Article on violence against labouring women

There is more awareness of violence against labouring women, as this article shows (link below). It is the bare minimum that no one under Dr. Claudia Holland's care dies. Labouring women have the right not to be abused and if obstetricians don't understand that, they should not be allowed to deliver babies.

This article doesn't even address the kind of abuse I received from Claudia Holland, M.D., which is detailed in this blog: shouting threats when she burst into the O.R., keeping me waiting under anesthesia, strapped down on the O.R. table for 20 minutes plus because her colleague had another emergency to attend to (St. Luke's Hospital allowed this to happen), slamming my body on the table, telling the other doctors she "nearly had to take out the uterus" and then walking out without explanation never to be seen again, an inadequate suture (according to my current O.B. at NYU Medical Center) that nearly ruptured during the birth of my son.

What it does outline is the kind of violence that has become commonplace.

http://mumanu.wordpress.com/2013/02/14/violence-against-pregnant-and-labouring-women/

"During labour, telling a woman that if she doesn’t birth her baby within two hours they will do a ceasarean is like telling a man that he has to have an orgasm within the next three minutes or they will cut the end of his penis…. except what they are threatening the woman with is major surgery. A woman doesn’t need to know what might happen while she’s in labour as this will disrupt her feelings of safety and the release of hormones that will improve her chances of a safe and easy birth."

Guest Post

Learning about Pelvic Organ Prolapse Following Childbirth

When you begin planning a family, people are quick to offer advice. Your doctor will set you up with prenatal vitamins, and instructions for what foods and activities to avoid. Your friends and relatives will give guidance on the best remedies for stretch marks, cures for colic, and which diapers to buy.

But it seems no one really talks about pelvic organ prolapse, a condition that affects 50 percent of all women who experience pregnancy and childbirth. Subsequently, many women do not recognize the very real risk of pelvic organ prolapse and fail to take the steps to strengthen the pelvic floor after childbirth to reduce their risk.

What You Should Know

Many women with pelvic organ prolapse do not experience symptoms. In fact, it is usually diagnosed in menopausal women, as symptoms become amplified with declining estrogen levels and weakening pelvic tissues.

Symptoms can include pain or pressure in the pelvic area, incontinence and discomfort during sexual intercourse. Some women experience frequent urinary tract infections and constipation, and can also develop a sense of bulging in the vaginal area or feel the pressure of sagging pelvic organs against the wall of the vagina.

Unfortunately, pelvic organ prolapse is sometimes treated with surgery using a transvaginal mesh implant. The Food and Drug Administration warns that these surgeries carry a high risk of serious complications, such as mesh erosion, organ perforation, pain and infection. Correcting these complications may require numerous revision surgeries.

It’s important for women to talk to their doctor about non-surgical measures before any surgery is considered. In addition, there are surgical options that do not use mesh.

What You Can Do

During pregnancy, the pelvic floor supports the weight of the baby. Having a strong pelvic floor can shorten labor and ease delivery. Women who implement exercises – like Kegels -- to strengthen their pelvic floor throughout their pregnancy are less likely to experience incontinence, which is fairly common during the third trimester.

The strain that pregnancy and childbirth place on the body is intense. It is no wonder then that although the body can return to its pre-baby size in weeks or months, pelvic muscles may need years to recover their pre-baby strength. It is this decreased pelvic floor strength that puts women at risk for pelvic organ prolapse.

As the pelvic floor heals following childbirth, it is critical to protect it from further injury. Avoid heavy lifting and arduous activities, and when your doctor says you can begin exercising, it is better to stick to low-impact sports like walking, yoga or Pilates. One of the best ways to evade symptoms is to practice pelvic floor-strengthening exercises before prolapse sets in.

Be proactive about strengthening your pelvic muscles, and add pelvic floor exercises to your daily routine. Not sure where to start? Consult a physical therapist who can help you construct a healthy and safe exercise plan to repair and strengthen your pelvic floor. Try other alternative treatments like massage therapy, and maintain a healthy diet.

It is never too early to focus on pelvic floor strength, and the good news is that it’s never too late to start either. Especially in mild to moderate cases, pelvic organ prolapse can be treated and even reversed using physical therapy rather than surgery.

 

Linda Grayling writes for Drugwatch.com. Linda has a number of professional interests, including keeping up with the latest developments in the medical field. Join the Drugwatch community on our Twitter page to find out more.

To Dr. Claudia Holland: "Having a baby is hard enough. No woman should be asked to do anything else while she is having a baby. She shouldn't have to renegotiate a birth plan, argue with her care providers about the evidence supporting her decisions, or advocate for her baby. She also shouldn't have to comfort her husband or reassure her mother or educate her sister. Everyone around the birthing mother should attend her like the queen she is." --Elizabeth Allemann, MD

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 (I wasn't in distress; in fact I was kept waiting for at least 20 minutes on the O.R. table for her arrival). 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.

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."

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.

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