This glared out at me! I don’t know, because you speak nothing of it, but I’d *highly* encourage you to create an “All the wonderful things that can happen” birth list. In each of your writings, the post and the last comment, it is all pinpointed towards the pain… and I do understand that, but now that you’ve disclosed you are pregnant again, I want to be there to help you turn the light from the pain and negative, opening the circle so you are able to acknowledge all the really cool things you can have happen this time. Perhaps a list of things you want? A wish-list even. Just because you write it down doesn’t mean you are chained to it, but it is fine and helpful to have the “perfect” picture you’d love if you could choreograph everyone, including your child. As the sentient being you are, you will remember there IS no choreographing everyone or every thing, but nodding and saying, “Oh, I recognize this!” when you “see” something or someone during your experience can help your walk tremendously.

I am going to STRONGLY suggest you not have your mother anywhere near this next birth. I think working through the abandonment issue with the midwife is crucial (especially if you have the same midwife).

An anecdote: I had a mama who needed me as a mother figure. Her own mother was mentally ill and emotionally unavailable to her as she grew up and had children. Her first birth was extremely traumatic; she nearly bled to death, so she was filled with fear during the pregnancy I worked with her. We talked endlessly, my being the soft and loving mother figure throughout. (This was earlier in my midwife-life.) I even said to her, “I am glad to be your surrogate mother during this birth. I will hold you and love you and I WILL NEVER LEAVE YOU.” Emphasis because I sealed the fate of that birth experience by saying that. 2 days of tremendous labor, a couple of excruciating, screaming vaginal exams to break adhesions and figure out the baby’s position, the decision was to take her into the hospital. As we were gathering our belongings, another mom called… her first baby’d been born in 6 hours, so it was a sure bet she was going to go fast. She also lived 75 minutes away. I had to leave.

I had to leave.

I held the mother and apologized profusely. She looked at me with terror in her eyes. I was sending my then-apprentice Donna with her and said, harshly and loudly, “DON’T LET THEM HURT HER WITH VAGINAL EXAMS.” And off they went.

I sobbed all the way to the next birth. I was an exhausted mess and had to call another midwife to replace me. I hadn’t slept for about 40 hours (and for someone with bipolar disorder, that is NOT good) and when the other midwife got up to the second birth (that was taking SO LONG), I drove the 90 minutes home, passing the hospital where my first client was… as she was delivering. I debated going to see her, but I was falling asleep at the wheel as it was, so I sobbed as I drove home, spilled myself into the bed and slept for about 10 hours.

When I awoke, I learned the first mom had a vaginal birth and then nearly hemorrhaged to death again. It was a torrential hemorrhage that was seconds away from a hysterectomy to save her life. While I had given my apprentice instructions about watching her dear vagina, I had TOTALLY forgotten to tell her to tell them of her hemorrhage history. I was so emotionally invested in her experience, I had neglected the crucial, life altering MEDICAL information of her history. I crumbled for months after this and it took over a year before the mom could speak to me. We now are able to talk about the experience, though it stings both of us terribly, in different ways.

My second mom had an acynclitic baby and, despite having had a beautiful homebirth the first time, she transferred into the hospital and had a cesarean… with the other midwife who stayed with her. I had emotional healing to do with her as well. She remembers most when I went to see her the day she got out of the hospital and I painted her toenails. She said that was so loving… I barely remember it… but I am so glad I did it.

All this is to share that even someone who’s considered a pretty good midwife can make stupid mistakes/decisions. That fate has a hand in what happens when we do EVERYTHING in our power to strong-arm it into submission. That words sometimes flutter into the ether as we reach to capture them… the closer we get, the more vaporous they become.

Working on the trust issue with a midwife IS crucial, but there will be a moment… some moments… when you will have to find a way to trust. Someone. Life in this culture is wrapped in interpersonal connections. We have to trust the mechanic not to set us up by removing a bolt somewhere. We have to trust that the manufacturer of our organic clothes really does only use organic cloth. It is good to question, to research, to arrange what you can, but, in the end, trust has to come.

Trust of your Self. Trust of the process. Trust that you will do what is right, even as things might ebb and flow in a different way than your Dream Birth.

I fall short of saying Trust Birth because I say, “Respect Birth.” A healthy respect gets you much further than trusting birth on her own. She is like the weather and earth in San Diego. Most of the time great, but occasionally disastrous. We do the best that we can in any given situation.

And no matter what, your experience will NEVER be the way that it was. You are not the same woman you were then. You will not allow the same naivete, lack of control, coercion and fear to collapse you. Your knowledge will guide you into a different place. It might not be perfect, but it will certainly be different.

But the EFM’s didn’t show distress when the episiotomy was performed. Meconium in the fluids were the only indication, and that’s indication enough. (I have the medical records.) Regardless that they got strong heart tones all the way until he came sliding out, he had none after that. He had to be resuscitated.

And for the coercion, let’s put blame where it belongs . . . my MOTHER cajoled me into pain medications with the HELP of the nurse.

And, yes . . . it was all normal hospital procedure. And I signed papers to take “the hospital ride” because my midwife wanted us to transfer. And, even though our signed contract stated that she would stay at my side as my doula, she LEFT ME.

And now that I’m looking into options for my second birth, I just keep remembering what I learned from this birth . . . That being afraid is OK. That even though I had a birth that didn’t go the way I wanted, I still felt SO CONNECTED. That I tasted a bare fraction of what birth COULD be, and I got hooked. Even through the drugs, the pain, the broken bonds of trust. Even through the nightmares and horror I had to drag myself out of, the sleepless nights . . . that I believe in myself, that I believe in birth.

The following is copied from my Solace For Mothers forum:

“03/11/09
A few weeks ago, I lay next to my slumbering men, still awake (insomnia is one of my most persistent symptoms), and I was thinking about if I got pregnant again.

Up until that point, I’d had a mental block. All I’d been able to picture or think (obsess about) in regards to another pregnancy and birth was how DIFFERENT and WONDERFUL it would be . . . How different and wonderful I would MAKE it be.

But then I finally let myself feel the horror and trembling fear of all the terrible things that could happen. I thought, “I could end up at the hospital. I could UC and die from complications. I could go with a midwife and be disrespected and have my birth stolen from me. I could have placenta previa and a C-section. I could be coerced into a C-section for any number of reasons. I could have a normal, beautiful birth and then die from blood loss. My baby could die. I could die. I could get hurt again.”

It was a huge floodgate, but I felt really energized by it . . . because, in the back of my mind, I heard a voice that said, “No matter what, I believe in Birth. I believe in myself. Things don’t go according to plans. What will happen was meant to happen. What has happened was meant to happen. No terrible incident can convince me that everything is bad, because I KNOW–because I TRUST. I know much more now, and I can be at peace with another birth no matter where, when, how, and I’ll figure out the why’s for myself.”

“My body knows birth because it is written into my cells, in the fabric of my spirit, and on the waiting hearts of my children. I know birth because I was born, because I have borne a son, and because I am a woman. I know birth because I have opened my eyes and seen that it has many different levels of existence, just as women have layers to themselves: The faces and shells, their words, their deeds, their secret yearnings, their dark and powerful selves, and the bright and unending light of their souls.”

Before, if I said “I’m ready to have another baby,” it would have rung untrue for me.
Now, if I say, “I’m totally unprepared for another child,” it rings untrue. Not that I’m ready. I’m just . . . past a certain point of denial.”

I could only have embarked on this journey of pregnancy again, with the support of my partner, with the excitement of my toddler, and with readiness in my own heart.

So, let’s see how this next birth goes.

-Leslie

It’s obvious you didn’t have the support you needed, didn’t have someone who was your walking/verbal birth plan. If I were your midwife, I either would not have left or found a doula to come in in my place. The doula would have been briefed before walking in. I’m sorry that didn’t happen and it is a really confusing part of the story for me; I just cannot imagine leaving a client alone in labor after a transfer/transport. To me, it is up to the midwife to speak up for the client so SHE is treated well. The midwife might
take a lot of flack, but she can suck it up and deflect the anger/frustration from being foisted upon the client.

Having done this for 26+ years, I can tell you that women often/almost always get to a place in labor where they cannot make a decision. “Do you want some water?” Instead, offer and if she doesn’t drink, she doesn’t want it. Do we sometimes tell women/encourage them to drink anyway? Absolutely, but only when she needs it to keep going and to nourish her child. Women who get dehydrated can get a fever and the baby is affected and then a transfer can happen when all that was needed was a few sips of water every once in awhile.

This brings me to a point. When I work with women, home or hospital clients, the goal is to develop the trust necessary to weather the moment that can come when the midwife says, “I need to give you pitocin; you’re hemorrhaging.” (Actually, I say, “I need to give you pitocin; you’re hemorrhaging. Okay?”) A midwife/doctor sometimes has to make an emergent call and it is imperative for the mother to agree in order to save her life or that of her baby. Agreement is typically implied. If she is in the hospital, she is agreeing to the hospital’s rhythm, the emergency services available.

But trust is crucial. If there isn’t trust, that opens the room for coercion – and you experienced that first hand.

As a provider, I have suggested an epidural for a woman. I have not manipulated or coerced a woman into accepting one. As we say in childbirth classes… epidurals are wonderful for women who are suffering, but women who are coping don’t need to be pushed into them. I am guessing your mother and the nurse assumed you were suffering and out of your mind refusing the epidural. Especially women who moan or writhe in labor can look like they are suffering. In fact, it was your mother and the nurse who were suffering and both needed another person to tell them you were doing perfectly fine and to please stop trying to convince you to have an epidural.

Women must be muted in the hospital or the nurses would have to help each woman through her pain. Nurses don’t have time to do this. Also, it would break their hearts to sit with women needing great amounts of emotional support. It takes a special kind of person to be able to SIT with a woman in labor, not attempting to DO anything for her process. It is one of the hardest things we try to teach partners… to not try to FIX the pain, but to bear witness to it.

The hospital would never believe they coerced you. I hear the other comments saying they can’t believe what the nurse did, but I am not surprised in the least. That is how the grand majority of nurses are; they don’t understand natural birth and have zero clue how to support a woman through it. They know epidurals. They know that women who are quiet are easier patients and allow them to get more paperwork done. It doesn’t surprise me at all how your nurse acted. She was the norm. So, the hospital gave you papers to sign when you came in and included on those papers were saying you consent to (basically) anything they wanted to do to you, up to and including a cesarean (although most hospitals do have separate paperwork for women about to have a cesarean). The episiotomy was consented to when you signed those papers. Was it right for the doctor to just do it? Absolutely not… unless the baby was crashing. You don’t talk about those last moments of birth but to say your child was in the NICU for a week. Was the baby near death at birth? An episiotomy might have been warranted. Doesn’t mean he couldn’t have said, “I need to do an episiotomy to help your baby, okay?” I cannot imagine many mothers who would say no. Would that have made a difference in your postpartum emotional/mental recovery? Just that request “okay?” It’s impossible to know at this point. Your experience was what it was.

I tell women who have been hurt as you have and who are going to have another baby. You can’t be here unless you were there. Women who have traumatic births become fabulous birth advocates. The understand, in a visceral way, the importance of trust and consent. It is important for them not to replay their own births or to attend to women as a healing for their traumatic births; it is vital to allow each woman’s birth unfold in its own way, even if it would suck for you to have that kind of birth. But, women who become pregnant again make different choices. That can be the most healing action of all.

It will be interesting to see how your next birth unfolds and to see if it is healing or if it continues to leave your first birth as a very sad and sorrowful taste in your mouth.

I wish for you healing and peace with all that you experienced.

Thank you for sharing. I feel so much less alone now.

Thank you for sharing this. I will be subscribing to your blog.

I am now a birth doula because of this experience. I had 2 great births after my first, but his has left me very wary of hospitals and their goals. I pray that you will overcome your PTSD and find phenomenal support for your next birth.

I will be sending clients to your story.