T's Story - Peace Arch Hospital, White Rock, British Columbia

2017 - I had an uneventful pregnancy. I was a laid back person, who trusted health care providers. I attended prenatal classes with my husband and during class we had to share our fears. I wasn't fearful of anything but having a birth complication. My husbands fear, was me dying. The prenatal coach pushed it to the side and said nothing we can do about that if it happens. Fast forward to baby time. I had a difficult labor, which was induced as I was 42 weeks. I vomited from the first contraction all the way until after my c-section, approximately 18 hours, when they gave me anti-emetics. I could not hold food or fluids down. I also had only recently fully recovered from a broken foot and my one leg was significantly swollen at the time of my childbirth. I had difficulty maintaining any strength to labor for hours due to both factors. I literally was begging for relief from my midwife, it was shameful to feel that helpless and to have no one listen. I begged for IV fluids all while I barfed everywhere. It was refused.

My mom told me after that she had pulled the midwife out of the room to tell her that as my mother, she knew that when I said enough, it was enough. Midwife didn't acknowledge. My nurse eventually stated that it all had to end and my suffering needed to be stopped and demanded I get my epidural. I lost consciousness after receiving it likely secondary to severe dehydration and a low blood pressure that comes with it. I did regain consciousness and saw my mom screaming for a "code blue" while my midwife was charting nothing to do with the incident. No one explained anything. I got a new nurse at some point and she and my midwife argued through the rest of my labour. Never once telling me what was going on. I was over-frozen, and the anaesthesiologists said to hold the epidural. At some point my nurse turned it back on without consultation. I was so terrified. I was not only paralyzed from the epidural, but I couldn't speak. My moms says that I looked lost. My mom was lost. My husband was lost. My mom and I are two vocal women and none of us said anything. It was like the hours of not being heard finally just shut us up. We realized no one cared. I pushed for over 4 hours, the crown at some point being visible. However my guy got stuck. There was side talk about forceps during labor, there were all sorts of side conversations, one with the nurse wanting the OB and the midwife saying no. Again no conversation with me. At some point the nurse went rogue and called the OB when we all started decompensating. I honestly thought I was going to stroke on the table. The OB arrived significantly late. To the point the paediatrician was beginning to panic. OB stuck a hand in and said "c-section" and something that my babe had turned. I cried. I was relieved. I was also devastated that I endured so much pain and anguish just to be cut open in the end.

My postpartum experience consisted of the following; a broken bed, elevated to the max - despite requests for the bed to be swapped, no one cared to do it over three days. I had to jump into my bed, post op. I can count on one hand how many times I rang the bell in my three days1) IV leaking 2) breastfeeding help x2 and X1 for dilaudid due to severe pain. Yet nurses came in and left just as fast. I had to clean my own toilet and blood off the floor because no one cared. I asked for breastfeeding support and no one came. My mom had to demand a nurse to help and I got a two minute lesson. I literally saw no nurse for an entire shift, but her student came in a handful of times.

I felt like once you give birth they don't give a crap about you. But I didn't just give birth, I also had major surgery. I walked up and down those halls at a 90 degree angle in complete agony. I asked for narcotics once because it was so bad and I was told I don't need them (this comes into play later on). I discussed AMA-ing from the hospital because the attitudes on top of my traumatic labor was too much. It was only my work colleagues who convinced me to stay.

On the day of discharge I saw my nurse once. No one ever told me I was discharged. I went down to the station and had to ask for the information package. I had to go back down to ask them to do the car seat check. No one said good bye. No one took a photo. Two days later I was in the hospital with septicemia, likely the reason I could not mobilize well, despite my efforts. Likely the reason I was in so much pain. I had an infection. I was alone at home with my baby with a fever of 49 and fighting to stay awake. I remember it vividly. My husband got home to find me shivering, asleep under a mound of blankets. I saw him and immediately told him to call my mom, I told him I felt like I was dying. My mom came and called my midwife and said something is wrong. She comes and despite my overall appearance tells me "I'm panicking because I'm a new mother.” I tell her I really don't feel well. She says maybe it's mastitis and to take a herb instead of antibiotics. I agree. My husband wants to get formula, because he doesn't think I should be breastfeeding in my state, we were told no, because it's the easy way out. Once again, our concerns were dismissed, I felt put down and ignored. I'm hospitalized 4 hours later. I begged to not be taken back to the hospital I birthed in. But the ambulance gave me no choice. I'm alone in a bed leaking breast milk everywhere, because I have no clue wtf I'm doing and no one can help me as none of the nurses have been through it. It was awful, plain awful. No one really knows what they are doing because this doesn't happen often in the ER. Protocols were not followed around postpartum patients (e.g. No maternity nurse came down to assess and no OB was called in). I was treated for sepsis. The staff tried their best me showed compassion, and for that my heart is a little bit warmer. The ER doc, a male, tried to talk to me about breastfeeding. They talked to me about discharge and a plan of care, understanding that I needed to be home, as only my mom and husband were able to help. It is sad when the best care you received in your postpartum period was in the ER. I missed the first two weeks of caring for my son. Even while home, I was not safe to care for him.

I've been told conflicting stories about what happened, I pushed too long, I laboured too long. I had chorea, I had endometritis. No one knows because procedure wasn't followed. I was told in OB follow up, "oh well if you get sick again we will know if you have an abscess.” That attitude, that I as a mother, don't matter is the prevalent theme I experienced. It doesn't matter if I'm dehydrated, it doesn't matter that I'm in pain, it doesn't matter that I'm saying I don't feel well. It doesn't matter that I almost died doing something that society is repeatedly enforcing is natural and safe. Women do not give birth fully informed and this a right afforded to every other patient but obstetrics.

Not once did anyone check to see how I was doing during postnatal visits. My midwives couldn't make eye contact with me. My OB made inappropriate jokes and told me a story of another patient who almost died to do with something else. I dreaded every visit where I had to act like all was okay just to get the &@$# out of the room and away from the people who contributed to my suffering, but couldn't admit it. All they had to say was that they were sorry and acknowledge the suffering of maternal morbidity. I did not just have a medical issue. I had a medical issue and a newborn baby who needed me and a husband who just about lost his wife.

I now have complete total fear of interacting with health care providers. I have not had my pap smears done, despite having a previous history which requires them. I become sweaty and anxious when I see my son’s doctor. I downplay things just to get out. I’m terrified to question anything. I feel like a beaten dog. My husband has to do any hospital visits with my son. I cried non-stop for the first 6 months after the birth of my son. I had no inner joy, just empty feelings, like I was a just a vessel, that mom doesn't matter. We will not be having another child. My husband has flashbacks of the experience. I cannot rationalize the way I was treated, and as a health care provider myself it just erodes me to know this goes on day in and day out.

I had a sexual abuse history, but I find it absolutely absurd that you have to share that with people, just to get treated with more empathetic care in Obstetrics. All women should be assumed to have a trauma history given the statistics. And all women should be treated with empathy and compassion regardless of their abuse history. Also sorry, not sorry, not going to share that with someone just because you’re a health care provider, it's called building a therapeutic relationship. If you are asking me whether I've been sexually abused as a checklist, just like when my last menstrual period was, you probably aren't going to get an honest answer. I have been through significant gynaecological issues prior to childbirth and never felt traumatized by any procedure, despite my abuse history.

I filed a complaint with the hospital. I was called by the manager who downplayed much of what I said. She also wanted to blame the nurses and wanted names, where I was trying to explain it is a systemic failure. When that many people do not perform to appropriate care standards it is far more than one person. I wanted it to be a learning lesson. For them to look at my case and say "what can we do better?". I felt defeated after my conversation, I waved a white flag.

Feedback from every maternity patient should be sought upon discharge. All cases of significant maternal morbidity (e.g requiring hospital visit) related to childbirth should automatically be reviewed. Anytime a new mother becomes ill, this should be done. Maternal morbidity is a huge issue and the implications can affect maternal mental health, attachment to the newborn etc., yet I feel that it is treated like you got stitches or something.

Submitted by T.