Coercive C-Sections and the Hostile State of Obstetrics

2011-04-09T03:14:00.000-07:00

My son was born in January 2011 and I had my 3rd c-section, during which the slapdash work I always suspected Dr. Holland performed on me (during my second c/s) came to light.

My O.B. explained that instead of making a low transverse cut, which she said was the safest, Dr. Holland just cut in her "line of sight." A low transverse cut is safer because this region of the uterus has less muscular fibre and is less easy to rupture in future labors. There was no reason other than carelessness for her to do this. Furthermore, my O.B. found an aneurysm or "window", which is like bubble gum when blown, which would have ruptured at any minute.

During the c-section, my O.B. kept saying to the other doctor, "Why did she (Dr. Holland) do this? Have you seen anything like this? Come here and look at this. What is this?" The other doctor added they would never do a single layer stitch at NYU Medical Center, as Dr. Holland had done. (She was surprised that an NYU doctor did this, and I told her it wasn't an NYU doctor.) In fact, when Dr. Holland and I initially met in her office, I had requested a double stitch--part of my birth plan--so she deliberately had amnesia about that.

My O.B. said, "She (as in me) would have ruptured." And the other doctor replied, "There was a hole (in the uterus) before we made it."

Everything Dr. Holland did endangered my son's life. For no reason other than spite and carelessness. If I had gone into labor, he would have died or been permanently injured. (Furthermore, after having two quick conceptions, it took us years--post Dr. Holland--to conceive him.)

It is really frightening what surgeons like Dr. Holland get away with. We would never have known the damage she had done if I hadn't gotten pregnant again, and of course people like her count on that.

The details of what my O.B. found are in her post-op report to NYU Medical Center.

2008-07-07T03:46:00.001-07:00

This is from a friend, re: a mutual acquaintance who is a medical resident:

"We went to a beach on the river with Inge. She said something that might interest you: that she was shocked when she saw how C-sections are performed. The part that shocked her was that the drs just slap together the stomach muscles and sew them together instead of trying to make a nice seam. That's why so many women have protruding guts after C-sections."

2008-05-11T04:24:00.000-07:00

Some Letters to the Editor in the May 12, 2008 issue of Time magazine. I'm copying them here because I couldn't have said it better. If you are a woman who was bullied, coerced, or assaulted during labor, or are a doula who has witnessed this, it is important that your voices be heard so that we can change the prevailing attitude in the medical industry that the physician's convenience is more important than the mother's well-being and that women are easy to marginalize, so if they have anything to say about it, the final word is that they're hormonal or have post-partum depression, etc.

"I am a former labor doula and am currently leading the national effort to reverse hospital bans on vaginal birth after cesareans. Mothers never tell me that they chose a medically unnecessary cesarean. Rather, their cesareans were ordered, coerced or bullied by their doctors because labor was too early or too late, mom was too small or too big, baby was too small or too big, mom had too much or too little amniotic fluid or for myriad other reasons sometimes verging on the bizarre. Plus, let's not forget that many hospitals in our country forbid women who have had cesareans from choosing vaginal births in later pregnancies. As for the woman featured in this article, I'm glad she is happy with her cesarean because chances are she won't be allowed to opt out of one the next time." --Barbara Stratton, Baltimore

"Nowhere in your rosy article about elective cesareans do you discuss the effects, infection, mistakes made during the operation, longer recovery, time lost from work for family members needed to support a mother who can't pick up or carry her new baby, etc. You discuss the cost of lawsuits to doctors who don't perform the operation but neglect to mention the cost to insurance companies or public funds when a cesarean is done--a cost significantly higher than for a vaginal birth with or without medication. I would expect a higher level of reporting from Time." --Morgan K. Henderson, Wellesley, Mass.

"After giving birth vaginally, by cesarean, and then vaginally again, I nearly lost consciousness reading 'Womb Service.' The line "Pretty tidy way to conduct the often messy business of childbirth," about Euna Chung's elective cesarean, was the most disturbing. Trust me: suffering the effects of major invasive surgery is not a tidy way to do anything. Vaginal birth has been proven to be safest for moms and babies. It is irresponsible for Time to suggest otherwise." --Alana Brown, Avon, N.Y.

2008-04-27T05:23:00.001-07:00

I've just been catching up to reading some comments that may have been there for a while. It occurred to me that some readers may be misreading my posts or my posts have not been as clear as I tried to make them. That is the problem with this kind of forum. In lieu of rereading every previous post, I'm posting the following exchange from an earlier comment section. My response below hopefully addresses some of the disconnects.

j said...
I am a labor and delivery nurse and this account has big holes in it, it appears from reading this that you were trying for a v/ bac, that is vaginal birth after a previous c/section. if this is the case ,did you discuss this with dr holland. there are many dr.s and midwives that are comfortable w/ vbacs, dr holland may not have been one of them. the time to ask for a secound opinion is not when you are on the o.r. table. you absolutly must have signed a consent. also if you are infact someone who was a trial of labor, the safest thing is to have i.v. access. how many centimeters where you when you got to the hospital? how many were you when you took the epidural? how many hours were you allowed to labor befor you were "coersed" into a c/section?these questions are very important to a successful vbac. I dont the answer but I suspect that you were not tied down and cut against your will. for many women a home birth may be the best answer, certainly a birth center is a good comprimise, but for a trial of labor, unfortunately the hospital is the safest place to have a trial of labor unfortunately i have seen the devistating effects of a ruptured uterus, the baby is forever dammaged.. you dont mention how long you were alowed to labor, how big the baby was and how soon this trial of labor was after ypur 1st section. ( reads as tho you were a trying for a vbac, correct me if i am wrong). I am not excusing rediculous behavior on drs. part I have seen them make dubious decisions, but it is clear to me that the whole picture is not being given and this is somewhat of a smear campaign. I am sorry that you feel that your experiance was wrong, there are many of us out here who are trying to do the right thing.

6:47 AM

4moms2b said...
J, Are you even reading my posts before commenting (as opposed to skimming)? I absolutely wrote down the answers to the questions you're asking. Don't make it sound like I'm trying to hide something. I absolutely mentioned how much my baby weighed, the length of my trial of labor, etc. It's cool if you want to attack me—this is an open board—but before you call this a smear campaign, at least read the posts carefully first. If I say I labored from Wed. noon until the next day and that the baby was 8 lbs 14. ou., don't write, "you don't mention how long you were alowed (sic) to labor, how big the baby was," etc.

And I say in my original post that I signed the consent form, which makes Dr. Holland's action of bursting into the O.R. screaming at me to give her verbal consent because she didn't want to be sued for assault or walk out of the hospital even more outrageous.

It occurs to me that you think I was saying that the coercion took place in the O.R. (I have to go back and read my post to see if that's unclear. Sorry for any confusion.) The coercion in fact took place in the hospital room with Dr. Rutenberg present and Dr. Holland angrily insisting over the phone that if we didn't do the surgery at the time she had scheduled (not because there was any medical need), the O.R. would be booked. Although by shouting at me to give her verbal consent, Dr. Holland presumably considered that verbal consent equal to or more authoritative than the consent forms I had already signed (otherwise, what's the point of asking for verbal consent?) And what I'm saying is that consent given on the O.R. table by a THREATENING doctor is NOT informed consent. I don't know how it could be considered such.

No, I wasn't "tied down and cut against my will" (well, actually my arms WERE literally tied down when she burst in screaming at me), but that is the problem with "patient rights" and "informed consent." Although I WANTED to say no, because I did not want to be operated on by a raving person, what real choice did I have? Leave the hospital and continue the labor in the lobby while I regained feeling in the bottom half of my body? Do you really think the situation I described even ALLOWS for careful decision-making?

If someone like a hospital administrator had given me a REAL choice, e.g., "Would you like Dr. Holland to continue the surgery, or would you like to wait for Dr. So-and-So, who can be here in 15 minutes" I would NEVER have said yes to her! But that's not the system in place. But the shouting in the O.R. was not the coercion, that was the abuse.

And yes, I discussed VBAC with Dr. Holland, what do you think? When I interviewed her she said she had a lot of experience with it. I do believe that Dr. Holland was acting within the guidelines of ACOG, but that doesn't mean she didn't trample my "patient rights" and treat me abusively and without thought to my feelings or birth plan. You may not believe this, but I was actually very calm and sensible before going to the O.R. I've heard of women who sobbed or shouted all the way to the O.R.

Your post, J, shows ignorance about the issues that patients face, and the fact that you're actually a labor and delivery nurse makes it especially sad. I hope that medical personnel would be better trained in patient issues. It could prevent a lot of pain and suffering as well as lawsuits.

5:20 AM

2008-04-06T18:05:00.000-07:00

Update: I recently received a phone call from the office of one of my senators, Hillary Clinton. They were responding to my request for assistance regarding the review of Claudia Holland, MD, that is supposedly being done by the Office of Professional Medical Conduct. As I've said to the OPMC in phone conversations and in letters, the longer this drags out the more unlikely the witnesses in the O.R. will recall this incident.

At least I have witness accounts in writing. I recommend that all moms go into the hospital in a defensive frame of mind and take down the names of your caregivers. It's easy to forget everything during labor if you don't prepare yourself mentally in advance. The names are helpful when you want to write complimentary things or thank you cards, too.

2007-08-05T07:51:00.001-07:00

Unless I'm mistaken, the Commissioner for the New York State Dept. of Health, Dr. Richard Daines, is also the president of St. Luke's-Roosevelt Hospital where my abuse took place. How's that for a conflict of interest?

I originally wrote to Dr. Daines on November 4, 2005, seven days after the birth of my daughter and Dr. Claudia Holland's abusive behavior. Dr. Daines--the president of St. Luke's-Roosevelt--didn't respond, but I got a letter from Dr. Oded Langer, the Chairman of Obstetrics and Gynecology, shrugging off the whole incident, referring to it as "mutual agitation." (To which I say, a surgeon's lack of self control should not be compared with the agitation of a pregnant woman about to undergo surgery who is being shouted at and then slammed repeatedly on the OR table.)

There were some comments to my original post that have oddly disappeared. I'm not technically savvy, so if anyone knows how to get in touch with the folks at eblogger, please let me know.

2007-08-05T07:33:00.000-07:00

The Office of Professional Medical Conduct (New York State) continues its investigation of Claudia Holland, M.D. I have Senator Charles Schumer to thank for writing on my behalf to the Commissioner of the New York State Department of Health, Dr. Richard Daines.

I just watched Michael Moore's film "Sicko." Very grim. Not only is there no political will to improve medical care in this country, but even if there were--which there isn't--it would take decades to get the U.S. out of its current state of health care chaos.

Of course, based on my experience, I am of the mind that the whole "Patient Bill of Rights" is a fraud. My rights were completely trampled. Organizations like the Office of Professional Medical Conduct could help if they could get their act together. My case is now more than a year and a half old (when I was told it would only take six months). Any witnesses in the operating room of Dr. Holland's unprofessional, abusive conduct have long forgotten it.

On a sad note, I received a letter from the executive assistant of the OPMC, in which she gets Dr. Holland's name completely wrong. In the subject line, and in the body of the letter, she writes "Dr. Claudia Cooke." I hope there's not a real Dr. Claudia Cooke! I want to make it clear that I'm not complaining about Dr. Cooke.

2007-05-22T09:41:00.000-07:00

My complaint to the Office of Professional Medical Conduct continues a year and a half after I made it. I have written to the OPMC to let them know about the delays that the new investigator is encountering, and I also wrote to my senators, Hillary Clinton and Charles Schumer, for help with this governmental organization.

I'll say it again, patients whose rights have been violated have to be heard.

2006-11-14T20:37:00.000-08:00

Patient rights are important. In a person's most vulnerable moments, they have to mean something.

The case Meador v. Stahler and Gheridian drives this home. Here is an excerpt about the case:

"The $1.5 million award to a Massachusetts woman and her family in Meador v. Stahler and Gheridian3 made news as a rare instance of a malpractice judgment based on an allegedly unwanted and unnecessary cesarean section rather than a failure to perform such an operation. The plaintiff, Mary Meador, did not claim that the procedure was negligently performed or that the rare and disabling physical complications that resulted from it (which left her largely bedridden and unable to work or meet her family responsibilities for several years) were foreseeable. Instead, she claimed that the defendant obstetricians had misrepresented the risks of the alternative procedure (vaginal birth after prior cesarean) and ignored her persistent pleas for this alternative. Moreover, she alleged, they compelled her passive assent to the surgery in an emotionally coercive manner while she was progressing normally in labor, despite their having previously agreed to such a trial of labor. -
Because the consequences of the cesarean were unforeseeable, and because Meador had signed a consent form for the surgery (to be used in case of emergency), this case did not meet the technical requirements specified under Massachusetts law4 for an action based on informed consent. Instead, the case was brought on the theory that the physicians' failure to obtain the patient's informed consent constituted substandard, negligent medical care. The forensic psychiatrist's expert testimony emphasized that the pro forma signing of a consent form did not constitute true informed consent, especially in light of the physicians' alleged disregard of the patient's expressed wishes and their inaccurate representation of the risks and benefits of the approach she preferred.
- The psychiatrist also explained to the jury how Meador's life history left her vulnerable to experiencing the denial of informed consent as a highly traumatic event."

My rights to informed consent were definitely violated. I was not consulted before I was pitted. Pitocin was administered to me at 5 a.m. while I was semi-conscious, without prior discussion. Is that informed consent? When I asked for more time to labor, there was no discussion about pros and cons. Instead I was told I had to have the c-section because I was "already scheduled." Is that informed consent? While I was strapped on the O.R. table, with an epidural and oxygen mask, Dr. Holland shouted at me to give her verbal consent or to "walk out of the hospital" because she "didn't want to be charged with assault." Is that informed consent?

2006-10-19T10:55:00.000-07:00

My thanks to M for finding out what Dr. Holland meant by "boggy" and writing in. Whatever Dr. Holland meant by the umbilical cord being "too boggy," it's always been clear that the reason she failed to extract cord blood after my c-section is that she forgot. It's difficult to say, of course, whether she willfully forgot because she had so little regard for me, her patient, or whether she forgot because she was in such a state of agitation and anger. (There were other oversights: she also forgot to introduce me to her partners as promised at our first meeting, forgot that I didn't want to be induced after my contractions started, forgot that she never came to see me in recovery after the c-section, and the day after, forgot to return for a follow-up checkup after saying, "I'll be back later." And she forgot--or chose not to--stitch a double layer, as I requested, jeopardizing any future VBAC.)

My complaint against her to the NYS Office of Professional Medical Conduct is still in progress. The investigator, John Lanza, originally interviewed me in February and said the investigation would take about six months. So I rang him at the beginning of October for an update, and he said that the investigation is still in progress.

2006-10-06T03:11:00.000-07:00

Most doctors I have met consider Cesarean sections to be almost routine. That is, it's no big deal to have the surgery. Your obstetrician talks about your recovery time in terms of days or weeks. But the truth is, you never recover. You have been sliced through by a knife. I still have minor pain in my incision area when I exercise. But that's not what I'm talking about.

This summer, my mother underwent surgery for peritoneal dialysis (inserting a tube in the stomach for dialysis) and the surgeon was worried the surgery would fail because there were so many adhesions, or scarring, from her cesareans and subsequent hysterectomy.

A cesarean also increases your chances of having to have a hysterectomy (which can lead to further complications and hormonal imbalance). It increases your chances of having placenta accreta in future pregnancies, in which the placenta adheres to the scar tissue.

Obstetricians won't take into account or discuss the long-term repercussions of the surgery because it is likely (s)he won't be dealing with the problems that may happen down the line.

But a cesarean is major surgery and don't let your doctor act like it isn't. You should be afraid.

Furthermore, your fears should be taken seriously. Your future reproductive and overall health should be factored into your care. You shouldn't be treated as if you are irrational or mentally ill, as Dr. Claudia Holland kept saying I was, because you disagree with an unnecessary cesarean. (I don't think an obstetrician should be commenting on your mental health, in the first place. Better to leave that to a psychiatrist.) You shouldn't be induced without your consent as I was by Dr. Holland. Dr. Holland said that I had to have a cesarean right that minute because the operating room might not be available at night, which is when I wanted to wait until. Is that a good reason for a cesarean?

My friend just gave birth and she said on e-mail, "They wanted to induce me on my due date, but I went early. I showed them!" She showed them. Her words reveal what she felt: that her doctor was an antagonist and not someone interested in her optimal care. It is really sad that pregnant women have to defend themselves from their own doctors. I wonder if the American College of Obstetricians and Gynecologists is aware of this or if they care.

2006-05-01T19:38:00.000-07:00

Tonight, my surgery has been on my mind because I just went to hear Dr. Mayer Eisenstein speak about his career, during which he has done more than 15,000 home births. He reminded me of two things that I learned the hard way:

1) Once you are admitted into the hospital, the clock starts ticking. Before long, you will have the baby--one way or the other.

2) Non-stress tests and other diagnostic screens are meritless (and will lead to you being admitted into the hospital, at which time the clock will start ticking, etc. etc.)

I started having contractions on Wednesday and by Friday, Dr. Claudia Holland had coerced me into a c-section.

I was at St. Luke's-Roosevelt Hospital on Wednesday at around noon having what had become a tri-weekly (I know! What was I thinking?!!) non-stress test and sonogram. The day before, Dr. Sharon Patrick (one of Dr. Holland's partners) had found 8 cm of fluids, but the sonographer on this day, Sharmista, said she only found 4 cm. (Sharmista was also the only sonographer out of several who kept getting fetal measurements that would make the baby macrosomic; in fact, my baby was 8 lbs 14 ou. at birth.)

The fact that each sonographer had such wildly different readings should have given me a clue that I should have refused to be tested.

Dr. Lois Brustman, a doctor in FEU (Fetal Evaluation Unit) who kept telling me to get a repeat cesarean each time I saw her, at first told me I could go home. When I got home, Dr. Holland called to tell me that Dr. Brustman and her had discussed it, and that I had to rush to the hospital.

When I arrived at the hospital, I was given another sonogram and this time, the doctor in question found 6 cm. of fluid. At this point, I should have been told to go home. Instead, he wanted to admit me and insert an I.V. immediately. My husband and I protested against the I.V., but he said that if there was an emergency, there might not be enough time to put one in.

At 5 a.m. Thursday morning, a nurse came in and started pitocin, which Dr. Holland had ordered without consultation with me. By 1 p.m., my water broke and then my fate was sealed.

Twenty-four hours later, Dr. Holland was shouting at me over the phone that I was "already scheduled" to be in the o.r. to be operated on by her partner, Dr. Kathryn Rutenberg.

The whole thing was like a textbook case of medical intervention leading to a cesarian.

A nurse said to me that obstetrics is a sub-category of surgery and that's what obstestricians know how to do. They don't know how to deliver babies. In other words, if the pregnancy isn't going perfectly, they have little knowledge of what to do, offer you options that are no choice at all. Whereas a midwife can tell you about different positions, using a breast-pump to induce labor, so on and so forth. Therefore, an obstetrician will either arrive just to catch the baby or to do the cutting.

2006-04-27T07:16:00.000-07:00

Moms-to-be you need to know that your obstetricians will keep telling you that the most important thing is the health of your baby, as if you don't already know that. That's their key weapon--your guilt. As in: How dare you think of your own health when the health of your baby is also at stake?

The thing is, there is no reason to believe that the health of your baby is at any particular risk with a vaginal birth. That's how babies are born! Obstetricians like Dr. Claudia Holland will try to make you believe you are high risk, because what they are really worried about is their malpractice record. (See my birth story in an earlier post.) Why else would she burst into the operating room shouting, "I don't want to be charged with assault!!!!!"

Until she said that, while I was strapped on the operating table, I didn't even know you could charge a surgeon with assault! My mind was racing on that o.r. table as I tried to answer her and digest this alien concept.

But it certainly felt like assault. And coercion. She coerced me into an unnecessary surgery because of her schedule. [Addendum: Because of some later comments from readers, it's clear that this paragraph has created some confusion about when the coercion took place. Please read my original post for greater accuracy.] Furthermore, the operation was so violent, my body was slammed up and down on the table and I felt pain even under the effects of the epidural. She had some medical data to support her actions, of course, such as the fact that my water had been broken for 24 hours.

But in other countries, such as Britain, where I suppose doctors are not so lawsuit-sensitive, the standard is for women to go up to 72 hours after their waters break before a cesarean is considered.

I relive Dr. Holland snapping over the phone that I had to have the c/section because I was "already scheduled to be in the O.R." and later shouting in the o.r. that she had to miss her "blind mother's (4 p.m.) doctor's appointment." And it's clear to me that I had unnecessary major abdominal surgery for no reason other than her schedule. It's also pretty clear that she forgot to extract the cord blood that we had intended to store for our baby. No one I've spoken to seems to understand the meaning of her explanation for failing to extract the cord blood: "The cord was too boggy."

All my baby needed was time to come. If I had been with a midwife, I wouldn't have undergone this trauma and still be living with pain. My baby would probably have been born on Halloween. I sometimes catch myself telling people she was born in November.

Since this has happened to me, I've read other women's accounts of their VBACs and other births online and spoken to women who have said that they were being coerced-- sometimes because their doctor was about to go on vacation--and they switched doctors at the last minute. I didn't know you could do that. It may seem obvious, but I've never had to consider it in the past.

My current obstetrician laughed when I told her that Dr. Holland said that I HAD to have the cesarean right then because I was already scheduled and the "o.r. might not be available" if we waited until that evening. She said, "No available o.r.? Of course there's always an o.r.! You don't have someone come in with gunshot wounds only to hear, Oh, there's no available o.r.!"

I am so angry with myself for falling for her stupid tricks and pressure. But another point is, one's obstetrician should not be acting and saying the things Dr. Holland did to me, her patient.

2006-04-19T08:37:00.000-07:00

Since my nighmarish birth experience at St. Luke's-Roosevelt Hospital in New York City, I've still been feeling out of sorts, and I want to reach out to other women out there--preferably BEFORE you give birth.

The experience made me see how combative the relationship with obstetricians and their patients have become. In my case, my obstetrician Dr. Claudia Holland burst into the operating room while I was strapped to the o.r. table, shouting at me that she wanted my verbal consent because she "didn't want to be charged with assault." Is this an incidence of a single individual with anger-management problems or the current state of obstetrics in the U.S.?

Women who want a natural birth should know what they are up against. More than 1 in 4 babies are delivered by cesarean section according to the National Center for Health Statistics. It's major abdominal surgery that risks your future reproductive health! So how does this happen?

Many obstetricians have a motto: "The only cesarean you get sued for is the one you don't do." This puts them at odds with their patients and accounts for the incredibly high cesearean-section rate in the United States today.

This hostile state of affairs leads to some nightmarish birth stories, such as my terrifying experience at St. Luke's-Roosevelt Hospital. I had not known Dr. Holland long, and although I had complaints about her bedside manner, I would never have imagined that any doctor could be so abusive in the operating room or so unprofessional before and after the operation.

At first, her partner was supposed to perform the surgery, but she was called away to do an emergency D&C, I was told. I waited on the OR table, with antibiotics and anesthetic pumping through my veins, and an oxygen mask on my face, for about 20 minutes for Dr. Holland to arrive.

I expected Dr. Holland to come in with some consoling words about why the VBAC was unsuccessful, but instead she burst into the OR and started shouting at me, “I want you to give me your verbal consent! Because I don’t want to be charged with assault! This is not a joke. This is totally serious. You can say yes or you can walk right out of this hospital. I had to cancel my blind mother’s doctor’s appointment! Say yes, or walk out of this hospital, because I don’t want to be charged with assault!!! (And so on and so forth.)” (Note that while she was shouting at me to walk out of the hospital, I was paralyzed from the waist down and literally unable to walk.)

I was completely in shock. If Dr. Holland was angry because she had to miss her mother’s doctor appointment, what had that to do with me? I didn’t force her to come. If Dr. Rutenberg was called away by an emergency to go to, it wasn’t my fault. And of course, I had signed the required consent form before they would even wheel me into the O.R.

Believe me, I did NOT want to say yes, because I did not want to be operated on by a raving surgeon. On the other hand, I didn’t know what would happen if I “walked out of the hospital.” I felt trapped. I do not consider this informed consent.

I was terrified throughout the surgery. I cannot describe to you what it feels like to be operated on by an enraged surgeon and feeling completely helpless. I relive the nightmare every night. It was terrifying and I started to shake uncontrollably. The surgery was extremely violent and painful, as she slammed my body on the table repeatedly. I asked the anesthesiologist for help with the pain, and Dr. Holland snapped, "Give her a general!" even though she knew that it was my wish to be awake to breastfeed immediately after my baby was born. Luckily, the anesthesiologist refused.

At the end of the surgery, I heard Dr. Holland say, “I almost had to take the uterus out.” She didn’t come around to ask how I was or to explain herself. Instead, she started to walk out of the OR. My husband asked her, “What about the cord blood?” (We had registered with the Cord Blood Registry.) She replied, “Oh, that was a complete failure. The cord was too boggy,” and then she left the building, as in I didn't see her again!

I expected to see her in the recovery room, at which time I would ask her why she shouted at me in the OR and what she meant by nearly having to remove my uterus. She never came! Later, she would insinuate that I had some kind of amnesiac episode, but there were other witnesses to the fact that she never came, including my husband and doula. (I wonder if she doctored the books to show that she did come to recovery, or else how could she dare make that claim to me?) She and her partners (not all--she has one lovely, caring partner, Dr. Deli, who unfortunately I saw very little of) continued to treat me like human detritus not worthy of their attention. (There is more to my birth story, including Dr. Holland threatening to sue ME and her repeated insinuations that I was mentally ill! There's no end to this woman's unprofessionalism.)

In retrospect, given Dr. Holland's attitude toward me, I realize that my cesarean section was unnecessary. My baby just needed time to arrive. But it didn't fit with Dr. Holland's schedule and her mother's doctor's appointment. I was supposed to be done by then. I had read about women being coerced into a c/section and about silly reasons for them, such as a doctor's schedule, but I am shocked that it happened to me. I don't know whether the surgery, which was so painful (even under an epidural) and violent, may have done to my reproductive organs.

I filed a complaint with NY State's Office of Professional Medical Conduct, and am awaiting to hear what they conclude. Although I was told that the doctors on these boards socialize with the doctors they investigate, I remain optimistic that there is some independent element to this investigation. My current obstetrician will be ordering some sonograms to check the condition of my reproductive organs once I have finished nursing.

But I can't stop reliving the days that lead up to this unnecessary and horrific surgery. I bought the book "The Thinking Woman's Guide to a Better Birth," took a so-called VBAC class at the hospital, and hired a doula, and I thought I was sooo covered. But I should have gone to a midwife. I had no idea how big the odds were against me and how alone I would be when they forced me into the operating room. No one in the room said anything to help or support me! I was just another annoying woman who dared to want a natural birth. I definitely felt that everyone was, like, "Let's get this over with! We're all busy here!"

One problem is there's a prevailing attitude even among pregnant women that a c/section is no big deal. I've heard a lot of people say it's painless compared to a vaginal birth.

Well, it's nearly 6 months since my daughter's birth, and I still feel pain in the incision. Of course this makes me worry about the carelessness and violence of the surgery. Will I rupture if I have another baby? What if my child needs the cord blood that Dr. Holland clearly forgot (in her agitation) to extract? Who will answer for this?

I don't want to admit this, but Dr. Holland has made a huge impact on our lives. My husband and I suffer from post-traumatic stress, my baby's first months have been far from tranquil, and we may now never have another baby.