Showing posts with label trauma. Show all posts
Showing posts with label trauma. Show all posts

Tuesday, April 24, 2012

Vacuum Injury

Vacuum injury.  That is what it is called in the medical world apparently.  Funny how we have been dealing with this crap for 2.5 years and that is the first time I have heard that term.  But according to an OB that recently reviewed Fisher's records - his injuries are textbook vacuum injury.  He said that the vacuum injury was of course caused by the brow presentation but that even pitocin induced contractions couldn't have caused the amount of damage on Fisher's face.  He said there is no way for a vacuum to cause such an injury except in a malpresentation situation.

I know it doesn't change things.   But having the cause of Fisher's problems laid out so simply, so succinctly is hard.   It would have been so easy to say "No, no vacuum.  Stop." I didn't.  I couldn't.  I didn't have the information and my head knows that I can't blame myself.  But sometimes my heart doesn't listen.  On the other side of the coin - in some ways "vacuum injury" is a little easier to stomach.  In my head I had always imagined Fisher's injuries developing over 22 hours of labor.  Thinking that the majority of the injuries happened over a shorter span is a little better to me.

This has been and continues to be such a long process.  In so many ways it would be easier to stop thinking about it, act like it didn't happen, and move on.  I know that many people could do that and a lot of times I wish I could. But I just can't ignore whatever it is inside me that keeps pushing me forward.  I ignored my intuition while I was in labor with Fisher and if there is one thing I have learned in this whole ordeal is that I will never make that mistake again.

Monday, December 5, 2011

The Gray Area

 For the past two years I have tried to reconcile my thoughts and feelings over Fisher's much needed c-section with my desire for a natural birth.  It is not unusual for women to have a c-section and then regret it.  Or to do research and question if a c-section was ever needed in the first place.  I don't fall into that camp.  I wish I would have had a c-section earlier on.  Go ahead and gasp if you are a natural birth advocate, but please read on....

Prior to having my son I did a ton of research on "unnecesareans" and I really felt like if I could go into labor naturally that I would have a vaginal birth.  I was super excited for labor and was ready to let my amazing body do what it was meant to do. I knew prior to having my son that coming into the world naturally would be the best start for him and for me as his new mother.  I knew that from all the research I had done but I also knew it inside.   It just seemed right to me.  I also knew that in the area I lived in this was very,very unusual.  But I wasn't worried because I had a plan.  My plan was to go into labor naturally and go to the hospital and put up with some BS but by avoiding the induction I would ensure myself at least a vaginal delivery. 

Things didn't end up that way though I did go into labor naturally.  I had been in prodromal labor for a couple of days and when my water broke I went to the hospital like my doctor instructed.  I was happy and felt so excited because I felt like I had won the battle.  I went into labor naturally and thus I was going to avoid major abdominal surgery (inductions increase your c-section chances by 50%)!  I was going to have skin to skin contact immediately after my son was born, get to hold him, look into his eyes, and introduce myself to him.  I was going to breastfeed him and cover him with kisses.  And oh yeah - I was also going to have an easy recovery and get back on my feet quickly because that is what I do. 

Things didn't end up that way either.  I get to the hospital with my water broken and in labor and the nurses pretty much freaked out.   The on call doc came in and introduced himself to me and I didn't see him again for about 18 hours and after I had been pushing for over an hour.  During that 18 hour time period where I didn't see him in person - he was ordering all sorts of things to "fix" my labor.  Pitocin, more pitocin, and more pitocin.  At first I declined because I knew that labors can stall out - but after a little longer I agreed to some pitocin. I thought it would be just enough to send me over the edge and let me push that baby out and move on to the next stage!  Ah, but the pitocin wasn't working and Fisher's heartbeat was decelerating.  So the pitocin was stopped for a while and tried again - he seemed to tolerate it better though I still was not dilating.  So more and more pitocin was ordered.  I was very uncomfortable with it, but I was afraid to say anything, because I am not medically trained.  Just some crunchy wildlife biologist who thinks that she is a mammal or something.  During this time I was never examined by the doctor.  He somehow knew what was going on in my stomach from afar.  After all, it was Sunday. 

So after hours and hours of pitocin hell I finally get to 10 cm and I get to start pushing. It was elated!   I freaking did it - I put up with all the pitocin and not moving but I was going to push my son out and hold him and that would make it all worth it.  Just give me my baby!

Only it didn't happen that way.  I pushed and pushed and pushed.  I worked harder than I knew I could.   The doctor came in after a while and I pushed and pushed some more.  He said he needed to use a vacuum.  I was just ready to be done.  The vacuum seemed to go on forever.  I knew that pushing a baby out could be hard work and take some time, but I started to get the feeling that something wasn't right.  And then the doctor said he thought something was wrong and I needed a c-section.  At this point I KNEW I needed a c-section.  It didn't make sense to me, I had no idea why in the world Fisher wasn't coming out, I knew it wasn't for lack of trying, but I knew that something wasn't right. So I went to the OR completely exhausted but not deflated.  I had done everything I could do and I knew it.  I was going to finally meet my son.

And then my son was born.  He was born beaten up, bruised, swollen, and was whisked away to the NICU.  The OB explained that he had been brow presentation which is why he wouldn't come down the birth canal - it was geometrically impossible.  And that geometric anomaly caused lots of problems.  Fisher had major facial trauma from his face being crushed against my pelvis with every contraction. See, I wasn't dilating for a reason.  I wasn't dilating because my son wasn't positioned properly to make a decent down the birth canal.   My body IS pretty awesome. It didn't fail me at all.  It knew that Fisher couldn't come out the way he was positioned so it didn't dilate past 5 or 6 cm.  But what my body and Fisher wasn't prepared for was the onslaught of fake contractions.  Pitocin induced contractions that after hours and hours, finally pushed his forehead down hard enough to dilate my cervix to 10 while crushing his face.    And the vacuum - the vacuum continued the assault on my son's head.  Pitocin and vacuums are contraindicated for brow presentation babies because it can cause these injuries. And they can also break a baby's back. Thank God that didn't happen. 

So basically, I am in this weird gray area. I am a very natural birth friendly mama that wishes I wouldn't
have even attempted to vaginally deliver my son.  He would have been so much better off. My son needed to be born via c-section as soon as I came into the hospital with my water broken.   Brow presentations can convert to full face or to vertex but if they don't convert they can't be delivered vaginally 99.9% of the time (a lot of medical literature say 100% of the time, but I have found one or two stories in which a brow presentation was delivered vaginally.  Regardless, it is pretty much impossible).   Because of this most OBs recommend a c-section immediately upon diagnosing a brow presentation.   However, that didn't happen because the OB didn't realize my son was malpositioned. 

So where does that leave me?  It leaves me at a place where I feel like the system failed me.  Many women have a realization after a c-section that the system failed them and they maybe could have avoided the c-section.  I am on the other end of the spectrum.  The last thing I wanted was a c-section, but under the circumstances that was the one thing I needed more than anything else.  Does that make me pro c-section now?  Kind of - I am very pro c-section in certain circumstances.  But what I learned from my son's experience is that what was was lacking was the one-on-one care, concern, and attention by a skilled provider.  See, I had convinced myself that I didn't need a provider that really took time to know me and one that I trusted because I was the one having the baby.  The OB was just there to "catch" it.  Most of the time I think women's bodies are amazing and will do exactly what they need to do to birth a baby.  But there is always those exceptions and THAT is why we pay people to be there for us.  To notice signs that something might not be right.  Not to search for problems that don't exist or to start throwing interventions and drugs at women to have them labor according to a schedule. 

The bottom line is I really don't want any other women to experience what I did.  I don't want any babies to be hurt like my son was.  What I want is for women to allow their bodies to do what they were made to do but when an intervention is needed I want it to be noticed and explained.  I want women to be able to trust their caregivers and know that they are being given information about what is best for them and their baby.   There is obviously a time and place for c-sections.   But there is no time or place to assume that all laboring mothers fit a mold and can be "managed" a certain way.    Nine times out of ten it might work, but for that tenth mother and baby it can be life changing.

Wednesday, April 6, 2011

What I learned from my freak out

I made it through my first OB/GYN appointment since having Fisher. I was really worried about it and didn't know how I would react to going.

While I was in the waiting room I felt my anxiety building. I wanted to walk out, but I kept trying to distract myself. And then my name was called. I followed the nurse back to get weighed and as I stepped on the scale, I lost it. I started crying and shaking. It was pretty bad. I tried to tell her that I had anxiety about seeing a OB for the first time since a traumatic birth experience, but I am not sure how much of that she could make out. I was utterly embarrassed at the same time. I kept apologizing. She was very nice and told me not to appologize. And then she gave me the robe to change into.....

If nothing else, I learned the key to getting seen FAST by a doctor. Have a freak out. I barely had a chance to get undressed before the doctor came in. I start crying again. Of course, he had no idea why I was crying - as this is the first time I have seen him. He sat down and asked me if it was the yearly exam that was causing me anxiety. I said no and tried to explain that it was the traumatic experience with my son's birth and I told him that I knew I would be nervous about getting seen by an OB/GYN but I had no idea I would have the reaction I did. And, my goodnes, the doctor could not have handled the situation better. He started asking me about my job, I knew he was trying to get me talking about something I was more comfortable about - but it worked! I slowly started calming down and then we got back to talking about Fisher's birth.

I told him an abreviated story of Fisher's birth and explained the medical records "mistake." and then I told him that because of this I don't trust OBs. Hey, I laid all my cards out on the table. After crying hysterically in front of a complete stranger, there is really nothing to lose.

Again, he handled this all great, didn't seem offended that I just told him I don't trust him and his peers. He explained to me that he has had two brow presentations in his career (and he is in his late 50s) and that the last one he didn't pick up on until he had checked her a couple of times. But he did figure it out...so two points for that. And then he told me that if I were to get pregnant again, I would have the option of having a scheduled c-section or a VBAC and asked me if I had strong feelings either way. LOL. If you know me at all, you know I have a tiny bit of strong feelings in preferance for the VBAC and I told him this. He said that I was an excellent VBAC candidate, he didn't see any reason why I couldn't VBAC. He said that I could wear a mobile monitor and cruise up and down the hospital halls as much as I want. (Wait, I thought it was certain death if you got out of bed while in labor???)

The only thing that was concerning to me was that he told that he doesn't support VBACs for women with a baby measuring above 9 lb 14 oz in utero. Fisher was 9 lbs, 3 oz and was not fat at all. He was long and skinny. Shawn and I are very tall, big structured people. I am 6 foot and Shawn is 6'6. So I think there is a very good chance that a baby of ours would measure bigger than 9 lb 14 oz. And we all know the problems with ultrasounds not measuring correctly. So I guess I will cross that bridge in the future if I need to.

But overall, I am happy with the appointment. The doctor spend almost 45 minutes with me, which was more than my last OB spent with me my entire pregnancy! He was calm, listened, reassuring, and honest with me. I appreciate that. Many of the fears I had about seeing a new ob were eased. I was worried that he wouldn't believe me since my medical records don't match what happened. I was worried that since I know I have inaccurate medical records I wouldn't be allowed to VBAC, I was worried that I would have to stay in bed while laboring. All of those things I am not worried about anymore. I hate that I had to have a panic attack and freak out to get those answers and things resolved. But I am going in the right direction.

Tuesday, April 5, 2011

Regaining trust

I have an appointment with an OB/GYN today in my new town. I called yesterday morning to set up an appointment and was told that they just had a cancellation. So I took it. And man, the anxiety has kicked in. I find it hard to believe myself that I have so much emotional issues involved in just going for a routine yearly appointment. Obviously my body, my mind, my soul know that it is more than that.

I don't worry so much about what happened with Fisher happening again, because it won't, I won't let it. I worry about what I might have to go through to make sure things don't go that way. I felt like being amiable and going with the flow was the right thing to do with Fisher. I felt like at the time,I was "suppossed" to ignore my instincts and what my body was telling me to do and do what the hospital told me I had to do. To go along what was hospital "policy". I thought by going with the flow, controlling what I could, things would be easier on me and Fisher because I wouldn't be fighting with hospital staff. Boy was I wrong. And I deal with the reminders of that every day. I am obviously still not "over it" and I don't know when or if I will be. I don't think I will be until Fisher has no more pending surgeries.

I don't talk much or often about all the anxiety, angers, fears, and regret. I might mention it, throw a comment out, bitch about the doctor, or the hospital, but I usually happy it up, gloss over it, pretend that I am ok. But I know I am not ok. I know from counseling that I avoid digging too deep into what I really think and feel about what happened. And here it is - in my face. The anxiety, the rushing thoughts, the fears, the lack of trust, the guilt. And I am worried about seeing a new doctor, because I am either going to 1) act like it is no big deal, pretend that I am ok, when I am obviously not or 2)put my true fears, anxieties, regrets, and hopes for the future out on the table and have the chance of it being minimilized, trivialized, or even not believed (thanks to the falsified medical records).


I pray that things go great. I click with the doctor, I am able to get answers to some questions I have, I get a good report, and I hope that the new doctor doesn't trivialize what happened, because I think one of the hardest things I have had coping with is the fact that the medical records do not show what happened. That what has been such a big deal to me and Fisher doesn't even appear on the records. I think my emotional state would be so different right now if the original doctor offered an apology, an explanation, and some compassion and acknowledgement of what Fisher and I have went through and are still going through.


So today is a big step for me. And hopefully it will be one that offers some healing and maybe I can start regaining trust in the medical community.

Thursday, August 19, 2010

Healing

I have been to therapy three times so far to address the trauma surrounding my son's birth. And I really do think it is helping. The therapist explained to me that my brain has not processed the trauma surrounding Fisher's labor and delivery and therefore it keeps trying to process it, which is why I have anxiety about it and reoccurring thoughts, images, and dreams. She is going to do a treatment to help me reprocess it and she really thinks the anxiety and other symptoms will go away. I know it sounds a little kooky, but I figure - what the hell? It sure can't hurt. And even though we haven't started the actual reprocessing part yet - I already know that I am healing. Just understanding why I am dealing with the things the way I am has helped so much. For instance - I have totally been ignoring and putting off dealing with the incorrect medical records and talking to a lawyer. While I had rationalized ignoring these things for many different reasons (mainly being so freaking busy lately!) - my therapists mentioned that some people ignore things as a way to avoid that issue because it causes hurt, anxiety, or pain. And I know that is the real reason I have been putting it off. It scares me to deal with it because it is like pouring salt on a wound. I have been much more aware of why I feel the things I feel and most of all - I know that it is normal. It is all normal. And I am not ashamed or embarrassed...I just am. Those who know me know that I have a very analytical, scientific brain and having someone explain to me the science behind why I am dealing with things the way I am has been priceless. Now that I understand the biology behind my reaction and I know that it is absolutely and totally normal I am so much more peaceful about the whole situation. I realize now that I had a ton of guilt just because of my anxiety and anger surrounding Fisher's birth. I thought that the "right" way for me to be was to be happy he is alive and here with us, and not care about any of the other stuff. I was told many many times by many people that all that mattered was a healthy baby and I didn't understand why I couldn't just be like "everybody else" because though I of course wanted a healthy baby - I also want to know what happened, need to understand why it happened, I feel anger, feel sadness, feel anxiety, etc.
But I am not like "everybody else." I am me and my brain is my brain and like all parts of our body do - my brain is trying to heal itself. It might not be doing it in a way that pleases everyone, but it is doing it the only way my body knows how. And I am happy that I feel like I am moving in the right direction. Towards healing.