Dear Friends:
I met a mother yesterday in a hospital, newly delivered of her 6th baby.
All the staff were buzzing about her birth story; she and her husband were
proud and angry.
A few weeks before the due date, her baby was found to be in a frank
breech position. They were told that while there were two options, a vaginal
delivery and a cesarean section, that the recommendation was for the surgery.
This family went home and combed the Internet and learned that their
baby was in an excellent position for a vaginal birth, and as she had a
wonderfully proven pelvis, that was the choice they wanted.
They are poor in money; of African descent, and Muslim.
When she got to the hospital in labor, both she and her husband were
appalled at the way they were being treated. They felt manipulated, coerced into
something they didn't want, and patronized. The husband told me that the
hospital staff reacted to their desires and education by turning
confrontational, and telling them that they could be killing their baby.This couple believes
that membranes were ruptured deliberately to trap them into a situation
where they would have to have the surgery.
So they left.
They went to the parking lot of another hospital, and sat there for 3
hours, until the baby was coming out. Then they walked into the ER, where the
baby was delivered. Everybody is fine: mother, baby, and dad.
The father was angry that no one in the other hospital attempted to meet
them where they were, or put out an attitude of cooperation. He was
disturbed that his expressions of what he had learned and what he and his wife wanted
was met with threats, and stirring up fear. He felt lied to; the staff at
the other hospital told him that his baby had a 20% chance of dying if she
delivered vaginally. He knew that breech is 3-4% of presentations, he knew that
frank breech was an excellent position for a vaginal delivery, and he knew
that 1% of all breech deliveries have complications.
I think they are very lucky (the baby was born with one foot first,
which is the riskiest type of breech, as the cord can sneak through where the
butt would fill if it was a frank breech). I am also impressed with their
advocacy. They were strong with each other, and polite and articulate with me.
Breastfeeding is going perfectly; because of their culture, she's nursed
all her babies for over 2 years.
After Rachel's lovely post about the breech study in Norway, I wish they
could have gone there.
This fits into our thread about power and control.
I believe how this family was treated; I've been witness to many such
things in my hospital nursing work. I've seen physicians use a vacuum during a
precipitous delivery, and then tell the mother that "that baby really tore
you up." ( I was amazed that the doc had time to get the vacuum cup on!) I've
refused to give pitocin to a woman contracting every 2 minutes for 1 minute,
and then had to face disciplinary action from my head nurse for disobeying a
physician. (I told him at the time that he could give the pitocin himself if
he believed she needed it. I also asked him if he wanted her uterus to fall
out?) I've seen physicians lie about a monitor strip because they wanted to
be done with their clinical day.
A trouble in this case is that folks don't know how to deliver a breech
any more. It is only the older physicians and midwives that have had any
experience, and there aren't enough of them around. Plus there is this incredible
fear of liability. Never mind that the mother is a wreck after a cesarean;
the baby has been got out alive and that is all that is important.
I am glad that I met this couple. I will be calling them to see how
breastfeeding is going. As her mother is coming to stay with her for at least a
month, and she is very experienced, I expect it will be just fine.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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