Guest Post: A Canadian mom recounts struggles with bad maternity care, depression, fistula3/22/2013 My name is Sarah and I'm from Ontario, Canada. Here's the condensed version of what happened when I had my first child, my precious son... I went into labour on July 31st, 2010, early in the morning the day we were moving to a new place. We managed to get everything moved, but around 4am the following morning, my contractions were every 5 minutes, so we went to the hospital. My water broke naturally about half an hour after we got there. They asked if I wanted to walk around, I said no I want to sleep, we moved all day....they let me, but that was the first and last time I was asked to move around. I told them I wanted to be informed when I had the opportunity to have an epidural. For the last two months of my pregnancy, I had horrific and I mean HORRIFIC sciatica because of the baby's position. This resulted in the worst effing back labour imaginable! But there I was, labouring on my back the whole time. Neither my mother or husband knew what to do to help and the labour nurse was utterly useless. I never got moved to different positions or was offered to walk around or anything like that, at any point. It went on like that for hours....they gave me nubane and laughing gas for the pain, so I was extra loopy and time slipped away and I didn't even think to ask for an epidural, I kept waiting for them to tell me I could have one because that's what they were supposed to do...finally I was in too much pain and my mom got the nurse and made the request. They went to go get the anesthesiologist but came back to tell me that he had been called away to the surgery floor and he was the only one on staff for the whole hospital, so I could not have an epidural. They gave me more gas instead and that was it. I had been pushing for about an hour and a half at this point. Then the OB finally came in for the first time, looked me over and decided he wanted to speed things up and felt he could do so by using the vacuum assistance. I agreed, having seen it used in birthing shows and it didn't look too horrible. I had also been told it had a far lower incident rate of complications than forceps. I was in a great deal of pain, pushing was not going well as I was not being properly coached. So he inserted it and it was the worst pain I have ever experienced in my entire life, overshadowing every other aspect of the birth from start to finish. A few pushes later and my son was born at 11:54am August 1st. The OB put in a lot of stitches and I was told I had been torn but not told how severely or given any aftercare advice that was different from what they tell anyone else. In short, I was treated like nothing out of the ordinary happened. I won't get into how bad the care for my son was because that's a whole different story, where he developed severe neonatal jaundice...but I insisted on being allowed to go home asap because the breastfeeding support at my local hospital is a joke, so I figured we'd have better luck at home. Again, no one told me there was anything unusual wrong with me. I was allowed to leave without having had a bowel movement. So we go home and two days later, I had my first postpartum bowel movement. It came on like diarrhoea for some reason, and I had to stop and hold it for a second so I wouldn't have an accident. As soon as I clenched my muscles to hold it in, I felt it pass through into my vagina...I can't even begin to explain what that was like....just, so effing awful....but I couldn't believe that it had really happened, I thought I was imagining it, there was so much other crap coming out of me (you know, all that postpartum gunk that no one warned me about...) I kept telling myself it was nothing.....our son ended up being admitted to the NICU at a different hospital and so were wrapped up with his problems and I ignored mine. The NICU nurses noticed how rough I looked while we were visiting our son and made me go to emerg at their hospital, but I ended up back at my local hospital anyway because our son was being taken back there too, so I was checked more thoroughly there...the OB who saw me (not the one who delivered my son) confirmed that I had a recto-vaginal fistula. I was told I had no choice but to have a diverting ileostomy right away. I was borderline septic at this point. My white blood cell count was through the roof. Normally they prepare you in advance for an ostomy surgery, plot out where they're going to place it, all that....I was such a bad case they had to hurry all that along. Hours later, I was in surgery. NOTE from Momma Trauma because I had to look it up, too: MayoClinic says, "A rectovaginal fistula is an abnormal connection between the lower portion of your large intestine — your rectum — and your vagina. Contents of your bowel can leak through the fistula, meaning you might pass gas or stool through your vagina. Meanwhile, my son was doing much better and got to spend some rare daddy-only bonding time as a newborn while I was in the hospital. I pumped and dumped as best I could during my week in recovery in the hospital, but by the time I came home, he was drinking more formula than I could produce, my milk was already slowing down to a trickle. I couldn't eat a proper diet because ostomy diets, especially for a new ostomy, are very strict, PLUS I was on pain meds and antibiotics for weeks after. I didn't know there are so many other things I could have done to save the breastfeeding and I ended up giving up on it. Muscle graft taken from this leg. So....here I'm thinking, ok so I have to live like this for a few months, this will all be over before the year is out. Not so much. It takes time to get into specialists, to have surgeries scheduled and performed and then to have to wait to see how things went. My first two surgeries (Jan. 2011 and March 2011) for the fistula were day surgeries, so fairly minimal, but neither was successful. The third and final repair surgery (end of August 2011) was a bigger deal. They took the gracilis muscle, which is the muscle that runs up your inner thigh and used it to repair the damage. It took a few months after that to be sure the fistula was repaired and in that time, found out I had developed a hernia due to the ostomy. So once they knew for sure I was finally fixed (had to have a dye-enema to check....that sucked), my last surgery was scheduled. Late January 2012, I finally had the ostomy reversed and the hernia repaired. 18 months of pure hell, from start to finish. This horrible incident affected every part of my life. There were many times I didn't think I would make it through. With every failed surgery, I resigned myself to a lifetime with an ostomy and depression....depression that at times, bordered on suicidal. It was so hard, not just for me but for my loved ones who have had to go through it with me. My son was deprived of so much because of the awful care I received. I thank god that he will not remember this time in his life and is now a happy, healthy almost 3 year old. In conclusion - I have always believed, and still believe, that the damage was caused by a number of factors during my labour delivery, but most significantly by the OB's use of the vacuum. I felt so strongly that I took my case to the College of Physicians and fought it as best as I could...to no avail. They ruled that while what happened to me was certainly unfortunate, it was not the doctor's fault and probably (although they of course can't say for sure) was the result of my flesh not adequately stretching to allow the baby's head (or something to that effect...all I can focus on is that they didn't take my side) but that what happened to me is very rare and basically, the kind of awful thing you hear about but hope will never happen to you. So sorry about my luck. I had the option to fight the decision but would have had to go to tribunal and fight them through a separate body and two years later, I just don't have it in me to fight anymore. So I've had to come to terms with the fact that I will never get vindication from this and I just have to move on with my life. But that's why I share my story - I believe what happened to me was entirely avoidable and I wish I knew then what I know now....but if hearing my story makes a difference for anyone else, it will have been worth sharing. Two of my biggest regrets in life are that I didn't stand up for myself more during my whole birth process and that I didn't educate myself better while I was pregnant. I thought I knew everything I needed to know...I mean really, who the hell thinks something like this will happen to you?? It really is rare what happened to me, but it does happen and I just can't stress enough how important it is to know what your options are. It has now been just over a year since my last surgery and I am currently expecting my second (And last!) child in July :) I will be delivering her via scheduled c-section and while I am still very nervous, I took special pains to do things differently this time. I've educated myself, made connections with other people with knowledge, learned about resources available and perhaps most importantly, opted to go with a very respected, high risk OB in a nearby town and deliver at the hospital there. I am hoping and praying that this time, things will be different, that I can finally experience a happy birth. But that's the big thing – I did NOT let my first experience stop me from fulfilling my dream of having another child. If anything, it made me that much more determined. And that's what I really want people to take away from reading my story – don't let external factors rob you of your dreams! I am proof that you can overcome adversity and go on to accomplish them! :)
2 Comments
3/22/2013 05:54:46 am
Sarah, I'm so sorry for your experience and the pain you had to endure following your son's birth. What an absolute nightmare. Something that continuously stands out to me in stories like this is the complete and utter scapegoating and protection that physicians receive when called out on their care in instances like this one. It is such a double standard. Can you imagine what the repercussions would have been for a homebirth midwife whose intervention resulted in the kind of fistula you described?
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