My first week of Aunthood was enormously pleasant in between all its emotional/physical/mental exhaustion. Since Sister has been able to recover a bit (when BestNieceEver isn’t crying for four hours straight as she apparently did last night), I’ve been able to catch up with her on some of the details of the end of her pregnancy and birth. If you are squeamish about these things, feel free to ignore this post– but Ucellina and I had a good initial conversation about it the day BestNieceEver was born and I’ve learned more since and I’ve been digesting it all for several days now.
Like a lot of people, I guess I have some discomfort with the topic of labor and childbirth– which kind of surprises me because there are so many topics that make other people uncomfortable that don’t phase me a bit. My sister’s impending labor the past few months got a lot of people around me talking, including my mother– and I was sort of… disappointed in myself for finding myself unsettled in certain conversations. Sister has scared me with her behavior in several crisis situations, and maybe part of my anxiety about the whole thing is not feeling, since I have never borne a child myself, that I really knew what it was that was coming in the deepest sense. I was nervous about the pain, about Sister’s fears, about the baby’s health, about things going wrong– what didn’t I worry about?
Anyhow, now that all of that is over I feel a tremendous sense of relief. But I have pieced together some of the narrative of Sister’s experiences and there is a lot about them that disappoint me. In a personal way, of course, but in a larger political way I guess too. As I’ve said before I am acutely aware of how easily I take on others’ anxieties, especially those of my family members. And there are ways Sister was treated that I feel hurt rather than helped her in a time of great need. Finding out these things was, for me, its own trauma as well. Those stages of Grief everyone talks about– well maybe this is the Anger stage I’m in, suddenly wanting to write to Congress to demand reforms to maternity care in this country, to asuage the pain I felt to think of Sister ill-treated in any way.
So… some things in the long story that bothered me…
1. My Sister described most of her prenatal experience in this way “I just don’t think they knew what to do with me!” She underwent more Ultrasounds and Non-Stress Tests than anyone else I have encountered. This of course, was of great interest to my family because pretty much every time they did an Ultrasound, they declared BestNieceEver to be a different gender, all the way up to a week or two before delivery. (Apparently she likes to hold her legs up close to her body and didn’t approve of being re-photographed over and over again. She modest.)
BestNieceEver-to-Be was measured at 5lbs early in March. Supposedly babies-to-be are expected at Sister’s particular hospital to gain a pound a week or the Doctors determine the baby to be “better off outside than inside.” So after several weeks of insinuating to my Sister in rather emotionally manipulative ways that there must be something wrong with her Baby, the Doctors determined 13 days before the Due Date that they were probably going to “need” to induce labor. (It seems to me, not that I have a medical license or anything, that if the baby is on the smallish side but all tests that can be devised indicate it is perfectly healthy– wouldn’t it make more sense to hope and pray that the mother doesn’t go into labor before her “due date” rather than coaxing the kid out before she’s ready? )
2. Having made the determination that she should be induced, these Doctors, in their wisdom, decided WITHOUT INFORMING SISTER to do something called “stripping the membranes,” which, as I understand it, is a rather painful and dubious procedure that “hurries things along” as they say and, I’ve discovered, manages to increase risk of infection as well. Now on the particular day when the Doctors did this without Sister’s informed consent, it happened to be snowing. At the rate of about an inch an hour. While mixing with sleet. Did I mention Sister and Brother-in-Law live FOUR MILES UP ON TOP OF A MOUNTAIN? Not exactly an ideal day to make a run to SmallTown hospital FORTY-FIVE MINUTES AWAY. Sister apparently asked, in her cool-simmer-before-violent-explosion way, “Did any of you look out the window?” and none of the doctor’s staff seemed to understand what her concern was. Apparently one of the nurses said, “Well do you know anyone in SmallTown? Maybe you can go stay with them…” Even if this procedure WAS medically necessary, which I am in no way convinced that it was, couldn’t they have sent her to the hospital to do it THERE? Needless to say, Sister freaked out. THANK GOD my father’s cousin is a Big City Maternity Nurse so she could actually talk to someone she trusts who had a clue. Her response was that it was outrageous they didn’t tell her what they were going to do, and that they were idiots for not factoring in the obvious challenge of trying to drive without being killed or deliver the baby in the snow. She, very practically said that if anything were to happen they should get in their car but know that they would not be going to the SmallTown hospital they had wasted all that time touring and taking childbirth classes at, but to the CloserTown hospital half an hour away. She also said that in most cases when this is done, IF it works it works in a couple hours, so by the time Sister called, Dad’s Goddess of a Cousin was pretty reassuring that odds were good they’d be fine. And they were.
3. Sister’s water broke about 48 hours later on Sunday night. They were admitted to the hospital a few hours later and she was pretty much immediately strapped down to a bed with several IV’s coming out of her. SmallTown hospital gets a lot of recognition for having a nice “birthing facility” but I guess my Sister didn’t really get to take advantage of it. Again, I don’t have a medical degree, but what little I know about gravity tells me that lying down has got to be one of the least advantageous (or comfortable) positions to be in when one is giving birth. My limited experience with limbs falling asleep and trying to find a comfortable position in my own bed tell me that rarely does staying immobile work out as a pleasant long-term option in most normal cases, and I can only imagine everything is doubly true in a high stress situation such as this.
4. One of the drugs Sister was given almost immediately is called pitocin. It is intended to make labor happen faster. Sister and Brother-in-Law’s reaction when told that this would happen was “Um… we just got here. We don’t really think that’s necessary or a good idea.” They were not given an alternative in the matter and were told UPON BEING ADMITTED that if the baby did not arrive within 24 hours that she would have to have a Cesarean. I can’t think of anything more defeating than to be told, at the moment, “Oh and by the way, I know this sucks right now but if it continues to suck for the next 23 hours you’ll have major surgery.” How is that helpful? Pitocin is, I am told, like being kicked in the stomach by a horse over and over again and it doesn’t stop. It is supposed to speed up labor, increases the pain of contractions, not to mention fetal stress. Meanwhile, it works against the other drugs she was given so it becomes a game of a little of this vs. a little of that. Sister has been told that in the end of it all they had to give her twice as much anesthesia as is normally given in these circumstances as a response to the issues presented by the Pitocin.
5. My Sister got a 2nd degree laceration during childbirth that required stitches (all sorts of questions as to whether that would have happened if not for everything that had happened prior…). So my first hour with her after she woke up from a deep (medically induced?) sleep after she gave birth, involved watching Brother in Law carry her so she could go to the bathroom, with an enormous bruise on her back (from the Epidural), bleeding all over the floor, in a complete state of shock. There is a sign on the wall in the hospital room that says when “discharge” time is at the hospital, and all I could think at the time was– she can’t walk! are they going to throw her out of here in two days when she can barely function?
6. When asked if she wanted to feed or diaper the baby, Sister said, “I don’t know how.” Let’s be clear. My sister is not breastfeeding. She was saying that she didn’t feel competent to put a bottle in her child’s mouth. The hospital had charged my my Sister and Brother-in-Law for weeks of classes to learn how to breathe during labor and what kind of plastic outlet covers will prevent a toddler from inserting keys into electric sockets. In none of that time did the curriculum include the basics that would have empowered her to take care of her child or feel that she had a clue what she was doing. The whole first day she hardly touched the baby, making me worry madly about how the medication was affecting her and whether she was suffering from Post Partum Depression, when ultimately, I think, it was just that nothing in her experience to this point had given her any confidence that she could do what mothers have done since the beginning of time. Even the response of the nurses at the time was at best unhelpful– they agreed to feed or diaper the baby themselves and then did so where Sister was unable to watch.
7. SmallTown Hospital has a rule, which I’m told is very common, that all babies are to ride in little rolling baby carriers rather than be carried in the hallway. They cite safety reasons, which is fair I suppose– but it means that the nurses were yelling at my Brother-in-Law for carrying his own daughter.
8. One much-odder rule at SmallTown hospital is that all of the “public” paperwork lists the Mother’s Maiden Name rather than the Child’s Last Name. My guess is that this is an attempt to prevent baby snatching, but PLEASE. The nurses tried turned away each member of our family who asked to be buzzed in to see Sister WithBrotherinLaw’sLastName, saying that no such person was there, even when the child’s and husband’s names were both mentioned, and even when it was literally 2 hours after the birth and during normal visiting hours. Brother-in-Law liked to tell people that he and Sister were “under cover,” but this just ventures into completely ridiculous territory when the baby’s GreatAunt out-of-state has her flowers returned because she listed the family’s actual last name on the card.
9. The nurses came and went all day long while Sister was in the hospital, placing a great emphasis on charting every minute detail of what the child had been up to, to the point that Sister and Brother-in-Law started to get nervous that somehow there was something wrong if BestNieceEver drank half an ounce of formula one time and three-quarters of an ounce the next, or if the nurse said it’s 4PM she needs to eat and baby happened to be more interested in sleep at 4PM (I mean the kid doesn’t even have a watch!). No one spent anytime reassuring them that things were progressing normally or that the baby was quite capable of determing when she wanted to eat until their pediatrician finally came along and discovered that all of their questions were about the details the nurses kept pressing them about.
10. Now it was my 29th birthday the day BestNieceEver was born and yet I have the distinction of having been carded while ordering an alcoholic beverage as soon as last month. Well, Sister is going to be 27 next month but safe to say she will be carded well into her daughter’s teens. She easily looks like she could be 15 in a lot of the pictures I took of her at the hospital. And Brother-in-Law looks young too. They don’t dispute that they are new at the entire Baby Thing. But Sister says she strongly felt that a lot of the medical staff they encountered before, during, and after labor were unnecessarily patronizing and that that had a lot to do with it.
I don’t think Sister’s case is a horror story– I’m sure there are long lines of others who can lay claim to having a true childbirth nightmare. I don’t even think it is atypical. I just think there was a lot about it that was unnecessarily unpleasant. And that’s what bothers me about it. In many ways my Sister and her daughter received good quality health care, it is just that so many of the decisions made on their behalf seemed to take little consideration of their individual needs. Sister considers herself lucky to have delivered when she did at fairly small hospital with only one other infant on-site her first night– it could have been worse, she says. She feels she got more consideration and support than she would have if she’d had the baby even a day later. I don’t pretend to know everything, particularly on this subject, but I have very strong instincts that there is a lot about all of this that shouldn’t have been so difficult.