Nov 042012

“Well, I suppose I could suggest a psychiatrist for you, but that would just be another stranger, so I don’t see the point.” – OB to mother who had a D&C for a miscarriage under general anesthesia.  The mother had shared that she found it deeply upsetting and humiliating to have been unconscious and so exposed to so many strangers in the OR.

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 November 4, 2012  OB, pregnancy loss  Add comments

  21 Responses to ““Well, I Suppose I Could Suggest A Psychiatrist For You…””

  1. That is utter bull and so rude. No one should be disrespected like that, to have how they felt fluffed off like that. I am so sorry the mother had to go through not only losing her child, feeling embarrassed and over exposed but then just dismissed.

  2. Better to see a complete stranger than continue seeing a completely insensitve jerk-face OB…

  3. Why does everything have to be a joke to some people? The mother bared her soul to this doctor and was taunted…how cruel to kick her while she’s down.

    Can’t you just say, “It’s natural to have feelings like this. Do you need to talk to someone about this? Can I recommend a support group or therapist for you?” That way she doesn’t have to feel shamed if she says yes. Even if I did need a therapist I would never have felt comfortable asking for a recommendation after being put down like that!

    • This. Even if the mother’s reaction may have been extreme, there’s a wide range of normal emotional and mental reactions to a miscarriage and D&C. The simple reassurance that she’s not alone would itself go a long way toward healing.

      • I am the original poster. I realize that some further explanation of the context of this conversation might be helpful, so here is a little bit more detail about my experience with miscarriage and with this physician.

        This was my first pregnancy, and as I was an otherwise healthy mother with no prior risk factors coming into pregnancy, we chose to use a highly regarded Certified Nurse Midwife practice affiliated with a major L & D unit in a hospital in the city where we live. We had just moved from out of state a few months prior to discovering that I was pregnant, and I had not yet established a relationship with a new OB-Gyn. The CNM practice we chose was a wonderful fit for us, and we had fantastic care from them. Unfortunately, I was blissfully naive and did not stop to consider who I would see if a problem developed that would necessitate care from an OB.

        I found out that we had lost the pregnancy at a routine appointment at 12 weeks, and an ultrasound confirmed that the baby had died weeks earlier and my body was showing no signs of releasing on its own. It was absolutely time to discuss a the risks and rewards of a d & c versus watchful waiting, and we were referred to this OB through the midwife practice. I was in complete shock and devastated, and just sort of floated through the following days and consultations. I had an inkling at the time that this physician was a terrible match, but there were real and pressing concerns about the risk of infection and major consequences to my health and fertility without the d & c, and we did not have the luxury of time to wait the “four or five weeks” to get in to another practice as a new patient. (As someone dealing with an urgent medical concern, I find this policy on the part of several other practices we called in the first day after receiving the news totally infuriating and indefensible).

        I was not afraid of or disturbed by the idea of the procedure before it took place. My concerns beforehand related to the risk of general anesthesia and to the reality of the fact that the procedure definitively marked the end of a very loved, very wanted pregnancy. I have never been afraid of medical professionals nor have I felt anything beyond the usual “I can think of lots of other things I’d rather be doing” at my annual pap smear.

        So, I was totally blindsided when I woke up at home, with the anesthesia effects finally worn off, and felt consumed by panic when I got into the shower and saw the huge swaths of iodine all over my abdomen and legs. It was, for me, incredibly disorienting and frightening to see evidence of other people having been involved so intimately with my body and that of my baby’s while I was so unaware. Objectively, I obviously knew that that was, by definition, what was going to happen, but facing the reality of that was a different story. I was very surprised at my own reaction, and I didn’t want to feel it, because it was terrifying and upsetting and incredibly frustrating. I knew it wasn’t “fair” to use the word violated in my own head, but it was the word that wouldn’t go away in my thoughts. It was scary and confusing to feel so upset about something that I had CHOSEN….but a choice between a horrible procedure and horrible infection and death doesn’t really feel like much of a choice at all, does it. I went back and forth in my own head for days, berating myself for being ungrateful that I was healthy and fine and thinking about this instead of grieving my baby. The self-loathing was extraordinary.

        When my doctor asked at my follow up two weeks later how I felt the procedure had gone — and I assume he meant physically — I shared all of this with him. During a consultation appointment, he confidently stated that he’d never had anyone regret choosing a d & c, and that it was unequivocally emotionally easier. I wanted him to know that, while that may very often be the case, a common experience is not the same as a universal one. I thought he might find it valuable to hear how I had found myself reacting, so that it might add to his body of knowledge of possible emotional reactions in his future patients.

        I already felt like a lunatic. I already felt, very acutely, that I was “wrong” and “crazy” to feel the way I felt and think the thoughts I did. I know now, having experienced miscarriage, that “extreme” is the norm for many, many women. It is unimaginable until you go through it. Having your worst fears about your own sanity confirmed, or simply dismissed, is devastating.

        I would counsel any woman reading who is pregnant or considering pregnant to find an OB whom you trust before you need them in an emergency. A miscarriage like mine is not the normal outcome of the vast majority of pregnancies, but they do happen, and it is so important to know that you have a physician to call in the event that you are faced with a problem.

        Thank you all who have written supportively. It means a great deal to read your comments. I wish you all the best.

        • I’m so sorry for your loss, and thank you for sharing your story. The doctor took advantage of your grief and fear, and then pretended it didn’t even happen. You were thinking of others and he used that to leverage compliance and humiliation. Totally not fair. :-(

          Your feelings were neither wrong nor crazy. They sound perfectly normal to me, and I’m sorry you were treated so dismissively.

        • Elle, I’m so sorry you experienced this. I want to repeat what Jane said: “Your feelings were neither wrong nor crazy.” You shouldn’t have been treated this way by this doctor.

        • Oh, leiwi. I am so sorry for the way you were treated. It’s really normal to wake up from surgery with such overwhelming emotions. All those anesthetics they give you really mess with your mind.

  4. Entirely callous on all fronts. Wow.

  5. So dismissive and so utterly disrespectful.
    OP, I am so sorry you were so mistreated and then so rudely treated afterwards. This doc has a lot of nerve and I hope his conscience is driving him insane with guilt. I’m so, so sorry. What a jerk…

  6. Nice. The mother didn’t like the fact that she was exposed to total strangers while under anesthesia, strangers who probably conducted themselves professionally, but MAY HAVE been unprofessional or even abusive. And that makes the mother mental!?!?

  7. Yeah, the psychologist would be a stranger, but she wouldn’t be spreading her legs while being naked and unconscious in the psychologist’s office. So write the damn referral!

  8. It sounds like this OB is confused about what a psychiatrist actually does.

  9. I’m sorry to be such a dope, but what is a D&C?

    • Dilation (or dilatation) and curettage (D&C) refers to the dilation of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a last resort for a miscarriage that has failed to “abort” as in a missed miscarriage or if the bleeding continues longer than it should meaning some tissue has remained, as well as a rarely used method of first trimester abortion. it can be quite painful

  10. I actually was violated in some ways while under anesthesia, and the Dr tried the same thing(saying I had “issues” when I hired a lawyer. I specifically requested(the whole conversation is audio recorded) that unless is was an emergency, I was not to be catheterized and told this to the surgeon, anesthesiologist, and the nurse, and was told by all 3 that that would be respected. (The reason I asked for this is due to past sexual abuse.)I woke up and was “sore” down there and my panties were off. Asked the surgeon is I was catheterized and why my panties were off, and was told I wasn’t cathed and I didn’t have panties on(BULLSHIT!) Then, later, the nurse told me yes, I was cathed, and my panties were given back to me. I had panties and a pad on due to being on my cycle, so I know I had them on when I went into surgery. Plus, the nurse admitted it finally, and gave me my panties back. It was horrific. :( The Dr. lied to me about it for no reason. I now have bad PTSD about going into the hospital at all, because I really have no idea what happened, or why I was undressed at all.

    • Oh yeah, forgot to add, this was for an appendectomy. (Appendix being removed) There was NO reason for my pants to come off, much less my panties.

      • I am so sorry your wishes were not respected and that you were lied to. There is no excuse for that.
        Without wanting to take away from that at all, please let me just say that for an appendectomy they would definitely have needed to remove your pants and underclothes. If it was a laparoscopic surgery they would have made at least one of the small incisions near your pubic line and another quite low on your right lower abdomen. To keep the area sterile they would remove any clothing and apply lots of sterile draping. If your surgery was more emergent and they needed to do an open procedure (midline incision from above your belly button to nearly your pubic bone, then they also would have had no choice but to remove your clothing. And sometimes, I’m sorry to say, it’s necessary to drain the bladder to keep it out of the way of the instruments during surgery ( so they could see clearly and so it wouldn’t be cut accidentally). HOWEVER, they should have explained all of that to you before the surgery. They should have been up front with you about what would or might be necessary to keep you safe. I am so very sorry they were not honest or respectful to you.

        • Let me preface by saying I’m not a medical professional, but when I had my appendix out laproscopically, they did not need to remove my underwear. I got to keep that on, and they just had me put on a gown. Some of it may depend on the surgeon and his/her preferences.

          • Lisa,

            Not to cause an issue or bring up something bad.. but you may have had them removed or moved aside and put back on for you later. I woke up from my first D&C fully dressed.. underwear, bra, shirt, pants, socks and shoes. The nurses were very kind and awesome women (not being sexist, there literally were no male nurses in my surgery). These wonderful people were called in on their day off, after hours for my emergency surgery and took great care of me and knowing I was hysterical before the surgery were so very kind as to have me completely dressed before waking me up.. how they managed it is beyond me.. or maybe I was in that in between stage and they guided me? Regardless, they may have moved/removed some clothing and put it back afterwards for your comfort/dignity. :)

  11. All this woman really needed was a serious apology. Unfornuately, doctors have been taught that taking responsiblity leads to being sued, when the opposite has been proven. “I’m sorry that you feel that way. Let me assure that everybody acted in a totally professional manner. I can understand your reaction. I don’t like being helpless either.” would have gone a long way – unless Mom knew the bastard was lying (like Keely)in which case nothing is going to correct something like that.

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