can we talk about feedback/complaints on birth care? - Mothering Forums

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Old 08-27-2010, 02:10 AM - Thread Starter
 
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Lots of birth stories come my way. Right now, I'm thinking of the less-than-happy ones; whenever someone complains about their provider (or nurse or apprentice), I generally ask if the storyteller ever considered talking to the dr or mw (or nurse or...)--sending a letter, making a call, even going to whatever agency 'above' the dr or mw may apply-- making concerns known. And most often, people are reluctant to do this. Well, most loathe confrontation...or at least, they do if they feel it will go nowhere, only make them feel worse. This is understandable, of course.

I should add that a few have said they *did* try to complain, to no avail--the mw didn't respond, or tried to turn the complaint around on them. Medical complaints got lost in red-tape-land...and came to naught. In a very few cases, issues raised with 'overseeing agencies' among hb mws or med workers only resulted in bureaucratic stonewalling-- "thanks we have it in hand now, don't worry your pretty little head over it" Which kind of makes the above point (feeling confrontation will go nowhere) a bit more sharp.

Still, seems to me that things won't change that might need to change, if people don't speak up. If many people have the same complaints about a doc, nurse, mw, but only 1 or a few actually complain to the provider or overseeing agency, then making change is less likely. On the other hand, if 9 out of 10 people with same complaint DID speak up, it seems to me that change would have to come about one way or another.

Anyone care to speak to this? Any experiences with attempting to raise concerns...or just the experience of having a complaint about a birth professional that you felt you could not air toward a positive change? Or even 'should not air', lest you become the target of negative peer pressure? Not so much looking for the particulars (unless you feel like saying it), more hoping to hear your feelings/views on the general topic. Help me understand...and maybe come up with some ideas to 'break the silence'. Y'know...the worst of things thrive in silence, silence is the best ally of poor care. Me, I like to make some noise now and then

Responses here or via pm will be very welcome.

Thanks!
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Old 08-28-2010, 09:04 AM - Thread Starter
 
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Anyone?

I know that for many, including myself, just talking/venting about a problem is enough...enough to help me gain release from difficult emotions, to gain perspectives and insight, to feel supported...to heal, if there is any sense of injury, whether physical or emotional, large or small. Even I, who do like to make some noise , don't always make official complaints. Having done so, I know it can be tough to get results...and it only makes sense that people will naturally gravitate toward what feels good to themselves--and making complaints to providers or their overseeing agencies might not fall into that category!

So--no judgements here. Just hoping to hear from ppl who have had difficulties around birth care, anywhere, and your perspectives on seeking to make changes through complaints.

thanks!
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Old 08-28-2010, 10:57 PM
 
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I worked at the hospital where I had some huge problems including a major medical mistake that left my ds with neuro and digestive delays. Tattling or raising a fuss would have left me (a single mom with zero money who luckily had a job) homeless and unemployed with no chance at another healthcare job.

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Old 08-28-2010, 11:34 PM - Thread Starter
 
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That definitely qualifies as a good reason not to complain, kittywitty. Wow. That just so sucks!
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Old 08-29-2010, 01:03 PM
 
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I had a fairly horrible experience with my first, and I did complain and yell and cry (I had been in labor for almost 48 hours at that point) at the doctors involved at the time, while I was being treated that way. But they of course dismissed my concerns. I seriously considered filing a complaint. I certainly had cause as there was misuse of medication involved and some safety concerns could have been easily stirred up, I think, if I had been persuasive and persistent.

Ultimately it was my mother who railed against me taking any action against the hospital, even writing a letter. I was a new overwhelmed mom, and my mother had offered her help during the first couple of weeks and withdrew it because I had dared to call what happened to me in the hospital abuse. It was abuse. People charged with my care threatened, bullied, yelled, denied me basic necessities, administered dangerous drugs without my consent, and almost killed my baby. What would you call it? But my mother was convinced I was overreacting and needed to handle things better, so she decided not to be there for me and then wallpapered it with a bunch of excuses. I still felt I needed her in my life at that time, so I left it alone. What was done was done. And I think she may have been so opposed in part because my aunt worked in that hospital - in a totally different department - and was concerned for her job. I wish she had just said that. I would have understood and it would have caused less turmoil in our relationship.

I wish I had filed a complaint. Ignoring my needs didn't help or save my relationship with my mother. And for my second I just stayed away from there. I don't plan on repeating the first experience just so I can have another opportunity to complain. It's been seven years, so raising concerns now would probably be pointless.
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Old 08-29-2010, 01:30 PM - Thread Starter
 
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Thanks for sharing this...I can see that so many things can influence a decision of making a complaint, or not! I can see how, having experienced something so psychologically awful AND physically threatening to health, that someone would not have much heart for complaining. Particularly if the people we need for support in the aftermath have their own strong feelings against your complaining. We really do owe it to ourselves to look after our own healing, first, in whatever ways we can. The importance of making complaints surely pales by comparison to more immediate, pressing needs.

I said earlier that I like to make noise...and I do! But it's also true that having tried one way and another to make change by making noise, as the years pass I am less likely to make noise and more likely to look to my own needs, peace of mind, moving on. The results of my own efforts, and hearing stories like yours, make it seem like far too much trouble, more trouble than it's worth! I have helped some changes occur, by complaining and otherwise pro-actively pursuing changes...so I still believe in the power of speaking out, generally. And I'm more circumspect about all that now--most of the time.

Anyone out there have a homebirth experience which left them unhappy in some way? I hear almost as many hb stories where complaints are indicated--whether small issues or far worse....from people all over, now that I participate in this international forum Maybe I should say--even if so far you've been happy enough with your hb care, do you have any thoughts on what you might do/say, if you ever did have an unhappy experience that was specifically related to your care? Have you known others who had difficult experiences and complaints about their mws?

It seems to me that in dealing with large institutions like med care, one is more likely to have a harder time getting satisfaction...that really, most people are dissuaded from making complaints in the first place, because that institution is so imposing, intimidating, complicated. Heck, the reason so many docs get away with this crap is BECAUSE most people view them as intimidating in the first place. So I'm not surprised by the things that kittywitty and Qalliope say (tho both stories make me and )...I wonder if it's any easier for homebirth families, though--as I might be inclined to believe. Partly because I'm a hb fan, with a certain amt of prejudice, of course! But also because we are not talking about having to deal with a large, scary, entrenched institution....maybe a bit of a more personal, friendlier set of circumstances?

Anyone?
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Old 08-29-2010, 02:27 PM
 
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Hi! I am moving this to the Healing Birth Trauma forum. This does not seem to be a FYT topic.

Please read the Healing Birth Trauma forum guidelines before posting.



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Old 08-29-2010, 02:51 PM
 
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I did complain to the head of the NICU, nursing supervisor and wrote a long letter to the president of the hospital, copying to all involved. I did get results and it was very satisfying and healing.
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Old 08-30-2010, 10:52 AM - Thread Starter
 
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Thanks so much for telling us about that, homewithtwinsmama! It's inspiring to know that your efforts did make a difference.

I know a mom of triplets who also made some noise about NICU care--while in the middle of that care w/her triplets--and she also made a lasting impression. In her case, it was about keeping her head in spite of the bullying awful chief of neonatology, and insisting on evidence based care, bringing such things as more time holding babies to her breast to bottlefeed them (necessary while they developed strength to suck), and other kangaroo-care-type things. She told me recently (her triplets are now 8) that she regrets having never filed a complaint against the doc--but to me it hardly matters since she DID make a diff at that hospital with her pro-active approach. Yeah, I could wish he would be taken in hand--I had a few words with him myself...on my part, asking him nicely about a couple things (I was my friend's doula/advocate), on his part--supremely nasty and arrogant.

He said, literally--"the only thing mom needs to do is follow everything I say, to the letter!" Very ugly--and an attitude really not called for in the face of my friendly and level questions to him. I just nodded, trying to suppress both my ire AND my giggle, thinking only, 'well sir, have you *met* my friend? Not the sort to just do as anyone says! Not to mention that that is probably the LAST thing I would ever say to a family...'

Anyway, thanks for sharing that story--it really is inspiring to me.
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Old 08-31-2010, 10:48 PM
 
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ugh, when I first started therapy the therapist suggested I go talk to the mw about what had happened. And I'm sitting there sobbing in her office and she really didn't seem to care. At least not to have anything to do with her. She did recommend my current therapist who is loads better. That doesn't really convey what I was getting at, I really feel like I got written off as a ppd nutcase rather than having a real problem.

I never really considered talking to the OB, because by the time it was really getting to me I never even considered that he'd remember me at all. Well I didn't really expect the mw to either, but I also didn't have the whole "I trusted you and you screwed me over" thing with him, since I'd y'know never seen him before.

So I'm not really sure if that answered your question or not, but there it is.
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Old 09-02-2010, 10:42 AM - Thread Starter
 
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ugh, when I first started therapy the therapist suggested I go talk to the mw about what had happened. And I'm sitting there sobbing in her office and she really didn't seem to care. At least not to have anything to do with her. She did recommend my current therapist who is loads better. That doesn't really convey what I was getting at, I really feel like I got written off as a ppd nutcase rather than having a real problem.

I never really considered talking to the OB, because by the time it was really getting to me I never even considered that he'd remember me at all. Well I didn't really expect the mw to either, but I also didn't have the whole "I trusted you and you screwed me over" thing with him, since I'd y'know never seen him before.

So I'm not really sure if that answered your question or not, but there it is.
Thanks for responding. The part I bolded in your comment is a little confusing to me. Do you mean you were sitting in the midwife's office, and she was the one who didn't seem to care?

If so, this is sad! But I've heard and seen it before...heard from families who did not get through to the mw because she refused to take any responsibility, could not 'care' enough to consider complaints in light of what happened and how she might have contributed to distress of any sort. It's true enough in a situation where an OB is called in, that a mw may have very little control over what happens then (or NONE). Still, it seems to mean so much to us when people will hear us out, accept that they did have *some* part in things.

I also 'saw' this attitude in a mw who told me her story of a hb transfer for an emergency....not only did she not accompany transfer when she might well have prevented a very tragic outcome by doing so, also when she told me the story she clearly blamed the family for not following her instructions, and the hospital staff as well for *their* mistakes....mistakes they would have been hard put to make, if the mw had accompanied transfer and made the situation clear upon arrival. Her lack of any sense of responsibility or remorse was truly awful to behold..it made me feel shame for my profession. So--I do know that careproviders can sometimes be far too afraid of facing accountability; it is far easier to blame others, sidestepping any weight of the outcomes for families and just dismissing the complainer as in your case--by seeing you as a 'ppd nutcase'.

I'm so sorry you had to deal with that! But I'm glad you were able to get good help in healing from trauma later. I hear you about not having had the same expectations of the OB involved in your birth--that really can make all the difference in a person's perceptions of responsibility. Still--sometimes one's original care provider can be doing all they really can, and it is the OB called in at the last minute who does the damage. Yet if your mw believed this was the case, then it sure seems to me she might have given you a better response--and solid support in directing your grievance appropriately.
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Old 09-02-2010, 02:15 PM
 
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I did confront my MW about my birth (day 3 pp, talk about emotional!). She was very kind and open to the process, and apoligized for not being more supportive during the labor and for causing me pain when trying to remove the placenta. It also was nice to have her walk me through the labor, so that my pain muddled recollections could me matched up with her more percise chart notes.

However, she was a little defensive in stating that she did what needed doing to make me stable for hospital transport, and she didn't feel that she did anything wrong when she pulled on the cord, even though I suspect that it contributed to the PPH I experienced. As my husband said, some things I had issues with (like not feeling emotionally supported during the labor, and some things she said at the time) are more a faucet of her personality than something she can change, and therefore while I can let her know how I felt, it is unfair to expect her to be something she is not.

Overall, however, it was very healing to me to talk to the MW, get her "side" of my birth story, and let her know the issues I had with my labor, delivery, and PP care. I think it also helped me see my MW as a human being who is also struggling to deal with a tramatic situation. In some ways, I think she is even struggling more since she feels responsible for what happened. That made me feel better since it let me know that she does care about what happened to me.

It was very difficult to confront her, and I can see how some people would just let it all be water under the bridge. But I am less mad now, and more just sad that I didn't have the birth experience I desired. In the end, we did both turn out alright, and so I have come to grips with the fact that my MW did her very best, and I did my very best, and there is nothing more to be done but try to heal and deal with the emotions surrounding it.

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Old 09-02-2010, 03:20 PM
 
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With our NICU stay recently, I was treated poorly enough by the staff to develop at least borderline acute PTSD. My husband called to complain, and when I was feeling stronger I called to discuss things with the hospital administrator.

I don't think that the doctor who yelled at me for questioning his overtreatment of our daughter is facing any formal actions against him, but he evidently got put under enough pressure by the administrator to lie about having apologized to me for towering over me yelling while I sat and held a crying infant because I asked for an infectious disease consult. We were treated for presumed sepsis for 10 days in spite of negative cultures, negative x-rays, and no symptoms whatosever past her 2nd day in the NICU. They completely blew the diagnostics on her. They saw a 9 lbs 12 oz baby and thought "macrosomic" when she was extremely swollen with excess fluids. They couldn't differentiate between a healthy and an unhealthy high weight, and ignored the radiologist reports documenting fluid overload severe enough to spill over into my daughter's lungs.

But I was not going to win with the administrators on the medical issues, so I workd on stuff where I could win: on the "this is not how you treat parents of infants in NICU" front. And, as the hospital is going through a renovation, I suggested (and they are considering) creating a rooming in step down unit for families where the baby needs to be in the hospital but is stable enough to be with parents the whole time. I am going to follow up to see if they are going to create that sub-unit, because there is no reason why NICU has to be that bad for people who need to be there.

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Old 09-02-2010, 08:08 PM
 
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It was the MW's office, yeah.

The whole thing is kinda complicated, because from the outside it wasn't *that* bad (transfer for vacuum which came with a bonus epis w/o consent or notice or anything) and a lot of the actual trauma was (I think, still working on this part) the feeling of abandonment by the MW and my DH. So the problem isn't straightforward and I certainly wasn't explaining very well. But the whole experience was totally invalidating.
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Old 09-02-2010, 10:59 PM - Thread Starter
 
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I did confront my MW about my birth (day 3 pp, talk about emotional!). She was very kind and open to the process, and apoligized for not being more supportive during the labor and for causing me pain when trying to remove the placenta. It also was nice to have her walk me through the labor, so that my pain muddled recollections could me matched up with her more percise chart notes.

However, she was a little defensive in stating that she did what needed doing to make me stable for hospital transport, and she didn't feel that she did anything wrong when she pulled on the cord, even though I suspect that it contributed to the PPH I experienced. As my husband said, some things I had issues with (like not feeling emotionally supported during the labor, and some things she said at the time) are more a faucet of her personality than something she can change, and therefore while I can let her know how I felt, it is unfair to expect her to be something she is not.

Overall, however, it was very healing to me to talk to the MW, get her "side" of my birth story, and let her know the issues I had with my labor, delivery, and PP care. I think it also helped me see my MW as a human being who is also struggling to deal with a tramatic situation. In some ways, I think she is even struggling more since she feels responsible for what happened. That made me feel better since it let me know that she does care about what happened to me.

It was very difficult to confront her, and I can see how some people would just let it all be water under the bridge. But I am less mad now, and more just sad that I didn't have the birth experience I desired. In the end, we did both turn out alright, and so I have come to grips with the fact that my MW did her very best, and I did my very best, and there is nothing more to be done but try to heal and deal with the emotions surrounding it.
Thanks so much for sharing all this--I've followed your story somewhat, and I'm really glad to hear all this. And you are right--it is not always 'someone's fault', but it is always 'what happened' and what we have to deal with/heal from. I think it's really lovely that she did sit with you and hear you, also helped you remember more about your birth--shared herself with you in your need. That by itself is healing to some degree! And it can be so hard, I know, to review a difficult birth--mws ARE only human, and for most our hearts are so engaged, we do our best but do not succeed every time in helping someone have a 'just right' birth (whether mistakes or simply circumstances are in play). Sounds like your 'complaint story' is a success story in important ways, and I'm glad to know it.
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Old 09-03-2010, 05:28 AM
 
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well, i'll try to make this quick but hopefully it'll help...my dd is 6 months old..I have a midwife eval I still cannot fill out. Part of it has been that the birth is still too "close" and my emotions are scrambled, I want to be able to give constructive criticism, not emotional mixed messages. I have been dealing with many symptoms of PTSD so "bringing up" the birth, esp in a context that makes me feel so vulnerable can be traumatic in itself. so that's one aspect.
second aspect...you tend build a trust with your careproviders, esp for me my midwives for 9 months or so before the birth and I was very happy with most of my prenatal care...it's still hard for me to even know how to acknowledge my incredibly mixed feelings, and the fact that someone I trusted to be there with certain va;lues they had demonstrated, answering questions about certain situations in a certain way then becoming like a different person during labour...it's painful to see that total betrayal of trust, I don't even know how to think of it.
third aspect, no support from most friends/community...because this practice is new and previously friends had to travel for midwives, and because many are friends or previously knew them, the attitude is "well, at least we have midwives!" and "it's so hard for them!" and the idea of the care being so fragile and 2nd rate care being better than no choice,that I should take the fall for my friends because they had uncomplicated births in which the mw did fine...I am very careful/diplomatic but I can't say anything remotely non positive without people literally cutting me off. midwives are like gods to them. even my doula was a friend, etc. I won't say more to protect privacy but there is a LOT more that complicates it in a small community...it's not just confrontation but ostrasization (is that a word) from my entire community that scares me.Anyone else (only 1 or 2) who had traumatic births I know here had doctors. People would be all over it if I wanted to share feedback on/with/to an ob.

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Old 09-03-2010, 09:41 AM - Thread Starter
 
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With our NICU stay recently, I was treated poorly enough by the staff to develop at least borderline acute PTSD. My husband called to complain, and when I was feeling stronger I called to discuss things with the hospital administrator.

I don't think that the doctor who yelled at me for questioning his overtreatment of our daughter is facing any formal actions against him, but he evidently got put under enough pressure by the administrator to lie about having apologized to me for towering over me yelling while I sat and held a crying infant because I asked for an infectious disease consult. We were treated for presumed sepsis for 10 days in spite of negative cultures, negative x-rays, and no symptoms whatosever past her 2nd day in the NICU. They completely blew the diagnostics on her. They saw a 9 lbs 12 oz baby and thought "macrosomic" when she was extremely swollen with excess fluids. They couldn't differentiate between a healthy and an unhealthy high weight, and ignored the radiologist reports documenting fluid overload severe enough to spill over into my daughter's lungs.

But I was not going to win with the administrators on the medical issues, so I workd on stuff where I could win: on the "this is not how you treat parents of infants in NICU" front. And, as the hospital is going through a renovation, I suggested (and they are considering) creating a rooming in step down unit for families where the baby needs to be in the hospital but is stable enough to be with parents the whole time. I am going to follow up to see if they are going to create that sub-unit, because there is no reason why NICU has to be that bad for people who need to be there.
I appreciate hearing all these details...I remember your mentioning something briefly in another thread a little while back. You demonstrate that while complaining about the negatives may or may not have much impact, a person can prompt needed changes through a positive, pro-active approach. And that can be just as healing, if not moreso for some, than focussing exclusively on the issues of poor care. Well--women *should* have a safe, open-eared place to vent feelings and let care providers and admin know how their care went for them--and I do believe there is great value in discussing the 'negatives'. Just saying--as far as helping change occur, making positive suggestions is also important.

I hope the NICU step-down space does go through--that would be great.
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Old 09-03-2010, 09:57 AM - Thread Starter
 
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well, i'll try to make this quick but hopefully it'll help...my dd is 6 months old..I have a midwife eval I still cannot fill out. Part of it has been that the birth is still too "close" and my emotions are scrambled, I want to be able to give constructive criticism, not emotional mixed messages. I have been dealing with many symptoms of PTSD so "bringing up" the birth, esp in a context that makes me feel so vulnerable can be traumatic in itself. so that's one aspect.
second aspect...you tend build a trust with your careproviders, esp for me my midwives for 9 months or so before the birth and I was very happy with most of my prenatal care...it's still hard for me to even know how to acknowledge my incredibly mixed feelings, and the fact that someone I trusted to be there with certain va;lues they had demonstrated, answering questions about certain situations in a certain way then becoming like a different person during labour...it's painful to see that total betrayal of trust, I don't even know how to think of it.
third aspect, no support from most friends/community...because this practice is new and previously friends had to travel for midwives, and because many are friends or previously knew them, the attitude is "well, at least we have midwives!" and "it's so hard for them!" and the idea of the care being so fragile and 2nd rate care being better than no choice,that I should take the fall for my friends because they had uncomplicated births in which the mw did fine...I am very careful/diplomatic but I can't say anything remotely non positive without people literally cutting me off. midwives are like gods to them. even my doula was a friend, etc. I won't say more to protect privacy but there is a LOT more that complicates it in a small community...it's not just confrontation but ostrasization (is that a word) from my entire community that scares me.Anyone else (only 1 or 2) who had traumatic births I know here had doctors. People would be all over it if I wanted to share feedback on/with/to an ob.
I hear you on every word of this, doulawoman! Every word...and they all demonstrate how hard it can be to approach issues with hb care. I have seen this stuff myself, from the standpoint of a professional seeking to promote '1st rate care'--due to stories I've heard from families about that '2nd rate care' and their difficulties in effectively making complaints. And I've seen that while there are generally some people who agree that it is best to confront the issues (and the mws) in some way--with respect and courtesy if possible toward improved care--the majority of families and mws do seem to believe that any addressing of these issues/mws is essentially 'disloyal to midwifery'. And yes--have seen how so many fams see their mws as Saints/gods incapable of any bad thing no matter what the evidence--and how some mws like that status so very much that not only will they avoid hearing any complaints about their own care, they also will not help anyone address issues with another mw's care.

Yeah--the very same people (mws and fams both) who would be *all over* an OB for any perceived issues. When I point this out, the 'party line' seems to be that OBs are a highly supported, wealthy group with all the advantages--but we poor mws/homebirthers are an oppressed group that does better to maintain that strict loyalty/secrecy rather than make any problems for ourselves. And I can't even dismiss this attitude entirely--there is truth to the idea that we are oppressed, and need to be careful not to give 'THEM' (mainstream maternity care/politics) any ammo against us. Still--surely there has got to be a middle ground!

I hope you will find a way to fill out that evaluation of services--and forward it both to your mw and to any state midwifery org that may exist. I hear that this is difficult for you--and I really do know why--so of course I understand that you need to approach this (or not) in your own way and time. I wonder--might you get some help in doing this? However difficult it may be in terms of your strong feelings, I can't help but think it could be part of your healing to take this step...that is up to you entirely, of course--and there is no hurry about it.

Anyway, know that I do hear you, every word, and have shared your exact concerns from a professional's point of view. I much appreciate your taking the time to speak of this, and I send you good vibes for continued healing and finding a way to do/say whatever you most need to, on that healing path.
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Old 09-03-2010, 05:00 PM
 
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My first homebirth was wonderful. Pregnant the next time around, I continued care with the same midwife. I found my prenatal experience to be totally different. The midwife was going through a lot in her personal life, and our prenatal appointments were filled with her talking about her personal issues. We hardly discussed my pregnancy. I started feeling angry that I was paying her and not getting a service. Instead, I was the one giving a service....I spent our hour long appointments feeling like her therapist.

I was unsure how to handle the situation. I felt like I had a connection with her from my previous birth, plus we had also kept in touch afterwards and went to lunch a couple times, so I considered us casual friends. I would try to turn the convo at prenatals back to my prenatal care, but she'd go right back to her issues. I didn't want to hurt her feelings by leaving her practice so I hung in there. Eventually, I transferred to OB care due to some complications I was having, and I actually felt a sense of relief at having a good excuse for leaving her care. I realize now I was more concerned about hurting her feelings then I was about not getting the professional service I paid for. I put her over me. I think I've learned from that experience.

Christa
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Old 09-03-2010, 05:51 PM
 
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I felt like my midwife really dropped the ball with helping establish breastfeeding, and then did not properly manage what ended up being a critical level of jaundice.

I was a first-time mom, and I had the added pressure of my own mother who behaved very badly the day after the birth, part of it having to do with the breastfeeding. My midwife kept assuring me that breastfeeding was going fine, but I kept feeling like my baby was getting nothing. I was new and didn't know anything. My midwife even at some point, in response to my concerns, picked up my baby and said "does this look like a hungry baby to you?" My baby was fast asleep, we couldn't really wake her up. I really feel that my midwife should have known that a "sleepy baby" was a huge red flag. She never asked me how many diapers we were going through, or if there were any bowel movements. She seemed absolutely intent on everything being "just fiiiiiine."

I was so unsure, and I had my mother's huge pressure on me as well (to start formula feeding), and I just didn't know what to do. Finally the midwife dialed the number of a lactation consultant and handed me the phone (minor point, but I think it would have been a lot more professional if she had made the call herself, at least initially). The LC saved us, literally. My baby was so sick. We went straight to the ER. I kick myself to this day that I kept looking to my midwife for help rather than just taking matters in my own hands (but again, I didn't know what to do... I had never even heard of an LC at that point - and didn't trust doctors at all, knew they would just tell me I did everything wrong).

My LC was absolutely terrific in every way, and at some point she called my midwife to update her on the situation. The LC told me that the midwife was extremely defensive. Knowing the LC's personality, I doubt she was aggressive or hostile. And she didn't have an anti-homebirth agenda to turn me against the MW, in fact the LC was a huge defender of ours with the medical staff at the hospital (reminding everyone that homebirth does not cause jaundice, for example).

Anyway, did I talk to the MW about my feelings? No, I did not.

1) I felt raw and like I had no perspective. It took me so long to process it all. Years. I wasn't ready.

2) I felt protective of my midwife in a way - partly altruistic (for her, I still like her as a person), partly selfish (to defend my choice to homebirth and to hire her). So everyone is telling me (directly or, more often, indirectly) that I made a mistake, so I was defensive of it and kind of wanted to pretend it was all perfect. And I didn't want to cause trouble for my midwife, a lay midwife who works for women at great risk to herself (she's not illegal but if anyone wanted to make trouble, she'd be an easy target).

3) I didn't see how it would help. What would I say? "You apparently are incompetent and inexperienced. How could you not know?" Furthermore, I didn't want her to be so defensive about it that she would maybe make the same mistake again just out of pride. I hope she learned something from the experience without me having to draw her a picture.

4) And, yeah, I was a chicken on confronting at that time. Now that I'm a mama bear, I could and probably would have a talk.

She came for my 6 week PP visit, as she was obligated to, and we just chatted and made small talk and she left. No exam, no follow-up questions, nothing. Basically just fulfilled her obligation. I was fine with that. We probably both thought about just cancelling the appointment. I've never talked to her again.

Homeschooling mama to 6 year old DD.

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Old 09-03-2010, 06:43 PM - Thread Starter
 
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Originally Posted by rnchrista View Post
My first homebirth was wonderful. Pregnant the next time around, I continued care with the same midwife. I found my prenatal experience to be totally different. The midwife was going through a lot in her personal life, and our prenatal appointments were filled with her talking about her personal issues. We hardly discussed my pregnancy. I started feeling angry that I was paying her and not getting a service. Instead, I was the one giving a service....I spent our hour long appointments feeling like her therapist.

I was unsure how to handle the situation. I felt like I had a connection with her from my previous birth, plus we had also kept in touch afterwards and went to lunch a couple times, so I considered us casual friends. I would try to turn the convo at prenatals back to my prenatal care, but she'd go right back to her issues. I didn't want to hurt her feelings by leaving her practice so I hung in there. Eventually, I transferred to OB care due to some complications I was having, and I actually felt a sense of relief at having a good excuse for leaving her care. I realize now I was more concerned about hurting her feelings then I was about not getting the professional service I paid for. I put her over me. I think I've learned from that experience.
Oh dear...I've seen how this can be a problem in homebirth--have heard some families and mws both talk about this. Families complaining about a mw doing this, mws complaining that their clients 'don't want to be there for me, though I give so much'...oy. And I've seen myself do the same at times, catching myself going on about me if I'm under stress. At least, if it has something to do with the world of midwifery. No one has complained--and have hired me again. For me, it's been something I would catch myself doing and stop, turning back to mama's care with 'nuff about me, sorry!' I think since the topic was the midwifery world, it was more ok than if I'd just been talking about messy divorce or something...they are generally interested in the world of midwifery and know that it can be stressful at times (legal, medical, or community issues that can arise; mws are few, and fams want to help keep it available however they can). But while I've been grateful for my clients' indulgence, I know it's still not ok and have worked to eliminate it. Your comments were a good kick in the patootie for me!

So--'nuff about me! I don't know how far back your experience was, but this is valuable feedback to give if you have any inclination. Homebirth care does tend to be more intimate/personal, and lends itself more readily to such boundary issues. I see it as a new territory we are all still learning. And honestly, the busier a mw is, the less likely she has time for personal support and fun--the more likely she will be to use her clients for those purposes...her need is there, it spills over...not so good for families, as you so clearly say.
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Old 09-03-2010, 07:06 PM - Thread Starter
 
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I felt like my midwife really dropped the ball with helping establish breastfeeding, and then did not properly manage what ended up being a critical level of jaundice.

I was a first-time mom, and I had the added pressure of my own mother who behaved very badly the day after the birth, part of it having to do with the breastfeeding. My midwife kept assuring me that breastfeeding was going fine, but I kept feeling like my baby was getting nothing. I was new and didn't know anything. My midwife even at some point, in response to my concerns, picked up my baby and said "does this look like a hungry baby to you?" My baby was fast asleep, we couldn't really wake her up. I really feel that my midwife should have known that a "sleepy baby" was a huge red flag. She never asked me how many diapers we were going through, or if there were any bowel movements. She seemed absolutely intent on everything being "just fiiiiiine."
Oh goodness--that must have been so rough for you all! I'm so glad you got good help. This leaves me almost speechless...all I can say is that your story makes me glad that I always tell families in any situation of worry/doubt that does not too easily resolve--"I'm not seeing a problem, but your sense of the situation is very important--and I really don't know everything. Let's look for some help to clarify this". Stories like yours only confirm my feeling about how important that is.

All of you help me see how sensitive a topic this is--how hard it can be for quite awhile following birth, to consider making a complaint. You also help me see how very important it is for me as a birth professional to work to keep lines of comm open, and to be sensitive to families' feelings/needs even if they're not talking freely. But then, I'm a communicator and a 'relationship person'--midwifery is all about the relationships going on (all the relationships, including mine w/family). I see that not every mw is--at least not in the same way.

A big reason I started this thread was in response to dynamics in my own backyard where client complaints seem to get so easily dismissed by all concerned. Dismissed (or completely shut down) by one's own mw, by other mws, by the organizations (in an unregulated state), and even by other families. Its practically a superstition, magical thinking (not in the good way)--"you might bring your bad birth juju to me, if I listen to your sad story or grant any reality to your complaint". I'm the naughty 'disloyal' one who is not properly protective --not even of myself, apparently, because I insist, against all 'better advice' that I just shouldn't be so upfront with people about my skills *along with* my limitations...and various other things I won't enumerate here. Partly I've wanted to just talk about it--but also to see if I could begin to see ways to help change this for the better.

So thanks all, and keep talking to me
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Old 09-03-2010, 08:33 PM
 
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I saw an OB in the beginning of my pregnancy. My very first doctor's visit was a DISASTER! From their inability to find an ultrasound machine that worked (going in and out of my room with different ones while I was in a gown, leaving the door open, etc)...to the doctor bringing a standby as well as a student in without asking permission, so all of them plus my husband crowded at the foot of my bed as they are about to do a vaginal exam (I asked the student to leave.)...to the doctor making the most insensitive comment I've ever heard: when I asked him what I could do to prevent a second miscarriage, he said "Oh, you probably had the first miscarriage because of a birth defect or something. You should be glad! You wouldn't have wanted a baby with a problem." I wrote a letter of complaint. This was a military hospital, and I was contacted personally by a high up, important military officer with a personal apology. At the same hospital a few weeks later, that doctor walked by me in the hall and refused to even look me in the eye.

My birth was okay--I had transferred to a midwife. It was the best I was going to get in the area, as that midwife practice was the one and only non-hospital care available to me within a 60-70 mile radius. However, there were tons of vaginal exams, which I *knew* by that time, after all my research in pregnancy, were pointless...they gauged my progress too much by those exams. My midwife, who has a matter of fact & blunt personality, made some not-so-supportive comments to me throughout my labor. I was on my back when I started pushing, and nobody suggested a different position (not my doula, the midwife, the student midwife, the midwife's assistant, or my husband for that matter!) and although I wanted to move, I couldn't find the words or the strength to do it myself. When I was pushing, my midwife's hands were IN my vagina the entire time, and she kept pulling and stretching me, and grabbing at the baby's head...it was SO uncomfortable. They didn't respect my wishes to wait a long time to cut the cord, and rushed me out of the tub less than 2 minutes after she was out (I have it all on video so have the exact times). They also rushed me home from the birth center (it had been my last minute decision to use their center vs a homebirth because I wanted to use their jacuzzi tub) by saying, "You wanted a home birth any way, so do you want to go ahead and go home now?" just 2 hours after she was born, instead of the standard 4 hours. I felt weak & tired & didn't want to move, but felt I'd already inconvenienced them enough by asking to use the birth center last minute. I didn't feel very supported in my extreme post partum pain, or in breastfeeding.

I never complained to my midwife...not a word. At first I was on a birth high and pushed away my negative thoughts about the birth and told myself I was being too critical. Over time I've come to terms with my own emotions, and 15 months later, still having pain from my labial tear that may have been prevented had my midwife not had her hands in my vagina my entire birth, I feel anger without guilt for that anger. I don't think she even remembers me at this point, so I'm not sure what good it would do now.

Next time, I will be choosing a VERY hands off midwife. I almost want to do a UC, but will choose a midwife to stand by in case we do need something.

Single mama to S ~ 6/09

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Old 09-04-2010, 02:02 AM - Thread Starter
 
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Ihugtrees--well, that pregnancy sounds like it was just full of unpleasant things from providers....though I'm glad it was not enough to ruin your birth high at the time!

The more I hear from you all and think about it, the less easy it seems to glean insight. Well, some insights perhaps but no easy answers. I've known many fine mws and even a few OBs I liked (though of course there are reasons the medical world is not one I joined). There's such a complex weave of things involved in 'what goes wrong'--Drs who are taught to be detached as The Professional way to be, and have habits along with liability concerns and peer pressure to contend with; girls/young women NOT taught enough about their bodies, and birth, as they grow--not knowing enough to ask questions or find their own best answers. Hb Mws being an oppressed group with their own pressures to deal with; women in general being raised to put others ahead of them, like rnchrista mentioned. The input of husbands/family on birthing choices--the availability of choices--laws, religion, customs...personalities on both sides, limitations of being human...loyalties....sheesh.

Looking at it all this way makes me wonder how anyone has a birth they are fairly totally pleased with! But of course, women do, every day--including births that you or I might not have enjoyed much. Trying to remind myself of that here....

The med institutions and licensed practitioners do have methods in place for complaints--however difficult they might be to access, or get real results from. I don't know. Something I've done is to be a sounding board for those who are frustrated with all this. Just talking about it to someone who will listen can be so healing in itself; if the listener can really believe from their own experience, how hard it can be to get results on a complaint, all the better. And sometimes as a listener I can offer a suggestion along with the sympathy that may be helpful in some way--not always...anyway, babbling here so I'll stop now!
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Old 09-06-2010, 10:53 AM - Thread Starter
 
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Some who've posted here were able to share their 'success stories' about bringing complaints to providers...whether directly by seeing action on a complaint, or more indirectly through working for change at their local hospital.

Healing from disappointment or trauma is a very individual journey...and from my own experience I know it seems to take time, and a focus on one's own needs/feelings/care, throughout. The healing journey is seldom a straight and easy one--again from my experience and listening to others' stories, it can involve addressing issues stemming from one's persnal history as well as 'social factors' such as others' reactions and mainstream practices with birth. It might mean such things as learning to be more assertive in general, choosing care more carefully next time...all kinds of things.

If you have/had any issues with your birth experience--be that complaints about a doctor involved, your mw, nurses or LCs, 'policies' in place--what helped you? Or might help you, if it were available? What was missing that you would like to see changed somehow in the 'outer world'? Is there any way in which you helped yourself to heal by making changes of your own, in any way?

This is a lot of individual questions--not asking anyone to answer them all! Unless you feel like it....But if any of those questions speaks to you, please share with us...this healing work is so important. Making complaints can be important, personally and also toward more general social change; it's not the only thing that helps healing though, and some just prefer not to complain. Still thinking about what I might do, on a local level, to address this growing problem of women traumatized or at least very disappointed in their birth/birth care....all thoughts welcome.

thanks
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Old 09-06-2010, 11:52 AM
 
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For me, it was essential to take back a sense of my own power, and to recognize what things I actually did have control over and what things I didn't. I personally felt like a failure because I couldn't convince my daughter's doctors to let my healthy child go home instead of having IM antibiotics for an infection she *never had.* I needed to recognize my own strength and to be able to call out for what it was, and to recognize the good things that I had done and fought for the entire time. Claiming my own strength was enormously healing for me, because it made me feel like an active participant instead of the person who got hit by a steamroller.

In past births, there have been other issues. Like, in my first home birth, we had a serious shoulder dystocia. It was very unexpected and seemed to come out of nowhere, and while my midwife was prepared for it in terms of hands on skills, she did not know how to handle the emotional aftermath as well. My husband went on a "how do we keep this from ever happening again" spree, which he should not have done and he could see that after the fact. But she went down that path too, and I was literally recovering from a bad PPH (my iron was only an 8.4 at 2 1/2 weeks post partum) while they were discussing how I must have eaten too much ice cream and sugar binged my way into a shoulder dystocia. It was intensely painful and contributed to a PPD tailspin.

I indirectly raised it when I shared that birth story with my MW, where I wrote about how that discussion made me feel. And when we were pregnant again, we chose the same midwife and I had a respectful but clear conversation about how if we ran into complications we needed to not do any rehashing until I was at least 2 weeks post partum.

I'm kind of rambling, but for me here are things that have been helpful:

1. Having medical records. Your perception can get warped from everything going on, and having factual records (or seeing that your records are not factually true) can be very helpful to coming to resolution on things. For me, my daughter's records are full of , which made me free to understand that I didn't somehow miss the "right" language to convince my daughter's attending to let her go home. He had it out for us, as is evidenced by the brain damage he decided to throw into her chart. Seriously.

2. Hearing the care provider's side of the story. There were things that I had forgotten about that my midwife was able to tell me, and they made me feel much less responsible for somehow not miraculously being able to keep my daughter from needing hospital care.

I think that asking for someone's birth story might be a good start, because there might be things that a mother would be more comfortable writing than saying out loud. Listen to the mother's feelings in her words, and maybe use that as a springboard to ask how you could have helped her in that moment her feel more confident in her strength and courage as a mother, and how you can help her now.

Anyways, I'm rambling at this point, but I hope that is helpful! And thank you for caring about how to help women who have had trauma or pain related to their birth giving experiences.

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Old 09-06-2010, 12:52 PM - Thread Starter
 
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loveneverfails--

Wow, thanks for that insightful post, sharing your thoughts with reference to your experiences--very helpful to me!

I've definitely seen from seeing stories online, hearing them from mamas who connect with me for one reason and another, as a mom and mw as well dealing with disappointing/traumatic births, that perhaps the biggest issue for most moms is that sense of powerlessness that occurs. It is so debilitating! And all the moreso when some are invested in maintaining their power over families--out of defensiveness, and/or a need to continue controlling events in the aftermath (like your NICU doc/scenario). You are so right that healing relies so much upon finding one's power again. In part that can mean re-membering the ways in which one truly WAS powerful as things occured, and after--reframing the events to include the real ways in which one worked to act toward normal birth, or to deal pro-actively or assertively in situations of difficulty that may have been no one's 'fault' but still led to trauma (no provider or parent can always cause birth to go perfectly well). And also, claiming the power in the present to have a positive, chosen impact on what happens next.

Your story about your SD is also very helpful. After any birth that was hard for parents in any way--even in 'smaller ways' such as more pain than expected, more pp bleeding or a baby who is a bit slow to start, but nothing really 'emergent' or long term--as you point out there are a few parties to emotional aftermath: the parents along with the mw, sometimes other fam/friends as well. It can helpful *eventually* to discuss such things as growing smaller babies or building a higher hemaglobin prior to birth...but oh my! I cringe to think that your mw engaged in that sort of discussion so very early in things--only encouraging your dh in that trend while you were still recovering from birth and so vulnerable (most all postpartum women are emotionally vulnerable--those whose births were difficult/disappointing, only moreso). To me that is ALL about their feelings of trauma/fear--and trying to get rational control instead of facing and working through the feelings. Far better if your mw had recognized that emotional component for herself and your dh--and done 2 things: one is, to acknowledge her own emotional trauma, and seek *private* healing for herself. 2nd, to affirm his feelings, but discourage your dh from going there--"let's put that discussion off for the time being--for now, let's focus on everyone's immediate recovery and comfort. That was so scary for everyone, we need to let that settle first. Time enough later for review."

In any event, I really appreciate your post! I can see that while gathering insight that might help me to help moms/families, one important element of this is to also work with mws/providers on this issue. This topic comes up sometimes among birth professionals--how to handle difficult emotions following a hard birth. One problem for caregivers is that we are seen--and tend to come to see ourselves--as so strong, and needing always to be in rational control. We may not always be so fully aware of our own feelings--but they ARE in play, whether or not we see that at the time (as I think your SD mw shows). Obviously, a provider can't have a crying fit or nervous breakdown while needed to provide care--we do have to have some control over ourselves/feelings while working. But definitely need to know how to acknowledge and care for our own feelings in due course and appropriate ways. This is something I'll be thinking about for sure, as I also consider how families can be helped.

thanks so much
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Old 09-06-2010, 01:57 PM
 
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Yeah, it was pretty bad from my perspective with the SD birth, but I can very easily see why my MW got overwhelmed. It was the worst SD she had seen, and it was a danged atypical one. You don't necessarily expect a multip having a near painless labor, 2nd stage of all of 8 minutes to get a serious SD seemingly out of nowhere. That anterior shoulder just popped right over my pubic bone and got impacted there, and it was bad. I don't blame her for being caught off guard. We all were, and I'd absolutely work with her again.

But I didn't feel "vindicated" so to speak in that I hadn't caused my daughter's dystocia by sugar bingeing until the next birth where I followed Brewer to a T and ate zero refined sugars, passed the GTT with flying colors and wound up with an even bigger baby born earlier than Little Miss 3 Minute Shoulder Dystocia to Apgar 0. Turtling on your umbilical cord is not something we recommend.

That MW is still my friend, and I trust her judgment and skills. It's just one of those things where you really really need to hold the birth space for the mom, to get back on the bonding and confidence track instead of the "ok, what do we do to fix this for next time?" track. I was so weak from blood loss that I couldn't even stand, and probably would have benefitted from a transfusion. Tack on "my baby was kind of dead for a little bit there" and "she looks awfully chubby in a GD kind of way" and it's a bad combo. But I'm glad that I got to be the guinea pig, if that makes any sense? I was on my 3rd baby, and I was able to come back from it probably more easily than a first time mom would have, and I already knew how to care for infants and breastfeed. And it has to be hard to be the birth professional, to have professional responsibility in a situation and to likely be at least somewhat of a friend to the mother. The personal investment that this is *your* friend and her baby and something either just difficult or dangerous/traumatic happened.. it has to be hard. I know it was hard for the MW we had this most recent birth with NICU transfer, but she also had 30 years of experience in birth work, and she really helped me keep going throughout the nonsense we went through. In many ways, this birth had the best "labor" support I've had in a birth yet.

Maybe you'd get less resistance from local birth professionals if it was framed as a post partum depression prevention thing? Or PTSD screening? Like perhaps try to make it a standard of care thing in your community that when there is a risk factor for PPD/PTSD due to birth difficulties, there is a more in depth screening?

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Old 09-07-2010, 10:53 AM - Thread Starter
 
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So--are you saying that your next large baby did NOT have SD issues?

"That MW is still my friend, and I trust her judgment and skills. It's just one of those things where you really really need to hold the birth space for the mom, to get back on the bonding and confidence track instead of the "ok, what do we do to fix this for next time?" "

I agree with this 110%. I've had people ask me sometimes--'how do you deal with the fear in a crisis situation?' I say--I try to just recognize it if/when it arises, and mentally tell myself 'ok, fear, I see you; you just have to stay in *this* corner for now, cuz I have other things to attend to right now'. Compartmentalizing has it's uses! Same idea would go for helping families move as smoothly as possible into pp time, in the days/weeks following a difficult birth. But sometimes--especially in such a surprising and intense situation as your SD--it's harder for a mw to keep the compartments tight enough...especially if someone like your dh was busy trying to 'figure it out right away', as a method of coping with his own trauma. I can think of a few times when my own compartments 'cracked' at least a little, when someone in the situation was leading the way into territory best for me avoid for the time being.

I'm so glad to know that you did not lose respect or affection for that mw, though--that in spite of that one misstep of hers, you could still see that she had done a good job for you guys in the most important moments of saving your baby's life. I think you're right--that being your 3rd baby probably helped you a lot in recovering from all that.

I'll think about your suggestion re: framing post partum discussion of care in terms of ppd/ptsd prevention/healing....it's definitely a good idea to find positive, pro-active ways of framing anything! I've recently had a discussion with a Birthing from Within facilitator/teacher about this issue. Her idea was to set up a Reconciliation Circle for the birth community (including docs, doulas, mws, LCs anyone really, who is involved with birth/after-birth care)...a place where families can face those with whom they have some sort of issue, for all concerned to freely speak their part, toward peace.

This sort of reconciliation work is now being done in South Africa, in this time so newly post-apartheid when social conditions are begining to change but the attitudes of many are still much effected by hatred/bigotry, from one side or the other. The idea is to face and acknowledge all the feelings and other results people have experienced (on all sides), without any pre-conceived plans for 'redress' or punishment. It is a place where the 'offended' can freely speak, and the 'offender' can receive that and also speak their own part. The only goal I suppose is peace and healing, however people are able to use such a circle to help themselves and anyone else involved. As spoken already here, just being heard and acknowledged can have a powerful healing impact--but when it's just one to one, you never know if that will occur (if the provider is defensive/denying, or the family too hostile). A circle can be present to help all people speak their truth, and hear the others' truth.

With something like this, I would think, a lot of providers and families might feel safer to participate. And if either side refuses to participate--choosing either denial/avoidance, or more legalistic/punitive ways to address a problem, well that in itself would be a statement for the community to hear and consider, KWIM?
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Old 09-07-2010, 12:55 PM
 
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Heh.. my 11 lber, on further discussion with my past and current MWs, was not a bony impaction so much as a positioning issue. He couldn't do the cardinal movements and needed to be turned, but it was a question more of lining him up right than of freeing an impacted shoulder. And now I just had my 5th birth where she followed the same pattern of needing to turn the same direction, going from ROA to shoulders delivering only if they're OP and most quickly if I'm rocking the stranded beetle with some suprapubic pressure. So, I'm just going to plan on that as my "normal" from now on. I figure if every kid from my dinky little 7 lber to my 11 lber came out the same way, that's just how my pelvis funnels little people. But if we're going only by "turtle signs", I've only had 1 SD.

This last birth was a 9 lbs 12 oz, but fluid overloaded and to me felt more like should have been 8 1/2 lbs. She was not a SD, but did brace herself in my pelvis with her arms in the startle reflex, so my MW had to resolve that but it took all of 30 seconds. I controlled protein intake in the 1st trimester, and had fundal height measurements that were right on this time instead of 4-6cm ahead, and her placenta was not gigantic. She did have her lost twin's placenta fused to hers (H1N1 early 2nd tri), but hers was reasonably sized and blood loss was pretty minimal. Very very weird stuff that birth. We may be getting written up as a case study, possible twin to twin or possible RH disease between an RH negative placenta fused to an RH positive placenta and baby, with very odd vascularization connecting them and two hard impact falls that pregnancy. Man, I think I need a year or two off even after just thinking about that birth. Geez.

I think a reconciliation circle is a really good idea, especially because it might bring into the dicussion some impartial perspectives that can validate or offer new insight into difficult situations. And it doesn't have to be judgmental to say "birth throws us curveballs sometimes, and we want to learn from the rare and difficult situations that come up so that we are stronger and more compassionate going into other births down the line." Hard situations are inevitable in terms of the numbers. It's *going* to happen. It's impossible to avoid. But bringing everyone together to support all the parties involved and to honor their experience, and be stronger as a community for working through things together? That would be a very good gift to everyone involved.

Catholic wife in love.gifwith my husband, mom to superhero.gifx5,  babygirl.gifx2, angel1.gifx6. Birther of babes, baker of bread, and connoisseur of human folly. WINNER OF THE SILVER BIRTH STOOL, APRIL 2010 DDC! Happily hospital birthing with my BFF, Epidural Man.
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