Fact vs Fiction in Modern Birth: An Intro

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Childbirth is distinctly different than any other discipline of modern medicine: Unlike every other medical specialty, humans have been giving birth for as long as– well, for all of human existence. As modern medicine started to really develop at the turn of the 20th century, childbirth– once looked at a normal life process– was taken over by doctors who at first really didn’t know at all what they were doing and had very little actual understanding of the female body or birth. That either the mom or baby made it through the process of birth in early hospitals was often a matter of luck.

I joke sometimes in class that so much of what’s wrong with birth in the US, with our rising maternal morality rates, is thanks to the arrogant, misogynistic, vain, and ignorant decisions made by men of the medical establishment since at least the 1850s. Who came up with the idea that episiotomies should be routinely done without evidence to prove their claims? Men. Who decided, without any evidence otherwise that once a mom had a cesarean, all births should be cesareans after that? A man–in 1912. And I’m not saying this to make a generalization that men are terrible, but to point out so many aspects of modern birth came from those without any real knowledge of the process. Once medical research really kicked in in full force in the 1950s, we saw some outcomes in maternity care improve, but not always.  Here’s where I strongly suggest that you read Tina Cassidy’s fantastic book Birth: The Surprising History of How We Are Born. If you want to know the full play by play of modern maternity care–this is the book you need to read.

The reality is, while there are a few things that can be measured and quantified about pregnancy and birth (hypertension really being one of the most obvious situations, followed maybe by cholestasis of pregnancy), many doctors who provide maternity care struggle to fully grasp that birth can be really hard to study. However, just because some aspects about birth can be difficult to study or quantify, that doesn’t mean that evidence-based maternity care doesn’t exist–because it does. In addition to the 6 Healthy Birth Practices as laid out by Lamaze International, other strong resources and proponents of evidence-based care can be seen in the Report from 2008 called Evidence-Based Maternity Care: What It Is and What It Can Achieve and in the joint consensus statement  Safe Prevention of the Primary Cesarean Delivery from ACOG and SMFM, originally published in 2014 and reaffirmed this year.

I am a strong proponent of intellectualism. Our shift to anti-intellectualism in all facets of life is more than a little disturbing. And while I can’t address everything in the world, I can go through some of the aspects of maternity care in the US and abroad, explain where they originated, what the original motivations were, and place those beliefs in the continuum between fact and fantasy. This post is an introduction to what I hope will be a interesting project. The next couple of posts will cover the rise of early birth “methods”…and then see where that takes us.

Are you ready? Let’s do this.

Warmly,

Veronica

More birth options at Fairview!

This month marks a decade since I attended my doula training at a hotel in Bloomington. I’ve been a huge birth nerd for a decade. Regular readers know I’m a birth nerd. Anyway….

I’d written in the past when hospitals have significant policy changes. I think the last time I wrote about it was when Allina instituted a waterbirth ban and Hudson Hospital banned VBACs. Or maybe it was as nitrous became an option at pretty much every hospital and birth center in the area.

A couple of weeks ago, I was SHOCKED (in a good way) to learn that Fairview had bought the Paul Larson Clinic practice. Evidently I was living under a rock, because that happened in the 3rd quarter of 2015. BUT…now they have a midwife group at the clinic. The midwives attend births at Southdale. If this doesn’t seem like much, consider the fact that Fairview, if you took the U of M hospital out of the equation, was one of only 2 systems that didn’t have a midwife group. Allina doesn’t have a midwife group that’s on staff (and they even went so far as to restrict access for HealthPartners midwives at Abbott). I was also told that they are working on hiring midwives for South of the River.

So here’s the thing: In the 2012 report, the Paul Larson clinic was the 2nd to worst in the Twin Cities for primary cesarean rate– way above the median rate in the state. The new midwives at the clinic under Fairview’s ownership have a cesarean rate of 5% so far. That is a REALLY big deal. Some people have complained that it’s not enough, but change happens slowly at first, and then there’s an avalanche of progress.

Also, Fairview Southdale began offering waterbirths as an option as of November 7th. Fairview was pretty much the last holdout (except for that time when Allina didn’t have them, but was still advertising that they did) on offering waterbirths.

Full disclosure: I haven’t attended a birth at a Fairview hospital in years. However, I have been impressed by the speed they have been adopting certain things: Fairview’s hospitals adopted nitrous oxide before St. John’s and Woodwinds. Having one, much less two, midwife groups on staff is….well, I still can’t wrap my head around it. It’s a huge as heck step.

Now, let’s celebrate the increase in options!

Warmly,

Veronica

From the Archives: Writing a Birth Plan

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The subject of using online birth plans came up last night, so I wanted to distill my advice here on the blog. Turns out, I wrote about it 4.5 years ago. Ha! Ah well, it’s still good advice.

-Veronica

Originally published February 7th, 2012:

First of, let me say this:  I know you can’t plan your birth.  You can’t decide it’ll last only 20 minutes, or that you’ll only push twice.  Do you know this?  I hope you know this.  Rather, a birth plan is a tool that should be used by a mother to sort out her options and to communicate those preferences to her care provider.  While she can not plan what will happen, she can give a good amount of thought to how she will handle what happens.  Also?  I believe very, very much that it’s something that should be done no matter the place of birth.  Even moms planning home births need to think about what they want or don’t want.  So, after giving much thought over the last couple of days as to what makes a birth plan good, and what can make it very, very bad, I give you the following advice:

DON’T: Go to a website that “writes” a birth plan for you by having you check off a couple of boxes that sounds good.  Why?  Well, it comes across that you put very little thought into writing your birth plan.  Also, you can end up “choosing” things that are not even an issue at your desired birth place (like saying you don’t want to be told what to wear during labor at a home birth).  However, if you feel completely stuck, you can check out one of those websites for some ideas, just make sure you rewrite things in your own words.

DO: start with an introductory couple of sentences. Think along the lines of: This is my second birth.  My first birth was very long, and very difficult, with many things that felt like I was not listened to.  I am hoping for a much calmer, more supported birth. Or whatever fits your specific situation.  Make it short, to the point, and applicable to this birth. It will help the people who are part of your birth team know very quickly what you are looking for, which means that (hopefully) they will be supportive of where you are physically and emotionally, not where they think you should be.

DON’T introduce anyone and everyone in your life in the birth plan.  A birth plan is not an autobiography.  Please don’t use it  to introduce the nursing staff to your cats, or your turtles, or your childhood home that you haven’t been to in 25 years.  And for goodness sakes– no pictures of these things!

DO keep the information relevant.  If there is something about your medical history that is relevant to this specific labor and birth, include it.  Yes, it’s in your chart…somewhere.  But save everyone a headache and confusion and include that important information right at the top of your birth plan. Have you already met with an anesthesiologist and found out that you are not, for a specific reason, a candidate for an epidural?  Include that!  Is the father of the baby not participating in the birth because of religious or cultural reasons?  Include that! Trust me, it will save so much time and frustration of everyone is, almost literally, on the same page.

DON’T make your birth plan more than a page long, two at the most.  Very important information gets lost in long birth plans, and it can seem like not much actual thought went into writing the plan.

DO make sure only time-specific information is in the plan.  Don’t bring a plan to the hospital that talks about laboring at home (or how long you’ll wait before calling your midwife for a home birth). You do need to think about things like that, but it can end up burying the more relevant information.

DO write out a really long plan, if you feel you need to.  You can include things like how long you want to labor until calling your doula, or at what point you want to o to the hospital, or fill up your birth tub at home–whatever.  But then sit down with someone and go through that list with a very critical eye, and think, “What will people need to know at the time?” Then start to cut things out, leaving a shorter version.

DON’T list things that are not done at your chosen place for giving birth. If they don’t do routine IVs, don’t say, “I do not want a routine IV.” On the flip side, be reasonable.  Don’t list things that just CAN NOT happen, like, “If I have an epidural, I do not want an IV.”

DO take good, comprehensive childbirth classes so you can understand all of your options and help you understand how to avoid those things you do not want.  So, for instance, if you don’t understand why IVs might be used, you might need a class.  If you were never told the many different ways an induction might be done, you need a better class.  This might ruffle a feather or two, but knowing about something doesn’t mean it’ll happen.  Ignorance IS NOT bliss.  Hopefully there are things you’ll never need to go through, but knowing about them, just in case, is always a good idea.

And finally:

DON’T assume that writing something down means that it will be so.  Make sure that your care provider (and, since most people see a group practice, ALL the possible providers) will take the time to listen and respect your voice.  There is nothing sadder to me than telling families prenatally to address specific things with a care provider, only to watch those parents find out that  Midwife X won’t allow it, or Doctor Y doesn’t believe in it while mom is in labor.  Yes, you are the patient, but birth time should not be battle time, and if there are options, find the very best care provider to fit what you want.  And yes, it is worth it.

Quickly, in my opinion, what should a birth plan touch on?

  • support people
  • environment
  • comfort measures
  • labor positions/ tools
  • medication preferences
  • pushing and birth positions
  • newborn procedures (right after birth and the few days after birth)
  • post-birth maternal procedures

I’m sure I missed a thing or two (or three).  What do you think?  What tips would you add?  What else do you think is a MUST INCLUDE?  Add it in the comments below!

Warmly,

Veronica

Twin Cities Cesarean Rate Trends, 2005-2015

OK, so I’ve been collecting historical data on Cesarean rates in the Twin Cities metro hospitals from as far as I could go back, which was 2005. I’ve finally had enough time to pull it all together. There are some pieces of info missing, but here’s a decade’s worth of Cesarean rates:

twin-cities-cesarean-rate-trends

Back in March, I made some predictions for 2015 overall Cesarean rates. I had written:

Speaking of 2015 Cesarean rates, that info isn’t available, but I’m going to throw caution to the wind and make a few guesses. I think we’ll see an increase in rates at Woodwinds, a slight increase at Methodist and a larger increase at Maple Grove (largely as a result of the high primary rates from OBGYN West and Western OBGYN), increases at Ridges, Southdale, and Regions. I’m going to predict a drop in the overall censarean [sic] rate at Abbott Northwestern, St. Joe’s, and North Memorial. I don’t think there will be many changes at St. Francis, St. John’s, or United. As far as the Unity and Mercy…who knows. Now, we’ll have to see if I’m right.

 

So, how did I do?

I was right about Woodwinds, Methodist, Maple Grove, Regions, Abbott, and North Memorial. St. Francis saw a significant increase. St. John’s held pretty steady, and United had a teeny drop, but still a decrease in their Cesarean Rate. St. Joe’s saw the trend continue, with an increase in their rates that began in earnest in 2010. Woodwinds trended higher again in 2015 after a decrease from 2012 to 2014. Regions, Waconia, and St. Francis had the most significant increases, While Stillwater and Mercy had the largest decreases. And THANK HEAVENS that Abbott has made significant strides in reducing their overall cesarean rate after 2010.

See my previous post if you have questions about why this stuff matters. Otherwise, these trends are very interesting to look at! Now to wait again until data comes out in March again….if it comes out. If you’re looking at this data and mad that more isn’t out there, well, start pulling together the resources to get laws like the ones in New York passed. Without a state grassroots effort, we get what we get and we don’t throw a fit, unfortunately.

Warmly,

Veronica

Corrected 2015 Minnesota Cesarean Rates and Insights

First of all, I had warned that last week’s post may have some numbers that end up changing. Yeah, a few numbers changed. The reality is, to calculate one hospital’s rate, you have to go on 6 separate screens to get 6 different numbers before you can figure out a cesarean rate for one hospital. And since I calculated numbers for the 89 hospitals that provide maternity care, that….that’s a lot of screen toggling.

Second, while I’ve been blogging about these rates every time they come out, the backlash to releasing the numbers was abnormally defensive. Comments on social media were not what I’d seen previously. There are a few things I want to get straight first:

  • From the joint statement from ACOG and SMFM: “In 2011, one in three women who gave birth in the United States did so by cesarean delivery. Cesarean birth can be life-saving for the fetus, the mother, or both in certain cases. However, the rapid increase in cesarean birth rates from 1996 to 2011 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused.” You can read through the full Obstetric Care Consensus here.
  • The sad fact is, while there are times that Cesareans are truly needed, our rising Cesarean rate is causing a rise in maternal mortality rates in the United States. Overall, Minnesota is better than the national average, but some rural hospitals have rates that are too high. Discussing these numbers is critical for protecting the health and safety of pregnant patients and their babies.
  • Multiple studies, including studies published by Consumer Reports and Blue Cross Insurance networks, continue to affirm that the biggest factor in if a birth will be done vaginally or by cesarean is the place of birth and care provider preference.
  • If you’re questioning how different clinics affect each hospital’s rates, check out my blog post from the beginning of the year with that information.

This information does matter- a lot. We believe that childbirth education and informed choices are the key to empowering families that will allow them to make the choices that best suit their situations. And I do want to point out that, at least in the Twin Cities, Cesarean rates peaked in 2009, with Abbott Northwestern reaching 37.1%. Rates have gone down overall since then.

In the next blog post, I’ll compare this year’s results with those over the last decade.

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2015 Minnesota Cesarean Rates

Update 10/12/16: Corrected tables have been posted below and the old numbers have been removed.

I have had a very, very long day. Very long. A long week, actually.

But enough about me. It’s my favorite thing ever! Time to figure out 2015 Cesarean rates!!!!!!!

I can’t even tell you how excited I was when the raw data from the Minnesota Hospital Association was available. I’m SO excited that I’m going to post all of the rates for hospitals with more than 100 births. There are some limits to the info that’s released publicly, but this is true for any health information that’s made public: numbers that were small than 5 were not reported. There is a whole category that only 5 hospitals in the entire state had numbers high enough to count. This info is the best I can do right now with what info there is. It may change after a good night’s sleep and my eyes are no longer crossed.

More posts will come in the next few days, including some handy-dandy printables you can use because, while I’m thankful for the Pawlenty Administration for mandating this info get released, ease of use was not a priority.

Enjoy, and be peaceful to one another.

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Insurance reimbursement for childbirth education

With third-party reimbursement for childbirth education, one of the biggest barriers that exists in policy discussions is that not all stakeholders, including the educators themselves, understand what the current system is. The system is intricate and always changing, but on the surface, it boils down to three things: What is covered, who can render services, and how much are they paid.

Part of our existing insurance system is controlled by the federal government. A good example of this would be how the Affordable Care Act mandated that breast pumps and breast-feeding support was a covered benefit. Otherwise, most healthcare regulation decisions are made on the state level. This is where childbirth education falls right now: the coverage varies from state to state, and can change as new statutes are passed.

In Minnesota, childbirth education is considered a mandatory covered service by the Department of Human Services for residents who have coverage through Medical Assistance programs. Strangely, newborn care education is not considered essential, so as a standalone class it is not a covered service, but birth classes that include this information can be billed to insurance. Residents who are on Medical Assistance are either enrolled directly through the state’s Medical Assistance or MinnesotaCare coverage. Some of the plans are managed though the state itself, but most are have PMAPs (Minnesota Prepaid Medical Assistance Project plans) that are administered through Managed Care Organizations.

So then, in Minnesota, not all employer-based insurance plans or plans purchased by individuals have the same coverage parameters. So while some do reimburse providers for in-person group classes, other health plans consider access to online information or sending pregnant patients a book as an acceptable way to deliver childbirth “education”.

Most state’s health departments then decide who can provide services– what kind of credentials they need to have and if they have to bill under a supervising provider. Again, in Minnesota, I have to operate under a “supervising provider” as an LCCE. It usually doesn’t take much digging, but each state is different, so what applies here may be different, but states are currently in charge of the “Who.”

As for the how much…that gets really complicated. Reimbursement rates for Medical Assistance services are set at the state level, and many of the rates haven’t been adjusted for inflation in 10-20 years. Employer-based plans set their own reimbursement rates, and those rates can vary even within the same insurer as determined by what the employer has negotiated. For example, you could have Blue Cross Blue Shield insurance and the contracts would say that if the provider bills the insurer for a procedure at $150 and the contractual obligation would be to only reimburse $110 of that money; Somebody else with a Blue Cross Blue Shield insurance plan with a different employer might have that same service reimbursed at $97 when it was billed for $150. And then you have some other insurers who would take that $150 that was billed and only reimburse $35.

Not just anybody can bill insurance though, even if you are providing care within the state’s parameters. If you are not contracted with an organization as a provider, then anything billed would be out of network and would be subject to reimbursement rates set by the plan for out of network reimbursement. This really only applies to employer-based or individual plans; I’ve yet to find a state that allows billing reimbursement for out of network providers.

Hopefully this brief explanation helps you understand the very basics of third-party reimbursement for childbirth education as it exists today. If childbirth education is covered depends on which state you are in. Who can provide that childbirth education in a way that’s billable is also up to each state. The how much is something spelled out by each plan coverage. It’s not an ideal situation in the slightest; however, anyone who  wants to fix something first needs to understand how it works, otherwise it’s very likely any attempts to fix it will break it.

I am hosting a series of workshops, first for doulas locally, later for birth professionals via webinar. If you’d like to notified of upcoming dates, sign up for the professional development newsletter below.

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Parent Shame and Car Seats

It’s National Child Passenger Safety Week!

Last week, in a fit of irritation, I wrote a little tweetstorm on how irritated I am with the notion of “parent shaming”.

And I really meant all of it. Yesterday, I got called to help a very well-meaning family who knew something was up with their car seat and wanted it to be installed correctly. Once I got there, though, I looked at the seat and realized it was not only an expired seat, but a recalled seat. But it’s so common to buy used car seats, many parents don’t even question it.  Or what about this viral video from last month? Here. Here’s a screenshot:

bad-car-seat

I haven’t watched the full video, nor do I care to. Why? Because every time I look at this I get sick to my stomach. Not only is this an infant seat that’s ONLY supposed to go backwards, but I’m pretty certain it’s close to 10 years old, the straps aren’t even on one of the little boy’s shoulders, and my WORD…what is going on with the seatbelt? It’s over the arm, it’s…it’s just a mess. There is almost no likelihood that this poor sweet little boy would escape a crash without major injuries or worse.

Or what about this video?

bad-car-seat-2

The straps are too loose, they are falling off, and she’s too young to be facing forward. Truthfully, 99.9% of the videos and pictures parents post of their kids in car seats have at least one horrible, obvious flaw. Nothing else you buy is THIS critical to keeping your child alive. Nothing. And yes, for a variety of reasons, car seats are just really hard to use correctly. It also doesn’t help when parents so commonly are exposed to other parents making unsafe choices, such as:

  • Buying used car seats
  • Choosing to use expired car seats
  • Placing car seats on top of carts, tables, chairs….
  • Keeping babies in a car seat when they aren’t in a car
  • Turning a baby to be forward facing when they turn 1
  • Letting a baby nap in a car seat outside of the car
  • Not keeping a baby buckled in when the car seat is being used in a stroller
  • Using coats under car seat straps

Parents don’t want to hear that they’ve been doing something that puts their children in danger. I would never DREAM of going up to a parent when I see any of the above things. No matter how it’s phrased, it’s never taken well. Ever. So we try to educate broadly, and I go along and say a silent prayer every time I see a baby sleeping in a car seat, head falling forward, or a $450 car seat precariously perched on top of a shopping cart.

If you’ve been committing any of these car seat cardinal sins, today should be the day you stop. Car crashes are on the rise as more and more people are driving while distracted. Nothing is more important than keeping your children safe. There’s always a solution to every car seat problem. Have a trained professional, a Child Passenger Safety Technician (like me!), help you out if you need it. But really, don’t brush it off. Please.

Warmly,

Veronica

The Allina Strike: Another Mom’s Warning

Veronica: I’ve been continuing to collect stories from moms who gave birth during the June strike at Allina hospitals. Another strike started today at 7am. Staffing levels are lower than in the last strike. Not all birth workers share this sentiment, but going to a hospital during a strike is risky. Talk to your doctor or midwife, with the caveat that many of them didn’t take the last strike seriously. Contact me if you have questions, concerns, or stories you’d like for me to share here.

Below, a story from Jessica, shared in it’s entirety with permission.

Upon walking through the doors of Abbotts Mother Baby Center in Minneapolis on June 19th, a cold and erry feeling came over me. The feeling of walking through an abandoned building, the uniforms were different; almost like guards in a prison. I never saw a smile– only the faces of replacements looking confused, frazzled and pressured. Wasn’t this suppose to be the happiest and most friendly place welcoming new life? Not here.
After patiently waiting for my name to be called, bags in tow and my husband by my side, we were lead down an empty hall into a room and simpy left alone. My contractions were fierce, I was hurting with tears of pain, not joy. And finally we were joined by a women who couldn’t explain why we couldn’t hear my son’s heartbeat until she was assisted by another 2 women. He was of course healthy as could be! It was then confirmed, we were having a baby on Fathers Day! My husband was thrilled to have a healthy son born on his day!

But we couldn’t get over the fact of how inadequate the replacements were. Once we arrived in our 2nd room, it was time to be hooked up to countless machines and ivs. It took my nurse and 2 other women with 4 times and blood everywhere to correctly place my IV; it was a bloody mess. My husband had to direct the many women who tried to help but thankfully my husband knew where the blankets were, and many other things in the room were that were needed to comfort his wife and mother of his children.

It was only 7 hours after being admitted that I heard the sweet cry of my baby boy, never was he placed on my chest, never was he cleaned from the mucus covering his sweet glowing skin. I still kissed him and the mess didn’t matter. I was never guided to breast feed, I was never escorted to the bathroom to clean myself, luckily my husband had been through this and helped me. My epidural was not effective , so I was able to care for myself immediately. I don’t think we saw a nurse for almost 2.5 hours after delivery, we enjoyed the time alone but knew I was missing something.

As the nurses prepared to do the newborn screening, my son began to choke and I had to direct the nurse to please help my baby breathe, and they immediately started to do the newborn screening- it took almost a half an hour and 3 attempts to get him to bleed enough to complete the pallet. As we sat there helpless listening to the screams of my baby, I was broken inside. Needless to say, we very adamantly pushed to go home after 24 hours; we knew we could care for our baby alone in the comforts of our home as a family of 5. Since then, we have watched our son grow into a beautiful healthy baby.

 

Allina’s Replacement Nurses and Patient Neglect: Another mom’s story

Nurses Union

After I shared Lisa’s story Monday and Tuesday, another mom contacted me who had given birth during the strike. This time, the circumstances were a little different; Ashley had a planned cesarean. She was still suffered from incompetent care, and she wasn’t given food, water, or medication for long stretches of time for the duration of her 4 night stay.

When you read her story, please keep the following things in mind:

A few things are starting to become clear: While staffing during the strike might have been adequate in other departments and other hospitals, the night nurses at Abbott from 7PM to 7AM did not take care of the patients. Food, medication, and water were withheld from at least 2 moms for very long stretches of time. Only very vocal family members saved these moms from total neglect.

Penny Wheeler is a former OBGYN. Again, she claims up and down that the replacement nurses took good care of patients, but no decent OBGYN would find this to be safe care. How can anyone justify the care that these moms received? I’ve spent the last decade of my life advocating for good maternity care, and nothing has angered me as much as hearing this care happened within my own city.

As before, if you have questions about your care options after Monday, contact me. If you have a story about your care that you want heard, contact me. My phone number is 651-200-3343 and I can be reached at veronica@babylovemn.com

Ashley’s story is below. It was edited for clarity, and I have been given explicit permission to post it.

I had a scheduled C-section on June 22nd, 2016 due to my son being breech. When I arrived at Abbott, I noticed that there were hundreds of people walking around protesting only to learn these were the nurses I had gotten to know over my entire pregnancy journey.

I was scheduled for surgery at 12pm, and up until I was brought into the OR everything had been going great. Then things went downhill.  The nurse who was assisting with the surgery was holding the clamp opening up my incision pulled so hard that she fell backwards off of the stool she was standing on. This ripped my incision open larger than needed and made for an extremely crooked scar. I was not allowed to hold my son for a good 45 minutes once he was taken out, but not because there was any complication. I begged and pleaded to get some skin to skin contact with him as I knew it is very important in the breastfeeding process. I was told skin to skin was unsanitary for me while being in the operating room.

Once I had been all stitched up, I was put into recovery while they made sure my uterus was shrinking and I wasn’t going to lose too much blood. At this time, they noticed my son was grunting and took him to special care to be evaluated for fluid in his lungs.

Two hours later I was brought up to my postpartum room and was introduced to my first nurse. She was amazing, and I would take her again any day. She promptly gave my meds and kept my water full, but she wouldn’t allow me to eat anything. She informed me about everything going on and kept me cleaned up well. I asked when I could go see my son and she said as soon as my catheter was removed. I was told the next nurse would do it immediately after shift change at 7pm– at that time, it was around 6pm.

When 7pm came, I paged for my nurse. I was in excruciating pain and I was bleeding so much that I had bled through the pad I had on and the blankets on my bed had become saturated. I paged my nurse at least 3 times, but nobody ever answered my calls. My dad came to visit. He found me sitting in a bloody mess,  bawling my eyes out. I was desperate for help that I was not receiving. My dad was outraged and tracked down any nurse he could to help me. At 9PM I was finally given my pain medication. I asked again about having them take out my catheter; by 10pm it was finally removed and I could go see my son.

While my son was being kept in the nursery, the staff had done an x-ray and his lungs looked clear. I had received a call from special care at 8pm saying my son had still not been fed and he was delivered at 1:18pm. He hadn’t been fed anything at all since he was born, and his blood sugar dropped to 35. I asked to breastfeed him, but I was told that was not allowed. I was told I could pump to feed him, but because I’d had a cesarean, I wasn’t allowed to breastfeed him. I was heartbroken. The only options I was given for feeding him was donor milk or formula.

I got to him around 10pm and stayed until 11pm. I went up to my room to rest and let my body recover. I was told 3am was his next feeding time, and I was welcome to come bottle feed him–but I still wasn’t allowed to breastfeed. At 3am when I came down my son had an IV in his hand. Neither his dad nor I ever gave informed consent for this to be placed. Then the nurses told me they had to give him sugar water because his blood sugar was still too low. They didn’t mention to me that his blood sugar was low when I had been there 4 hours prior. Then they also informed me they started a preventative antibiotic while I was away to stop his grunting, and he was going to have to stay in special care for at least another 48 hours. I cried as they told me if he pulls out this IV would need to put it in his head. I felt scared, sad and angry that not only they had done these things to my baby without me knowledge or consent, but that they could threaten more procedures. Infection had been ruled out prior to this IV, so I knew my son was fine without then.

On day 2 of my stay again my morning nurse did a fantastic job. My night nurse completely neglected me; she never filled my water or told me where I could go to fill it. She didn’t bring me my pain meds until 6am– right before the end of her shift. This occurred all 4 nights I was there. By 7am I was begging my good nurse to help me get the pain managed again. And it would continue to relapse at shift change every time.

My last night I was finally able to have my son with me in my room. The morning nurse was there to help me breastfeed him finally for the first time. He latched great and stayed on 30 minutes each side she was so supportive of me the entire time wanting to breastfeed my son. She promised the second I got him I could feed him myself and kept her promise.

A week and a half after I was discharged, I developed a staph infection in my incision. Originally, they told me I was mistaken. I insisted on a culture. They finally did it and sent me home that I would get results later. Next day they called me and told me I had a serious staph infection;  they sent antibiotics to my pharmacy that I needed to get immediately. If nothing got better in 3 days I was to go to urgent care. Thankfully, the infection cleared.

I encourage anyone due during strike to do your research before going through with your delivery. I also want to apologize to any other mothers who had a terrible experience during their deliveries. The delivery of my son turned into the biggest nightmare I could have never imagined. I expected it to all be so happy and didn’t imagine I’d be so depressed throughout my hospital stay. Thankfully my son and I are both extremely happy and healthy since being home.