This post is part of a series we are doing for our local community with focus on Obstetric Violence at Abbotsford Regional Hospital. Some of the responses were given privately in direct message and some were posted in the comments thread of a post calling for stories. Last names have been protected and permission was granted to use first names or initials prior to posting. The image shown below is from Birth Monopoly and depicts the degrees and levels that define Obstetric Violence.
On Friday, March 6, 2020 a doula got in touch with me after one of the conference calls/Zoom Meetings I have been attending as a way to learn what is going on in the birth community and make connections with birth workers and birth enthusiasts. She asked me to collect stories from people in my community who had experienced obstetric violence at Abbotsford Regional Hospital.
It’s no secret that Fraser Health doesn’t like me, and the truth is that if they don’t like me it’s because I’m not letting them intimidate me. I can say what I like, as long as what I am saying is the truth. And it is. Everything I am saying is based in fact and echoed by many people in the birth community who are AFRAID to come forward. I will not expose them, but I will say that it’s a LOT of people who are afraid.
I also will not expose the clients who were traumatized by the system or on a lesser scale, felt they were mistreated or disrespected. Obstetric violence comes in all forms, and you can see that by Birth Monopoly’s hierarchical chart. It is happening everywhere, not just at ARH, and not just in Fraser Health. I intend to share EVERY STORY that comes to me, protecting the client whose story it is in the process.
I have received criticism from a few people for focusing on these “negative” stories instead of balancing out with positive ones. To that criticism I will point out that this is OUR #MeToo.
I refuse to diminish the stories of mothers and birthing people who come forward by including a “nice” story in the same post. That would be the equivalent of what Brock Turner’s asshole family and friends did when his victim came forward. Just because it didn’t happen to YOU does not mean it didn’t happen to many, many other people. So please sit down and listen, or please leave this space. But these stories WILL be told, because exposing a violation of human rights is how we END it. Consider already how there is pushback to #MeToo, but those voices are being drowned out now by the huge echo of stories that many women were afraid to speak about for far too long.
I put up a post asking for stories, thinking I would get a handful, and the response has been OVERWHELMING. Messages flood my inboxes, my comments threads, and I am trying my best to keep track of them all while also trying to recover from a nasty cold virus, so if I haven’t posted your story yet please be patient. I have a long list to go through, and it grows every day. Additionally, if you have a story to tell you can message me on my Facebook page or email EmpoweringMomsCanada@gmail.com.
This is one story of MANY that are from people who experienced obstetric violence. The experience, feelings, and conclusions reached by this individual are theirs and therefore not up for criticism. There is no “other side to the story” in this case, because there is NO EXCUSE FOR OBSTETRIC VIOLENCE just as there is no excuse for a man to beat his partner or rape someone. I don’t care if someone was overwhelmed, overtired, or “just following orders”. That doesn’t excuse what happened. If there is minimizing of the issue in which a mother/birthing person was wronged after they come forward (and so many people DON’T come forward) then that is a problem. If there is justification for what they did, that is a problem. “I’m sorry, I screwed up, I was wrong and will make an effort not to ever do it again” does NOT include any excuses, justifications, or words of apology where you know there will be no meaningful actions to change. Passing the buck will NOT fly anymore. Some information has been edited to protect the person sharing. This particular story was shared as a private conversation with me in a direct message. I have done my best to capture her story accurately.
Kaitlyn’s story is one that was shared with me in a direct message. In September 2019 Kaitlyn learned her baby was breech and attempted an ECV. For those who are unfamiliar, an ECV stands for External Cephalic Version. You can find more articles about this procedure through our Resources post under the BREECH BIRTH–ECV category. An ECV is normally performed in the OR in case it is unsuccessful and the baby goes into distress. Kaitlyn was aware there was a 1 in 200 risk that she would need an emergency cesarean, which she felt were good odds. I will be leaving my thoughts for the end of her story, with some exposition only, so that the full impact of it is absorbed. Here is her story:
“It was September 9, 2019. We went to the fourth floor and I was put into triage. It took the nurse three tries to get the IV in. After her second attempt, she called another nurse in to do it. The day dragged on–we sat in triage for two hours and then were told we could go home for an hour and a half, as the doctor was called into two other deliveries. We sat in the hospital lobby for that hour and a half and then went back up. It was 6:30 when we went back to triage, and then the doctor came to see us at about 7:45pm. The nurse reattached the IV and at 8pm the doctor flipped [my daughter] head down. The doctor reattached the fetal heart monitor and all was well with the world…so I had thought.”
“After the flip, the doctor had told us that we had to stay for an hour of monitoring to make sure myself and [my daughter] were ok to leave. At 8:20pm or shortly thereafter (I can’t remember the time as it all became very stressful) the nurse couldn’t find [my daughter’s] heart beat. My husband had asked the nurse what her heart rate was supposed to be at; which was between 110 beats a minute to 160 beats a minute. The nurse tried moving the monitor around and still was having issues finding her heart beat, and that was when she called the doctor and within minutes, there were multiple nurses and the doctor all in the little curtained area where we were being monitored. Her little heart beat was below 70 beats and wasn’t coming up. There were moments where nobody could hear her heartbeat and that was when I was asked to go on my left side, then right side, and then all fours, and none of those positions increased her heart rate. Then the doctor tried repositioning the monitor and looked at me and said, “You’re having a c-section” and I remember the nurse saying to call a code over the intercom and they all went running to make room for us in the OR–her heart rate came and went throughout the ordeal.”
“I remember being in tears and the doctor looking at me and saying everything was going to be okay. I felt like everything was not okay–they couldn’t find my baby’s heart beat and I was panicked and scared and I didn’t want anything to happen to my baby. We were wheeled onto the OR section only to be told that there were no operating rooms available. I remember the nurse asking for my chart as we were sprinting to the OR, but they didn’t have my chart because I had only been into the hospital for the ECV and nothing more. I wasn’t in labour, my waters handn’t broken; I was there for a ‘simple’ procedure that resulted in my baby having to be extracted even though she was head down.”
“Prior to the ECV, the doctor explained the risks and how there was a 1 in 200 chance that this flip could result in an emergency cesarean section, which to me was great odds, but to my own demise I was the 1 out of 200 that this could’ve possibly happened to. We waited outside the OR for what felt like hours and [I] was told that they were going to knock me right out for the csection and that my husband couldn’t be in the OR with me. However, I went to reposition myself to my left side and ther tiny heart rate went up a little so the doctor then decided that I would only get a spinal and be awake for the procedure and that my husband could be in the OR with me.”
While no one could have predicted that Kaitlyn would need an emergency cesarean after her ECV, her difficulties extended beyond a recovery from surgery. She attempted several times to get help with feeding her baby, but her requests were sadly ignored.
“On September 11th, my best friend had come to visit me and my daughter in the hospital. I had mentioned to her that my daughter was having troubles latching and staying on. That same afternoon, we had a social worker come talk to me about my traumatic birth experience. My friend asked the nurse at the nurse’s station to bring me a pump to help feed my daughter. After the social worker left, I buzzed the nurse and mentioned I needed help feeding and I would like a pump, but one wasn’t provided. Instead, the nurse told me to hand express into a spoon and spoon feed my new baby. It was painful. At shift change, the new nurse came in and I asked for a pump again and it wasn’t provided [that time] either. The nurse brought in a breastfeeding consultant to help me breastfeed and that nurse mentioned a nipple shield and I asked for one of those as well but again, that wasn’t provided. They weighed my daughter that night and her weight wasn’t quite where they wanted it to be, so the doctor said we needed to stay the night so that my daughter could feed and gain more weight.”
“At weigh-in the next morning, we had a student nurse as the day nurse. She weighed my daughter, however because she lost more weight, [rather] than send us home we were told we had to stay in the hospital all day until her weight came up. That was when a breast pump was finally provided. I pumped all day and my daughter gained 2oz and after three nights and four days, we were finally able to go home.”
Kaitlyn knew that something wasn’t right with how she had been treated and contacted the patient quality of care office 2 months later. Her experience is not uncommon when it comes to mothers who have filed complaints.
“I contacted the patient care quality office in November about my experience because I felt like I wasn’t heard when I was a patient. When they contacted me, I didn’t feel like I was heard. The lady I spoke to said something similar that “sometimes we as medical professionals forget we have patients and we just do our thing without acknowledging that you, the patient, don’t know what’s going on.” So essentially, medical staff are robots, is what I got from that, and the reason I wasn’t told what was going on was because these procedures are so routine that I really was just another woman having a baby. She also tried to reassure me that they put [a] new policy in place to stop experiences like mine from happening, but whether or not that has happened, I don’t know”.
“The same lady I spoke with at the patient care office also said that there is [a] policy in place for when it’s necessary to give a pump and nipple shield. I’m not really sure what that means, as my daughter had lost weight already after birth and then more after that initial weigh-in. So when is it necessary to provide these things, and why aren’t women’s requests acknowledged about these things? Public Health gave me a nipple shield when my daughter was 6 days old because they called and asked about this. They took this seriously but the in-hospital nurses/doctors didn’t seem to want to help in that way.”
But thankfully her story isn’t all sad; Kaitlyn expressed her gratitude for having had some very kind and helpful nurses as part of her care team while she was in the hospital.
“I did have a couple good nurses during my stay there. Nurse J, Nurse M, and the student Nurse T. Nurse J reassured me that she would be with me the entire c-section and wouldn’t leave. Nurse M was the day nurse on September 10th–she helped wash me down and took the catheter out. She assured me that my blood loss as I walked to the bathroom was normal, and she helped clean that up as it all dripped down my legs–she was awesome and also gave my daughter her first bath, which I’m very appreciative for. The student Nurse T brought me a breast pump and was very kind about this. She didn’t force me to breastfeed, she didn’t try to show me how to breastfeed; she listened to me and made me feel like pumping is normal. As sad as my experience was here at ARHCC, I’m thankful I had a couple good nurses, as the rest of my experience was marred.”
After reading through her story and shedding a few tears, I expressed my sympathies that her birth hadn’t gone the way she had expected. While I was aware (through extensive reading these past 6 years and being a member of the Facebook group Coalition for Breech Birth) that there were risks to ECV, I was curious that this procedure happened in triage; with no preparation for the possibility that an OR might be needed should a complication arise during or after the procedure. I also knew that an ECV was often performed in the OR and an epidural often put in place to manage discomfort and also make the small likelihood of a cesarean easier to perform quickly. When I asked Kaitlyn about this, she echoed similar thoughts on the issue:
“I am also wondering why they didn’t have an OR on standby. My friend’s sister had an ECV done several years ago and they did hers in an OR so I was wondering myself why they did mine in triage or didn’t have an OR just in case. They didn’t have an OR on standby or [else] the waiting outside the OR wouldn’t have happened.”
*As a sidenote, I am aware that this is not the fault of the staff at the hospital, but a structural choice in the health authority and the provincial funding, and that not having an OR dedicated to maternity care could have been a factor as to why they did not perform an ECV in the OR as is recommended.
I thanked Kaitlyn for sharing her story and once again expressed my condolences for the struggle she endured after an already difficult birth. I would like to point out now that there were things that the hospital did, at that time, that I would consider a move toward respectful care such as bringing a social worker to speak to Kaitlyn about her birth. This small gesture can be most helpful for anyone who has had a traumatic experience, and I am pleased that her care team was mindful of her experience after the birth and provided that service for her.
I am disappointed that Kaitlyn’s continued requests for a breast pump and a nipple shield were not heard, and as Kaitlyn stated herself, she “did not feel heard”. It is important that even in the postpartum period, mothers and birthing people feel heard and respected.
As for the nurses who DID treat her with compassion, it is important to recognize how that kindness that takes so little effort can mean the world to patients and to an extent, their families as well. While I despise the rhetoric of “not all nurses” when people speak out about disrespectful care, I also give credit where credit is due, and Kaitlyn wishing to acknowledge the wonderfully respectful, individualized care of these nurses is part of her story and I am happy to include it as an example of how care providers can provide respectful care in the most simple but meaningful ways.
Finally, there is the matter of how legitimate complaints are addressed and how the people making those complaints are treated. I do not feel that Kaitlyn was heard in her complaint just as she herself expressed in her story that she didn’t feel heard. This is frustrating (but not surprising) and major changes need to be made. There was little empathy for Kaitlyn when she spoke to the rep on the phone. She was told she shouldn’t expect to be treated as anything more than just another mom who had a baby. That is a very low expectation and not at all respectful. EVERY mother deserves to be treated as if she’s a person, not a number. Not a bed filled, not a statistic, not a condition. The nurses that Kaitlyn spoke of by name (I used initials, but I do have their first names in a private file) treated her as more than “just another mom”. They listened to her and helped her. If these nurses could take their time to treat her with respect, even knowing that they had other moms to see, then how can it be that so many others feel it is okay to be dismissive in the way they treat the women and birthing people in their care?
Kaitlyn further wished to thank ME for bringing this topic into the light, and I leave you with her words:
“Thank you for bringing a light to negative maternity care. Everyone wants a healthy baby, however a lot of the time our experiences are diminished with that quote that “you have a healthy baby so that makes it okay”. But it doesn’t take away the trauma, or the tears.”