Why did my midwife DO that??

[onelittlesleep]

I had a pretty good second birth in late December that I am mostly pleased with. It was a waterbirth at a local birth center, and my daughter was born healthy and beautiful. I am recovering pretty well and am proud that I managed another natural birth experience.

But in the very beginning of active labor, my midwife did something that still shocks me and makes me angry! I wish I had refused her, but I was in the middle of trying to integrate some really strong contractions and didn't really have any power left in me to argue very long with her.

(which, to digress, makes me want to advocate for every woman having a low-intervention midwife attend to her in a birth center or at home, because I KNOW that, had I been trying to give birth naturally in a hospital this time around, I wouldn't have been able to say NO to anything they pushed for.)

ANYWAY, my midwife wanted to check me early on between contractions, which I was okay with. I didn't want a lot of checks, but I thought one would be okay. So she checked me.

Then, she said she wanted to check to see if my cervix was stretching WHILE I was having a contraction!!

I said "No no no no no...whhhhy?" and she was very stern and said she needed to know. So I hyperventilated a little and looked at my husband and he didn't know what to do, he'd never heard of that. So she kept arguing/bickering with me that she needed to feel the cervix stretching, so I let her.

SO STUPID.

First, having contractions while I was lying down on her exam table was already excruciating enough. And then she puts her fingers very deep in there and keeps having to put pressure on my cervix so she can feel it. I was moaning in pain and squirming before the contraction started, and she kept saying angrily "I'm not even DOING anything! I've just got my hand there! I'm not even DOING anything!"

Which! Just having someone pressing your cervix while you're in labor HURTS, right??

And then I had the contraction and I swear to god, she FORCED my cervix to stretch! She said she was only feeling, but I could FEEL her moving her fingers! I was only at two centimeters, so she wasn't just pushing back a lip or anything. I yelled in pain and she shushed me. My husband was upset and frozen in shock. And then afterwards, she was all "You did great! Okay, you're stretching fine."

I then went from 2 centimeters to 10 in an hour and a half. Which was so much faster than my first birth, I was a wreck and felt like I couldn't handle it. It was a very violent experience, all together. My first labor was so much slower and the hormones and feelings were so mind-blowing. This labor was just an incredibly jarring experience that hit me and then was suddenly, upsettingly over.

I just wonder...what she did...is it normal? Was it necessary?? Could it have made my labor progress so painfully and rapidly??

[barefootpoetry]

Yikes! I'm so sorry. No, that doesn't sound normal for her to do that at ALL. In fact that sounds like the kind of sadistic crap they do in hospitals!

I hated having internal exams SO MUCH during pregnancy that I practically begged my midwife to not do any during labor. She did do ONE when I started pushing just to make sure I was fully dilated, but that was it!

[jazzybaby9]

I know it's NOT normal for a "low-intervention" midwife (or any respectful birth professional) to try and rush the process, especially in such a harsh way. I am so sorry you experienced that on your labor and birth day...I also think it was very wrong of her to lie to you while she was doing it and not ask your permission first. Shushing you and downplaying her actions is completely inexcusable.


Have you talked with her about your birth experience? IMO, you should tell her how uncomfortable you felt and how her actions affected your entire experience. She should not get away with something like that. Esp if she is most likely doing it to other women, as well. Good luck healing. I know how it can feel...my doctor put her fingers in me when I was pushing and ripped my vagina open, I split completely open...it was very traumatic, still to this day.


s & congratulations, mama.

[yarngoddess]

Wow. I've had 4 births. 3 doc's 1 midwife. All in birth center hospitals. NONE of them EVER did anything you described! I had my doc check me during a contraction, something I was comfortable with- but he did nothing that added to the pain. He also would have NEVER done something, unless absolutly nessicary, that caused me that much discomfort. I would be upset that she was so "dominering" in regards to MAKING you do this- susshing you! and basically saying that you're being a baby because "i'm not doing anything" *insert eye roll* Sounds very violent to me. I'm so sorry.

I hope you take the time to heal from this. Birth Trauma is VERY real. I still have issues with each of my birth's- especially my 3rd. It took me a long time to heal and to accept what happened. By the time I contacted the hospital to discuss what happened they were horrified and the nurse culprit had already been fired (she was on 90 day probation hire period) because of similar things she had done to me. PLEASE talk about this...with the midwife, you DH, friend or counselor.

Congrats on the new baby!

[meganmarie]

My midwife did not do anything like that. I'm sorry you had this experience.

Even if this "check" was somehow medically justified, her attitude towards you - shushing you, ignoring your protests, berating you and invalidating your pain - is absolutely the opposite of what you should expect from a midwife.

I read a really great piece that talks about how even the most caring midwives and HCPs, with the best of intentions, sometimes fail to have basic respect for the patient's autonomy and experience - just being so focused on what they feel needs to happen that they run right over the laboring woman and don't even realize it. This sounds like an extreme example of that.

http://observantmidwife.blogspot.com...bate-blog.html

You could cross-post your question in the birth professionals forum where other midwives may be more qualified to judge whether what happened was in any way connected to evidence-based-care.

[SquishyBuggles]

I've had two hospital births, and neither time did the doctors or nurses do anything remotely like that! That would make me very angry and uncomfortable, too.

[tireesix]

I would complain about her.

[Jane]

I have checked someone during a contraction in order to try to see if they were at a point where they should not go home. Sometimes a woman is at 2 cm, but there is terrific pressure opening her cervix during the contraction. That woman is about to be quite a bit more than 2 cm. When nothing is happening down at the cervix with the contraction, it's a better bet to send her home to sleep and rest in her own environment at 2 cm. It could be days before her labor kicks over.
However, I'd like to think I do it more humanely than that. I ask, truly ask for permission, explaning the above, I'll take no for an answer, and remove my hand entirely when I get the information I want or the mother has any reaction that's more than usual for the contraction, or she says to stop, of course.

Is there a possible reason? Sure? Does that excuse her unhelpful attitude? Nope.

[jennica]

This is called "manually dilating the cervix". It is a skill that mostly midwives, and rarely doctors, use. This is a good skill for a midwife to have, if it is necessary. It can help in an emergent situation, or it can help progress a stalled labor in order to avoid a hospital transfer.

However, it is a medical procedure. As with every procedure, your care provider should give you the risks, benefits, and alternatives to the procedure and allow you weigh your options before refusing or giving your consent. There are risks involved with this procedure, which would include damage to the cervix, or extreme pain. In almost all women this procedure is extremely painful, and women should be warned of this before the procedure is performed. I have heard of other stories where midwives do perform this particular procedure without informed consent, and while a woman is protesting. My own CNM tried performing this procedure as I screamed at her to stop. I'm not sure why certain midwives do not see this as an assault, when it clearly is. Especially when there is no medical indication for such a painful and invasive procedure to be done. I have read that one reason many midwives do this is to speed up a labor for their own convenience, and in the absence of any emergent medical need, that is the only logical conclusion I can ever come to on why this is done. I truly wish the midwives who do this would realize that they are committing a violent assault on women.

To me it sounds as if your midwife coerced you to allow her to do this procedure, and shielded you from what she was doing in attempt to hide that she was in fact performing a procedure on you. When you protested, she did not stop, but continued with the procedure. There is no medical reason that I know of to feel a woman's cervix stretching, unless the provider wants to help it along.

As far as whether or not it was necessary, that depends on what was going on at the time. From your description, it sounds like she was trying to speed up labor. If there was a reason in her mind, such as trying to avoid a transfer, that still doesn't give her a right to do this without your consent.

I think talking to her is a good idea, if that is what you decide, but first you need to process this experience. I'm sorry this happened to you. This shouldn't have happened. Midwives need to learn that this is not okay, and that it is no better then the way women's rights are violated in hospitals.

[Arduinna]

I am so sorry that happened to you. How horrible. She sounds extremely disrespectful. Personally, I'd write her a letter telling her exactly how you feel, and I'd let the word out to everyone I know and every group I'm a part of to save anyone else from ever having to deal with her. I'd report her to her supervisor and file a complaint with the licensing board.

[MamaRabbit]

What state are you in? Is she licensed? You can file a complaint with the licensing board if you feel you need to. Is she a CPM? You can complain to NARM if you need to.

[Cheshire]

If you decide to make a formal complaint and write her a letter be sure and explain that she violated your rights as a patient. I know everyone that's mentioned you should tell her how you "feel" are trying to be helpful but just writing about "feelings" alone will not be a strong enough case to show how unprofessional her actions were.

Write about your feelings - that is so important to process your birth experience. But, if you decide to report her stick to the facts, that you did not give informed consent, that she did not stop, that she "shushed" you and that she then patronized you on how well you'd done after having a procedure performed on you that you did not consent to.

Hugs to you. I'm sorry you had to go through that and congratulations on your beautiful baby. Best wishes on your recovery.

[Romana]

Everything that Jennica said. I am so sorry your midwife did this to you; it was wrong.

[wbg]

Congrats on your baby. I am so sorry your MW took steps that to me sound both unprofessional and unnecessary.

[mwherbs]

I don't like how your midwife spoke to you -I am sorry that it happened the way it did. your story of rapid dilation from 2-10 makes me think that she may have been looking for or breaking up adhesions -- 2 cm isn't active labor --so if she checked you and you were 2cm between contractions but your labor pattern and behavior caused her to think you were in true strong labor I could understand the desire to check you during a contraction- to feel if there is a change/pressure like Apricot said and/or to rule out adhesions ...but I would be saying to a mom what I wanted to know and why -

[jennica]

Originally Posted by mwherbs

I don't like how your midwife spoke to you -I am sorry that it happened the way it did. your story of rapid dilation from 2-10 makes me think that she may have been looking for or breaking up adhesions -- 2 cm isn't active labor --so if she checked you and you were 2cm between contractions but your labor pattern and behavior caused her to think you were in true strong labor I could understand the desire to check you during a contraction- to feel if there is a change/pressure like Apricot said and/or to rule out adhesions ...but I would be saying to a mom what I wanted to know and why -

What exactly are adhesions and where are they? Do they inhibit labor, and how so? What is the technique for breaking them up? What are the risks and what are the benefits? How painful is the procedure? I've never heard of them before. If she was checking for change/pressure then why did the OP feel her pushing her cervix with her fingers? Doesn't that indicate manual dilation? And why would it be desirable to check for change or pressure in this way, when by observation she is seeing a pattern and behavior that would indicate true labor? In other words, why would a midwife disregard the woman's feeling that she is in labor, and her own observations of the woman being in labor, in favor of performing an invasive and painful exam to determine what they both already knew?

[KestrelDream]

Originally Posted by mwherbs

I don't like how your midwife spoke to you -I am sorry that it happened the way it did. your story of rapid dilation from 2-10 makes me think that she may have been looking for or breaking up adhesions -- 2 cm isn't active labor --so if she checked you and you were 2cm between contractions but your labor pattern and behavior caused her to think you were in true strong labor I could understand the desire to check you during a contraction- to feel if there is a change/pressure like Apricot said and/or to rule out adhesions ...but I would be saying to a mom what I wanted to know and why -

I was thinking that possibility too, if you had a stenotic cervix. You can read about it here: http://www.gentlebirth.org/archives/....html#Stenotic

You can develop scarring on your cervix from LEEP procedures, cone biopsies, etc. If the scarring is preventing dilation, it can be broken up.

Regardless...what she did was wrong. I'm so sorry. I had a similar experience with my MW last time, although she wasn't harsh...just persistent about pulling my cervix forward when I was about 6cm dilated. It hurts....a lot.

[TzippityDoulah]

sadly that kinda of cervical check seems to be very normal in my experience in hospitals and with oer zealous midwives. it is WRONG and can be dangerous and dag on hurtful too!

((hugs)) I woud search for a better midwife next time.a midwife should NEVER do something against your will no matter how much she thinks it's important.

[cileag]

I agree with Jackie and mwherbs, checking for the possibility of adhesions (which do sometimes have to manually be 'broken' for labor to continue) and checking for active labor were the two reasons that popped into my head. However, her words and behavior were completely unacceptable and I would first discuss it with her--and then depending on her reaction to that, consider a formal complaint.