come from the official complaint filed in Cook County Circuit Court.

15 December, 2008


been up late web-browsing & indulging my X-files-loving aspect, reading all about Nazca Lines, Ica stones, cosmology, mythology, hidden archaeology, and well, this just blew my mind.

12 December, 2008

another chance to ignore the evidence

tonight I wax cynical.

a cautious thumbs up to this bit of research stating it is perfectly normal for the active phase of first-stage labor to "stall". Often the stall is viewed as abnormal, a reason to hasten surgical delivery. I'd prefer the authors use the more positive term "plateau" in lieu of "stall". Semantics aside, defining a "stall" or "plateau" is predicated on the near-universal obstetric assumption that progress=cervical dilation.

there are different ways for this quite normal plateau phenomenon to play out. contractions may continue with full vigor and frequency, or they may space apart somewhat, or they could stop completely. in each of these scenarios, cervical dilation ceases for a while (our wondrous cervices can even reduce in dilation, per the brilliant Ina May Gaskin's Sphincter Law).

what else could be happening during the "stall"?
-baby is rotating into optimal alignment with mother's spine and pelvis
-an asynclitic (cocked to one side) head is centering
-the uterus is gathering its strength for the work ahead
-the baby is descending
-adrenaline and oxytocin are waging an inner battle for dominance
-the woman is craving/receiving some much-needed nutrition & hydration
-the woman and her partner, or mother, or sister are working through some emotional blockages

The study authors exclaim: "we found that just by being patient, one-third of...women could have avoided the more dangerous and costly surgical approach." So perhaps Friedman's curve mandating 1 cm dilation per hour can now be cast aside as a terribly outmoded and ridiculously machinistic view of human physiology. Perhaps.

But change is slow. practitioners often stick with the first approach they learned (old dogs/new tricks & all). being patient works fine in a low-volume setting where the staff and beds are plentiful. yes, surgical birth is costly--costly to women's postpartum quality-of-life and future obstetric choices. costly to insurance companies. but it sure is one heckuva money maker for hospitals and doctors.

Even if practitioners and hospitals consider change, what of the birthing women who hear story after story of disempowered birth, who do not trust the process, do not trust their bodies, who were brought forth from their own mothers by unnatural means and have no cellular memory of normal birth? What of these modern birthing women who are inculcated in a culture of birth fear? how to rouse our sisters' somnolent warriors?

I'd like to think the admonition to "be patient" could resonate within the heart of every compassionate birth attendant. I'd like to see a reversal of the alarming upswing of unnecessary cesarean births. Just not sure this particular drop in the bucket will quench my thirst.


07 December, 2008

informative health journal?

while browsing through a pregnancy magazine for "older moms" at ye olde corporate booke store, wondering if they might be interested in some holistic-minded articles, I flipped back to the index:

M, m, m, let's see....magnesium sulfate, massage, mastitis, meconium, medications, membranes, methergine, milia, milk, miscarriage, molding, morning sickness.

midwife, where is midwife?
not one entry for midwife in the entire publication??!!

calm, mocking voice in my head, responding to my Id's outrage: "put the magazine down, back away slowly..."

02 December, 2008

creativity at altitude

when you are flying with a 4-year-old and you have read every book and magazine at your disposal, barf bags and pens make awesome hand puppets.