Posted by My OB said WHAT?!?.
Jul
30
Posted by My OB said WHAT?!?.
“I Know She Doesn’t Want This.”
“I know she doesn’t want this.” – CNM before cutting an unwanted episiotomy.
There are 33 comments to this post.
It’s not enough not to “want” it. You have to tell them you don’t consent to it and refuse to sign the blanket consent form they bully you into signing before you can deliver in their hallowed temples of health.
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Charity Reply:
July 30th, 2011 at 10:52 am (Quote)
I’ve crossed things out on the consent form. I will NEVER consent to an episiotomy. I also won’t consent to pitocin unless there’s an emergency after delivery. I think my midwife knows my boundaries pretty well, but I have to make sure and have my hubby there to remind her.
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Jane Reply:
July 30th, 2011 at 11:21 am (Quote)
The hospital I used wouldn’t let you bring a signed copy of the consent form, and I wouldn’t have the presence of mind to start altering it during labor. If you didn’t sign it, the nurse told me they would not help me give birth.
I know that’s probably horsepuckey, but when you’re 9.5cm and a nurse is telling you she legally can’t touch you unless you sign the stupid piece of paper, what do you do? (I refused at first, and then I signed only my first name. And later I complained to the head of the maternity unit.)
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C.Pratt Reply:
July 30th, 2011 at 12:06 pm (Quote)
That’s ok, most of the time it’s best if they don’t ‘help’ anyways. If dead set on being at the hospital for birth ‘just in case’ you can always have the baby in the waiting room, then if there is a problem they can bill for helping with that specific issue, but not the birth… and answer to the regulatory agencies why thier security videos show you arived hours before but you were never admitted.
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Missy Reply:
July 30th, 2011 at 8:17 pm (Quote)
Can you imagine a nurse or doc sitting by doing nothing in an emergency? And then later saying they did nothing because you never signed the consent form? I know they get kinda crazy and stupid, but that I just can’t imagine. Besides, I’ve heard lots of stories of precip births where they had to do all the paperwork after babe was born. But I totally get what you mean about being about to push out a baby and having someone in your face insisting that you sign.
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Imogen had this to say,
Jul 30, 2011 @ 11:24 am (Quote)
We don’t know the circumstances of this. The baby might have been in distress and the CNM may have said this in a regretful manner.
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Melissa Reply:
July 30th, 2011 at 12:38 pm (Quote)
The odds on an episiotomy being actually necessary is astronomically low. Episiotomies are almost NEVER necessary. Even with forceps. Even with shoulder dystocia. It’s almost nevernevernever the freaking SKIN that’s holding the baby in, folks, or keeping the lifesaving equipment out. Tears are preferable, even in those instances, except maybe when the two seconds to tear in the right spot would be dangerous for baby…so we save the two seconds by cutting.
If the baby’s in distress, and is close enough to being birthed that an episiotomy could possibly bring them out faster, how about just telling the woman what’s happening, what’s at stake, and ask her to push as hard as she can.
And that’s not even figuring in the fact that this is being reported on this website (and not on a Thoughtful Thursday).
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This was the first hospital birth I ever attended as a doula. I was so traumatized by it that I almost stopped doing hospital births. By the time we got to the pushing phase, I was already unhappy with the CNM. She’d picked up the scissors once and put them back down when I gave her a pointed look. This time she picked them up, looked straight at me and said her line and cut the mother. The baby’s head was barely visible at all, which means there was absolutely no pressure on the perinium to numb it. The mother screamed from the cut. The baby was not in distress, the mother was pushing effectively, there was absolutely no reason for it at all! In between contractions the CNM was chatting with the nurse about her son’s soccer game.
I refuse to work with this CNM and have had several clients that chose to continue working with me and switched care providers because of my refusal to work with her.
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Mama Wrench Reply:
July 30th, 2011 at 12:19 pm (Quote)
Was this, by any chance, a teaching hospital? I know that a lot of the time, in teaching hospitals, they’ll do things they KNOW are not medically necessary, simply to show students how it’s done in a non-emergency situation. Which I understand, from their perspective, but it doesn’t make it right or okay.
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Heather Reply:
July 30th, 2011 at 1:19 pm (Quote)
Wow, that is horrible. Good for you for refusing to work with her in the future and saving other clients from her!
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Colleen Reply:
July 30th, 2011 at 1:28 pm (Quote)
“The baby’s head was barely visible at all, which means there was absolutely no pressure on the perinium to numb it. The mother screamed from the cut.”
That made me wince and want to cry. Why why why would a woman want to to do that to another woman? How horrible.
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Jane Reply:
July 30th, 2011 at 6:23 pm (Quote)
If you assume a normal human being with a normally functioning conscience, I’d say it’s a justification of the way she was treated; of the way she was taught to treat others; of the way she has been treating other women all along.
You start with a CNM who goes into midwifery to help women give birth. She thinks she can help women have the births they want. Then in school, she’s forced to cut episiotomies on women she doesn’t think need them. She feels guilty. Guilt doesn’t feel good, and her supervisors tell her these women NEED to be cut.
1) Unnecessary episiotomies are bad.
2) Only bad people would cut a woman’s genitals for no reason
3) she is not a bad person
4) Therefore these must be necessary cuts
That makes her feel better, so she cuts more women. She can’t tell the difference between the women who “need” to be cut and who eventually birth without tearing, and they all look the same to her. She doesn’t conclude that only very few women “need” to be cut. Instead she concludes that in order for her previous cuts to be justified, then ALL women need to be cut.
So she starts cutting all of them. And when they make her feel bad, by not wanting to be cut, she cuts them earlier, or deeper. She doesn’t want to feel the guilt, so she finds more and more reasons to cut them, and to do it earlier, and all to ensure she doesn’t feel guilty for cutting women’s genitals.
Again, assuming a normal human with a normally-functioning conscience, I can see how someone would get trapped in that mindset. And once she’s got that much invested in believing she’s a good person, she can’t change the paradigm.
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Jena Reply:
July 30th, 2011 at 7:11 pm (Quote)
This time she picked them up, looked straight at me and said her line and cut the mother. The baby’s head was barely visible at all, which means there was absolutely no pressure on the perinium to numb it. The mother screamed from the cut.
Everything in me just SCREAMED!
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Just another reason not to get an epidural during labor. If my OB tried to do this while I was pushing, I’d kick them straight in the head. Well, that is if my husband hadn’t knocked him out first. There is no way anything sharp is getting near me.
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Erin had this to say,
Jul 30, 2011 @ 6:06 pm (Quote)
I don’t know that I agree that home birth, or even midwife based care, is as safe as ob based care in a hospital, and that isn’t an argument I am trying to start. I mean some of the research coming out if the Netherlands here of late is frankly terrifying. Accuracy and research methodology is of course an issue. But it is attitudes like this that are frankly speaking why so many women are choosing a potentially more dangerous option even in the face of literature like this. http://www.bmj.com/content/341/bmj.c5639.full
Care providers need to realize rust women are better educated in this day and age, and they need to be reasonable, rational, evidence based care providers if they want to regain confidence from their patients.
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Mama Wrench Reply:
July 30th, 2011 at 6:21 pm (Quote)
EXACTLY. Thank you.
OBs who bully women into fearing a hospital, OB-attended birth are JUST as responsible for the rising home birth rate as midwives and NCBers, if not more so. If they really want us to give birth in a hospital where they’re immediately available when necessary, why do they keep pushing us out the door by forbidding us real choice?
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Mama Wrench Reply:
July 30th, 2011 at 6:32 pm (Quote)
To be clear… I only object to irresponsible care. I don’t care who’s providing it or why, or what the setting is. If women or babies are ending up dead, injured or maltreated unnecessarily, it really doesn’t matter what the abbreviation is after the name. I’m not convinced midwife home birth is safer in terms of mortality, but neither am I convinced hospital birthing is preferable in terms of injury, whether serious or not.
Honestly… I’m just kind of disillusioned with birth in general. It seems like you can never win for losing.
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Erin had this to say,
Jul 30, 2011 @ 7:02 pm (Quote)
Mama wrench, that is it exactly. My husband and I are thinking about getting started trying to get pregnant and quite frankly I am terrified of the whole thing. The cesarean rate in my county is 40%, the only birth center we had closed after a hurricane, and the only midwives I found available were hyper christians who seem to treat midwiving as a proselytizing event with no basis in science our evidence based practice. There are no good options, especially for a woman allergic to latex, corn (as in the substance most IV fluids are made from), and narcotics, as well as having massive vein blow outs every time I ever had an iv. And these are the kind of things practitioners ignore you about. I about gave up on the whole idea of having a doctor respect me when I had an ob/gyn doing an annual who after I told her about my latex allergy she went ahead and used latex gloves and in the middle of the exam told me so by saying “I went ahead and used latex gloves because I really don’t believe latex allergies are that serious and I don’t leave it in you that long.” Yeah, everything swelled shut and I could barely pee for three days, but that’s not that serious.
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Mama Wrench Reply:
July 30th, 2011 at 8:42 pm (Quote)
Ugh, I am so sorry 
I do not, for the life of me, understand why physicians won’t simply take their patients at their word. No two people are alike, so why on Earth would they assume all women will respond to pregnancy, labor and delivery the same way? One-size-fits-all doesn’t work in maternity wear so clothiers respond accordingly. Why won’t OBs or CPMs/CNMs?
And I understand all the arguments regarding lawsuits and irresponsible litigation and malpractice insurance and blah, blah, blah. But I’ve given birth in a setting where lawsuits are irrelevant (since military doctors cannot be sued) and it’s not any better there, either. The fear of a malpractice suit isn’t what keeps OBs slicing and dicing; it’s the knowledge that, no matter what they do, if both mom and baby walk out alive and relatively uninjured (or if there’s any question that greater injury was prevented by action that would have been caused by inaction), they’ll win in court every time, if it ever even gets that far.
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angela Reply:
July 30th, 2011 at 10:40 pm (Quote)
“I went ahead and used latex gloves because I really don’t believe latex allergies are that serious and I don’t leave it in you that long.” Yeah, everything swelled shut and I could barely pee for three days, but that’s not that serious.
Ugg! I hope you made a complaint to the practice after that.
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Erin had this to say,
Jul 31, 2011 @ 2:58 am (Quote)
Angela,
No I didn’t make a complaint. That was before I knew what was what. But on the positive it was one of the event that made me research these matters (ie NCB, evidence based practice in obstetrics, etc.) thoroughly and for myself. But she was definitely one of those charming bullies that have been discussed, well liked in the community at large, heck I thought she was rational and down to earth up till that point. Now I wouldn’t hesitate to say something and to make a complaint against her license, but then I wasn’t educated enough.
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I had a necessary episiotomy with my first, but it was a rare situation. My son’s heart rate was dropping into the 40′s evwrytime I pushed. After 2 hours of pushing, doc used the vacuum, cut an episiotomy and clamped and cut the cord before he was all the way out. Turns out he had the cord wrapped around his neck and was getting strangled every time I pushed. That dr said she hates cutting and it was only the second one she had done that year (it was nov). That said, I tore with my last birth and it was soooo much easier to recover from!!! Episiotomies can be helpful in an emergency, but when they’re cut just cause the doc gets impatient, that’s just wrong!
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…so why are you doing it?
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