So it is my turn dear reader to share one of my many birth stories. Let’s put it this way I have about a 50% success rate in the old pregnancy game – I’ve lost a baby in every trimester but I have had my fair share of magnificent birth experiences. This is a blog about loss, about pain and the fact that the language used by medical professionals can really leave a lasting impact.
So to begin at the start (which is always a good place I find). I was 39, in a job I loved where I read all day, bought books, spoke to people about books, looked at books, (hopefully) engaged children with reading. I had a husband and two daughters who were all settled in school and work and a thin blue line on a pregnancy test threw a complete spanner in the works. Not planned at all that little line, steps were being taken to prevent it happening and yet Supersperm and Eageregg decided that they needed to get together and blow the consequences!
So Hubster and I find ourselves in an office in a back street of Manama, Bahrain seeing a doctor and looking at a grainy black and white screen at a baby and lying next to it, en utero is the aforementioned defunct IUD. We decided to not remove it as that would jeopardise the pregnancy and being very much of the mindset that when life throws you lemons you add them to gin and tonic we would see where this curveball would send us. So we went away to break the news to nearly teenage daughters and await the howls of laughter from friends who would no doubt think we were crazy to do it all again.
I started to bleed at about 12 weeks, just a tissue wipe showed that things weren’t what they should be. Another more significant bleed a few days later signed me off work for a month. The bleeding continued every few days but we knew that it was the risk that we had taken by not have the coil removed. However at 18 weeks, the cramping started and the bleeding moved from nocturnal to day time. We headed to the nearest hospital to see what was going on.
What was going on was chorioamnionitis a bacterial infection of the amniotic fluid and the surrounding sac. The only way, at the stage of pregnancy to get rid of the infection was to deliver the baby, which due to the scale of the infection and gestation would not survive.
So I found myself admitted overnight on IV antibiotics overnight with the procedure scheduled for the morning. We had a scan that evening to confirm assorted medical details for the morning – it went like this:-
Radiographer – lie down here. OK?
Radiographer – baby dead. OK?
According to the look on her face – my rather sweary response wasn’t ok.
Now dear reader you may by now have the sense that I am not the sort of person who likes to burden people with my sorrow. People have enough of that going on in their own lives without taking on mine too so when I asked the nurse who wheeled me theatre, so I could have my baby removed from my body, if she was tired – I really appreciated the response that yes she was as ‘soooo many babies born last night.’ Fantastic. Whoopdy doo.
I haemorrhaged, nearly died – that’s all you need to know about the operation.
I will never forget the Hubsters hand tightening on my shoulder as we were told that we’d lost a boy. Or the doctor trying to stop me seeing the photos of the baby – and not being quite quick enough.
In the interests of fairness I do need to say that my obstetrician was unfailingly kind to both my husband and I. He could not have done anything to change the outcome of what happened, he explained everything to us and was genuinely upset for our loss and pain.
So we head home and a few days later I discovered lumps in my breasts. After a brief debate with myself in the bathroom about whether I burden Hubster with this additional worry we head off to another hospital. Conversation with the doctor is as follows:-
Me – I lost my baby last week.
Doctor – How many weeks were you?
Me – 18
Doctor – It wasn’t a baby, it was a foetus
Soooooo yep. As every woman knows from the moment you are pregnant its a baby even though you also understand that it is a foetus until 24 weeks (when it becomes viable for life should it be born prematurely.) I really did not need to biology lesson at that point of my recovery.
In guidelines for Intrapartum Care issued by NICE (National Institute of Health and Care Excellence – a UK based organisation) senior doctors are encouraged to lead by example in their relationships and communications with women ‘and their birth companion(s) and of talking about birth and the choices made when giving birth.’* There is a growing realisation worldwide that pregnancy is not a sickness, that the relationship between mother and medical professional needs to change to reflect that. Likewise in a report published last year the WHO (World Health Organisation)** called for there to be ‘effective communication between maternity care providers and women in labour.’ This should at a minimum should include addressing mothers by their name, avoidance of medical language, and support of a woman emotional needs ‘with empathy and compassion.’ Furthermore an earlier article published in 2015 stated that ‘Poor communication skills of a […..] clinician can ruin the goal of providing support to the patient and eliciting patient’s collaboration for future treatment.’*** So why does it happen?
There are the obvious reasons of tiredness, compassion fatigue, of conceit, the staff not speaking in the patients native language, lack of education in addressing the mental needs of patients and the belief that the doctor knows best. For women in labour and pregnancy there has been a historical view that they are making a fuss, it doesn’t hurt that much, that if 140 million women a year can do it then why can’t they? All of those have a validity but when you are being told that you are having an ‘elective abortion,’ (miscarriage is the term that should be used), that your bump is small, too big, that you’re not putting in any effort after eight hours of labour, asked to bear the pain as its ‘only,’ having a baby, if you pray then the pain will get better and you won’t need painkillers, that you are ‘only,’ 4cm dilated, when medical staff put their hands on your body – let alone touch your vagina without introducing themselves then something needs to be done. Things need to change.
With so many guidelines from so many respected sources I have every confidence in the next generation of medical leaders to bring about a change in childbirth and mother care. Until then, we as the patients, as the customers should use our feet to do the talking and use facilities that give us the respectful birth that we are entitled to, call out the medical staff who are rude and if we can’t then expect our partners, family and friends to do it on our behalf. As a friend put it ‘at birth we are simultaneously armour-coated lionesses & the most raw & vulnerable we’ll ever feel.’ That is what needs to be understood, that we are women and we will roar until things change.
For me? That pregnancy started me on a course that has me now in front of a computer writing for you. Do I regret it? Not one little bit – he was the seed to the tree that I am sitting under now, the fire that got me started – how can I regret my only boy and that pregnancy?
- *Humanising birth: Does the language we use matter? pub Feb 2018 authors Mobbs, Williams and Weeks BMJ Blog
- **WHO recommendation on effective communication between maternity care providers and women in labour pub 15 February 2018
- ***Journal of Clinical and Diagnostic Research – How can doctors improve their communication skills? pub March 1st 2015