Inappropriate use of restraints

My birth story is hard to tell and always will be, but in another way it is easy because it must be told in order for things to change. I’m sure I will tell it many times over in print and in person – this here is my first public telling.

I have sent this text to the lawyers filing an amicus curiae brief for Human Rights in Childbirth in the lawsuit that Rinat Dray has brought over a forced c-section. “Amicus curiae” are “friends of the court” who are not parties or lawyers for parties, but independent. They are seeking stories from women who were subjected to unconsented interventions during childbirth, and will present them to the court in an amicus brief. If something like this happened to you, please consider submitting your story here.

My hospital birth

I went into labor at 35 weeks and my home birth midwife said I needed to go to the hospital because the baby was too premature to have at home. I went to the hospital, which has a large, highly respected labor and delivery unit, and explained that I had planned a home birth and had had a healthy pregnancy with no complications. I filled out forms, etc. and was admitted to a labor room.

The labor was quite intense and before long I felt like pushing. For a few pushes, my husband, doula, and a nurse were in the room, and the doctor came in. Suddenly about 4-5 extra people came into the room. (I later learned they were nurses, and pediatricians.) The doctor began shouting at me to “PUSH!” All the people were looking at me and I was on all fours in the hospital bed. The nurse screamed “GET ON YOUR BACK NOW” and two nurses grabbed my arms and legs, violently flipping me onto my back.

They wrenched my legs open, forcing my knees toward my ears, while several people (nurses? the doctor? I don’t know exactly who) screamed at me to “PUSH!” The doctor put her hand in my vagina which caused a great deal of pain. I was filled with terror as the nurses held me down and I pushed my baby out.

I later learned that the heart rate monitor had shown a normal, healthy fetal heart rate the entire time. The baby’s APGAR score was 9/9, he breathed and cried right away, and weighed almost 6lbs. The medical record that the hospital released when I requested my and my son’s records has only one phrase describing the delivery: “uncomplicated nsvd [nulliparous singleton vaginal delivery].”

The noise, pain, screaming and unknown people’s hands touching my vagina and my thighs terrified me and I still have PTSD symptoms. I received a minor, but permanent, injury during the delivery.

Because my Group B Strep status was unknown, the doctors wanted to give my baby broad-spectrum antibiotics. They did not discuss benefits, risks, and possible alternatives with me. I consented because I was afraid if I did not, they would call Child Protective Services. My baby was fed formula during our entire hospital stay, without my consent. During the postpartum stay, the nurses often separated my baby from me for many hours in a row and did not bring the baby back when I asked. In spite of this, I was able to initiate breastfeeding after we were discharged from the hospital.

My formal complaints

Several months afterward, I asked to meet with the doctor and nurse(s) who attended my birth, but the hospital denied my request. The hospital did allow me to meet with the head of OB/GYN and head of L&D nursing. Because my PTSD symptoms featured flashbacks from the delivery itself, I decided to center my complaint around that, rather than around the antibiotics, formula, and forced separation which took place postpartum.

Both of the hospital officials expressed sympathy for my trauma and said they were sorry I was unhappy with my care. However, they firmly stated that all women deliver on their backs in that hospital, and if a woman is not on her back when the doctor wants her to be, she will be forcibly moved into that position. They said they were sorry there had not been time for the doctor to explain that this was the way their hospital worked. They promised to implement new training to help nurses be more gentle – ostensibly when they forced women on to their backs.

I did follow up to see what sort of new training they had implemented, but they did not give me any information.

I sent a formal complaint to The Joint Commission, thinking that my treatment might qualify as an inappropriate use of restraints. The Joint Commission has several guidelines regarding restraints, usually referring to psychiatric patients. The guidelines say that they may be used to ensure patient and caregiver safety, but may not be used for staff convenience.

ACOG also has stated that restraining incarcerated women in labor can compromise their health and is demeaning. There is a Cochrane review which found no significant difference in health outcomes for babies or women whether they gave birth upright or on their backs.

The Joint Commission said it would do an investigation. The investigation found that the hospital staff had behaved appropriately. I wrote a detailed complaint letter to the hospital. I received a formal apology letter in return, and the hospital honored my request that it forgive the 20% coinsurance payment that was part of my insurance provider’s agreement.

My next steps

This experience has affected me in a number of ways. I do not plan to give birth in a hospital the next time around. In case my next pregnancy requires hospital care, I would like to have an attorney on retainer, and I plan to pre-print “Against Medical Advice” forms to bring with me. I am even considering having a male friend serve as my “bodyguard.”

I am also giving some thought to the possibility of giving birth unassisted in case I cannot find a trustworthy medical provider. Finally, my family and I are seriously researching other countries where we might move. Certain countries do give women choice and control over their own bodies, and provide legal recourse if their rights are violated.

If I have any daughters in the future, I want them to be able to seek medical care without fear.

Even though my treatment resulted only in PTSD and minor, if permanent, injuries, it is on the same spectrum as that of women who emerge with severe complications from unconsented procedures. Even if no permanent damage results, I still believe it is wrong for women giving birth to have no say over who touches them where, and what procedures are done to them.

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About investigatingbirth

My investigations of birth began in 2009 when I was trained as a doula. I helped women consider the evidence on common interventions, and helped them prepare for the physical and emotional challenge of giving birth. After some time it became clear to me that there was another type of challenge that I was unable to adequately prepare them for, the challenge of the maternity system. But it was only after my own traumatic birth in 2013 that I realized how little I had understood. I began to ask questions that few around me - doulas, nurses, midwives, doctors - were comfortable hearing. Questions like: Under what circumstances, and for what reasons, do doctors not practice informed consent? How do hospitals deal with other patient populations vulnerable to abuse? How does loss of professional autonomy, for obstetricians, and professional authority, for midwives, impact the quality of care they are capable of providing - regardless of their training? This blog will collect noteworthy information that attempts to answer these and other questions. Most of what you see here will be aggregated from other sources and analyzed. You will also see original interviews, and the occasional opinion piece or personal story, as I try to piece together a clear picture of the system in which American women give birth.
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3 Responses to Inappropriate use of restraints

  1. Pingback: Birth Monopoly | Why Are We Asking Doctors if Women Should have Midwives?

  2. Pingback: Why Are We Asking Doctors if Women Should Have Midwives? | BIRTH WITH CONFIDENCE

  3. BettyUK says:

    It seems that America is so far behind with maternity care.
    Angry I found out 10 months ago that hospitals in the USA(many of them) strap the arms down of women having C Sections.
    This is absolutely not done here at all in the UK where I am and would be assault over here.
    So I cannot understand why they do it there in the US also what’s more frightening is that some posts I read from US sites women who had C Sections in American hospitals have said that they were strapped down without their consent even though they said no.
    How can this be right?
    Betty.

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