My c-section surgical report

Submitted by fullofgrace on June 4, 2006 - 9:28pm
Body: 

I was cleaning out an old notebook and found my surgical report from c-section-- which I never would have seen except that I requested my records when I planning my homebirth. It really makes me feel sick when I read what they did to my body and I wonder how in the world a c/s could ever be proported as a pelvic organ saver when they compromised my whole system with their scalpel.

"A Pfannenstiel incision was made on the skin, carried down through the subcutaneous tissue to the fasia. The fascia was identified, nicked and incised bilaterally. Fascia was dissected from the rectus muscles blunt and sharp dissection. Midline was separated bluntly. Peritoneum was enterered bluntly...."

What am I frog in a biology lab? No, wait, I'm still living!!! Oh, okay, I'll stop the sarcasm...not.

Here's the part I do not understand:
...infant passed to the nurse in attendance to further resuscitation.

WHAT?! My baby's apgars were 9 and 10... resuscitation? Perhaps that's just the terminiology, but really there was no good reason to do my c/s (except of course that my dr.'s 24 rounds were coming to an end at 7:00 and my surgery was at 6:00) and I'm wondering if this wasn't thrown in for justification???

"The uterus was delivered onto the maternal abdomen."

Huh? They took it out of my body...ewww! Gee, did that stretch or damage a ligament or other vital support structure to my uterus' natural suspension?

"There was noted to be a small uterine laceration to the write of the midline extending appropimately 1 1/2 cm."

Oh, so now you ripped my organ pulling out my baby?

Oh, and this is the most comforting part of the report...

"Sponge and needle counts were correct"

I'm not kidding, this is comforting...

mom30

June 5, 2006 - 7:22am

Yuck!!!! That was so gross to read!!! It's crazy what doctors do to our bodies and it's actually amazing how our bodies can recover from all of that. After my dd was born, I got a million hospital bills and I do recall one of them stating "infant resuscitation" and it was an extra $250 or something like that. My dd was fine too, I was thinking they just put that on there for extra money. That's what it's all about, right!??

louiseds

June 5, 2006 - 8:58am

Hi Fullograce

Sounds pretty icky to me too, but having babies is not exactly like an upmarket department store at the best of times, is it?

As horrible as it all sounds, I think we have to be a bit careful about criticising c-sections, as they can be life saving, both for mother and child, well I guess they can. Doesn't hurt to look back at what we've been through though, and give ourselves a pat on the back.

Cheers

Louise

Christine

June 5, 2006 - 9:16am

Dear Jane,

I’m glad you found your report and read through it, because it helps accept the reality of the trauma and move past it. Mine was similar to yours except I have not only permanent sutures in my uterus, as all sectioned women have, but also several inches of additional material suspending my vaginal wall to my abdominal wall. The MMK-turned-Burch was a procedure developed in the 1940s for post-prostectomy incontinent men, by the way. Pretty appalling treatment for young, healthy women with minimal symptoms.

It’s interesting that we haven’t really seen a generation of sectioned mothers completely mature. I think for many our instincts are telling us to turn back the clocks to natural childbirth, as it may be as important to our long-term health as other aspects of natural earthly life.

Hugs,

Christine

fullofgrace

June 5, 2006 - 1:45pm

The World Health Organization estimates that only about 5% of all c-sections are necessary. The rate in United States is climbing to high of 29%. This is not being instigated by incompetent pelvises or incompetent birthing women, but by an increase in technology (i.e. electronic fetal monitoring--a midwife worth her salt can tell a labor gone ary simply by watching the mother) this creates terrible birthing positions for mothers and increases the fear and stop the natural labor process. Many times the monitor will misread because it fell out of position. Other interventions such as busting the bag of waters by the physican create the need for further interventions because now the doctor has the mother on a time frame-- delvier in 24 hours of risk infection. Gee, why didn't we leave the bag intact until nature chose to break it so the baby has the added protection from the stress of labor, as well as the mother. (My o.b. broke my bag of water though I was only 3 cm-- my sister walked around for weeks dialated at 3cm. Why did the ob do that? To speed labor-- uh, didn't work.) Breaking the bag of waters limits baby's mobility as he or she cannot "swim" into the best position for birth and since most mothers are given a "slow leak" to prevent prolapsed cord, the mother is then confined to bed on her back so baby has little chance of getting maternal help into the right position. Epidural increases risk of fetal distress and absolutely confines mother to bed so that baby has no way to move into a better position. The rate is also being increased by malpractice fears and convinence (both for o.b. and mother). I'm not sure, but I think Britany Spears elected to have her birth by c-section. The risks of c-section birth to following pregnancies and labor is real and so is the risk of maternal death, premature birth, and birth injuries (my friend's daughters arm was severed from her body by the surgeon's scalpal).

My criticism is not for the life saving c-sections. Praise God for the ability to deliver an infant who severely malpositioned or in serious distress from a prolapsed cord. My criticism is for the 24% of c-sections that are unecessary and set a woman up for more c-sections. My doctor told me (in an effort to persuade me to consent to c-section) that she suspected all along my pelvis would be too small to deliver a baby vaginally. Horse pucky! :) My c/s baby was 7 pounds 11 ounces; my next two babies were 8# 5 oz and 8# 2 oz. Born vaginally, at home in uninterrupted circumstances--no fear, no confinement, no busted bag of water, no time table. I was free to move as my body directed me to help baby move into optimum position. These were empowering experiences and I had that feeling of getting off of a roller coaster and wanting to do it again. Nothing grossed me out about these births, my husband didn't almost pass out like he did during the c-section; instead he was holding onto me as our babies passed into this world. I love to relive those memories. What an awesome confidence booster that I could do motherhood. And an awesome journey of the natural hormones that are released after labor for me and baby. If only hospitals would return to allowing mothers the freedom of movement, perhaps the rate would go down and there would not be so many wounded women (see the increasing membership of ICAN -- international cesearean awareness).

Jane

fullofgrace

June 5, 2006 - 1:51pm

I cannot even imagine having foreign material in there. Can that material create autoimmune issues?

Can you explain what you mean by mature?
It’s interesting that we haven’t really seen a generation of sectioned mothers completely mature

Jane

mommynow

June 5, 2006 - 2:08pm

That is kind of scary.

I wish I had been more informed before my first baby. Nothing went wrong but the hospital birth was so 'mechanical'. It was like they had a list of routines and I wasn't asked permission for any of them. For example, at a certain point the doctor just came in and broke my bag of water....what for?? He didn't even say? I'm sure it wasn't necessary...for me or the baby anyway! It was necessary for his schedule I assume, to speed things along. And then pushing for an hour and a half when they told me to! It was all so institutional. I remember wondering about midwifery beforehand but I had no support so just went with the flow. I wish I hadn't been so naive.

fullofgrace

June 5, 2006 - 3:16pm

There are so many things that doctors do that are unnecessary. Really it would be a sucky job. You're trained as a surgeon, you're trained for emergency situations, and what really can you do for a laboring mother other than watch and wait??? How boring.

But they have their bag of tricks. They assume all mothers want it to be over as soon as possible and as painlessly as possible. But they bust the bag of water: increased pain due to loss of cushion; add pictocin to create wildly unnatural and painful contractions and cause fetal distress; so we have to have fetal monitoring to watch for those negative effects; we have an epidural to take away the pain we caused. So they get to do and they do do so without asking.

I told my ob upfront, no busting my waters and no episiotomy. She supposedly put the no rupture of bag of waters in my chart (yet that was the first thing she did when she came in the room-- then wanted to put a fetal monitor into my baby's scalp after I had been diagnosed with group b strep and we were doing iv antibiotics to "save" my baby from that-- uh, I really refused that and said so you want to inject any group b strep into my baby's head with that probe or or is group b strep really not a threat so the anibiotics are unecessary-- incidentally baby ended up with terrible yeast infections for over a year as a result of those antibiotics.), but then ob "convinced me" to have an episiotomy (according to her own notes, but that was a blatant lie in the records) as she so eloquently explained how much easier it is for her to sew a straight cut rather than a jagged tear-- gee, guess when my uterus ripped after being cut didn't ring a bell with her that perhaps cutting an episiotomy could cause further and deeper tearing.

I must say my natural labors and births and recovery afterwards were so much quicker and less painful than the c-s, especially since I did not even tear.
Jane

UKmummy

June 5, 2006 - 3:18pm

Interesting stuff Jane!
I am so with you all about the birthing "industry" and the harm it does! I have a friend who was told by her OB that she had the "pelvis of a child" and as a result couldn't deliver a baby over 5lbs!? Of course she has had two sections, quite conveninet for the Dr I am sure!
My latest delivery I was ADAMANT that I wasn't going to be flat on my back which my midwife and Doula supported. When I arrived in the hospital fully dilated, the nurse tried to make me lie down and put the monitor on. I was very insistent that she didn't! I think she realised that trying to mess with a woman about to have a baby just was not worth it. I am glad I was so much more informed this time and feel that it probably saved me from more problems.

rosewood

June 5, 2006 - 8:35pm

I've thought about it for years (with my first, vacuum extraction delivery) -- the whole thing still has me with a lump in my throat -- I desparately wanted a natural birth and planned for it. I ignored my own better judgement on several occasions -- where to birth, where to tell the doctor to go, who to have there; and ended up with a resident who pulled my daughter out of me after 4 hours of pushing, stitched me up for an hour, and 7 hours later, at the insistence ofmy dh, who saw too much blood, realized I'd lost over 1/2 my blood; so I was whisked to OR to be stiched up and given a blood transfusion. My ONLY saving grace was that I refused #1 PAIN MEDICATION and did it all on my own and #2 AN EPISIOTOMY. She rolled her eyes. I need to see my records, though, and grieve and move on. I have grieved -- what it did to my little baby; thankfullly she was pretty ok, but a fussy baby and wasn't pooping. Well this was all 7 years ago, and I wouldn't go near a hospital again, and learned the hard way about birthing well, but had the glorious opportunity to do it again, twice, at home, in bliss, without fear. In many ways it redeemed the first experience. Oh, and btw, I with the first, Ihad to be hospitalized post partum for a bacterial infection I picked up at the hospital, had to stop nursing because of medication they placed me on, but picked it up again and she nursed til 4! I almost didn't nurse her either -- that would have been icing on the cake. Thank God we made it.

Marie

Christine

June 5, 2006 - 10:41pm

I mean, it's really only been since the 80s that a sizeable chunk of mothers have been sectioned. We actually don't know what the really long term outcomes are. I can't imagine Polypropylene is great for the immune system. After all, the reason it is permanent is because it's walled off by the body into a bundle of inflammatory scar tissue. I have a friend who's a surgical nurse and tells me people come in decades post-surgery to have black, festering knots of the stuff removed. God only knows.

Christine

June 6, 2006 - 9:16am

I might add that my friend sees mostly abdominal surgery. Because the uterus becomes more fibrotic and less vascular with age, it may be that the sutures will be more apt to remain quiet for the duration.

fullofgrace

June 6, 2006 - 11:35am

My sister had a tubal done about 15 years ago and complains of pain in that region. She's often wondered if she's developed adhesions. I have been very fortunate (attribute it to the power of prayer) that I have felt no pain in the pelvic area.

fullofgrace

June 6, 2006 - 11:39am

Marie,
What a terrible ordeal! Thank God for your husband's persistence. I had a woman I worked with scold me for having a homebirth-- "That's scary!" she sneered at me. To which I replied that having a hospital birth is scary. When I was in the hospital with my first, my great aunt was only on the same floor recovering from salminela (sp?)-- that scared me-- how do they keep that stuff contained? Apparently, in your case they didn't.
Jane btw I finally checked my e-mail and replied. :)

louiseds

June 8, 2006 - 9:45pm

Reading all these responses tells me that many things happen in hospitals that we did not intend to happen. Sometimes they have to go outside the plan if things go awry. On the other hand hospitals and doctors are now much more aware, in Australia at least, that patients will not put up with incompetance and bad judgement, lying and being misled. Patients want increasingly to informed and involved, to the point where now, where a patients is unable to assent to treatment, the next of kin, rather than the doctor, is given the final decision as to the treatment necessary. There is always a consent form for surgery, and a doctor cannot give treatment without agreement from the patient. I would hope it is thus elsewhere too.

That's why it is vital to have somebody (smart and trustworthy) with you when decisions are made. There are rules when you are a Staff member about doing what you are told, but not when you are a patient. They expect you to say yes in an informed way. If you don't say "No", "Why?", "Why not?", or "Tell me more" or other terms of enquiry if we don't understand, then they take silence as a "Yes" (in the normal authoritative expectation).

Don't sign anything you don't understand FULLY, and make it known that your (trusted) companion will make decisions for you if you are unable or unwilling to. Give them Power of Attorney if necessary to enable them to sign or not sign on their behalf.

Don't play the 'obedient child' game just to make it easy for the Staff. That's what they hope you will do, because it makes hospitals run smoothly. You are not personally responsible for abetting them in that aim.

A patient who wants to be actively involved, and understanding of their treatment is no threat to a hospital where they routinely handle drug-crazed and violent individuals who need treatment to save their lives and post serious threats to Staff.

It is your body that you have to live with for the rest of your life. They go home at the end of the day, even if they have made some bad decisions that will adversely affect patients for the rest of their lives.

We owe this to ourselves. Lecture over!

Cheers

Louise

ps Whoa! I just read this over again, and it sounds very growly. I did not mean it that way. It was meant as a comment on how I perceive decisionmaking in hospitals from the point of view of a patient. It wasn't meant to be a growl at any of the women who have fallen prey to hospital decisionmaking practices. Shit happens and we just have to deal with it in the best way we can. My heart goes out to any person who has to deal with the less than perfect results. Please forgive me if I have offended anyone. I still stand by what I have said.

rosewood

June 8, 2006 - 10:56pm

if they want to have a natural birth, at least in most US hospitals. Women who are in labor are in a sensitive and altered state, and need to be in their bodies, not in their minds, which is where most docs are.

I'm in agreement with Ina May Gaskins about the sphincter theory and that giving birth in a hospital leads in many cases to stalled labor and unwanted medical interventions.

Birth is not a spectator sport! (As eloquently phrased by my doula)

Marie

granolamom

June 10, 2006 - 10:04pm

I agree (mostly) with what you said about our responsibility in speaking up. however...

when my dd was born I told everyone within earshot (and my dh did too!) that she was to be bf ONLY. unfortunately she *had to be admitted to the nicu since I was gbs + and didn't have time to complete my IV of antibiotics prior to delivery and dh was unable to stay in the hospital any longer. so when they said they were going to bring the baby back to the newborn nursery he reminded them and even taped a note on the basinette that she was to be bf ONLY and left.
I, meanwhile, was still hooked up to IV (pitocin, g-d alone knows why - this was my first, placenta came right out, no hemmorhaging or anything like that) and buzzing the nurses to bring me my baby. finally I got mad - I had still not nursed her and this was 4 hours after birth! so I got up and got her only to find A NURSE GIVING HER A BOTTLE. needless to say I flipped out.

sorry to go on and on, my point was, they don't always listen. in hindsight, my dh should not have left my dd alone for a second. but we thought we could trust the hospital to respect our wishes.

granolamom

June 10, 2006 - 10:06pm

that's pretty disturbing. I'm so sorry you had to go through that.

louiseds

June 11, 2006 - 7:03am

Dear Jane,

I am blown away and saddened greatly by the things that have happened to so many women in this thread. I'm so sorry that these bad experiences have happened. We only experience chldbirth a few times at most, and it can be such a rich experience for all concerned.

The birthing of babies seems to be more of an 'industry' in the States than I could have believed. It sounds like you live in a different universe from Australia, in so many ways.

Louise

fullofgrace

June 11, 2006 - 1:21pm

Women do need advocates, but even then they are ignored. I do not understand the "god" or "parent" mentality so many hospital workers have. As if I do not know what to do for my own good??? I think industry is quite an accurate depiction. Follow the textbook birth or we'll tinker--heck we'll tinker anyway so that you are sure to need more of our interventions. My homebirths were so much easier. I kept asking people (in the time I htought it was in jest) during my first pregnancy, "Why do I have to go to the hospital to birth when a girl just gave birth in the bathroom at her high school prom???" "Mary had her baby in a barn." I didn't think homebirth was at all an option for me and it certainly did not seem like part of my personality. I know that being in the hospital stalled my labor--after all I only went to hospitals to visit the sick and dying-- so I must have a pathology right? I am thankful for my hospital experience though becaUSE i NEVER would have had my two wonderful homebirths if that hadn't been so traumatic.
Jane

louiseds

June 13, 2006 - 9:44pm

I so agree with you Jane. The point is that it doesn't have to be that way.

Why don't they just take the beans out of their ears and just @&$(^$@ listen to labouring women!!??

We are the ones who go home carrying the baby in our arms and the results of their blocked ears in our bellies.

I have had three hospital labours; one highly managed labour which was planned, and was OK under the circumstances, except that I was flat on my back with my legs in stirrups and was unable to push even if I could. Both my son and I came out of it well.

The second was only managed in that I was induced a few days early so my husband could be there. Waters broken and pitocin drip, but not a violent quick labour at all, and the midwives were great about allowing me to do what I wanted while labouring.

The third was at a country hospital where I was confident and pushy enough to tell them how I was going to labour and birth. They just went along with it, because I wouldn't be swayed. I upset the head midwife by getting myself into an 'unconventional' position on the delivery table when Nic was ready to come out, but I wasn't about to turn around just so she could get my in a stranded cockroach pose! As it turned out she dashed for the phone to find the doctor just as Nic slithered out into my husband's waiting hands with the cord three times round his neck. A bit dramatic, but we all got over it, and I was forgiven for being difficult. DH and I have laughed about it many times since. :-)

I have been fortunate that hospital births have not been the alienating experiences for me that you describe, and I am thankful for that. I wish I could have birthed at home, but home birth in country Western Australia is a bit hard when you are 2 1/2 hours away from expert obstetric care.

Cheers

Louise