Reflecting on Childbirth after Losing a Womb to Cancer: Part 1 – Birth

Carl Vilhelm Holsøe (Danish; 1863-1935)_www.kaifineart.com-04_Motherhood 1_Cropped

“Mother and Child at the Window” – Oil painting by Carl Vilhelm Holsøe (Danish; 1863–1935)

My son and only child was born 31 years ago today – July 18, 1984 – when I was 31: 31 + 31 = 62, my current age . . . and a good time to remember that I am very grateful for the womb I once had.

Note, however, that this site is about helping patients become the most important members of their healthcare teams through acquiring information and actively participating in medical decisions. My life has taught me a number of difficult lessons leading to this realization. 

The following story illustrates how unempowered I was during my only child’s birth—in some ways, I was more helpless than my baby. The experience haunts me still with feelings of anger, guilt, and sadness. Somehow, I think I should have protected my son and me from indifferent, and possibly negligent, obstetrical care at this suburban Philadelphia hospital. 

Before I tell the tale, I should let you know that it had a happy ending—my grown son is alive and well. 

Here’s what happened. . . .


Part 1 – Birth

“Enjoy this process. Remember: birth is a sexual experience.”

Yes, that really is what the coach told my then-husband* and me during our natural childbirth education classes. It wasn’t LaMaze, but whatever the other competing method was back in 1984. Perhaps I don’t remember because it was moot when the time came for my son to be born.

Not only did we not enjoy the process, but we found it terrifying and disturbing. To this day, I feel surges of anger and a deep sense of grievance when I remember the way the staff at this suburban Philadelphia hospital treated us 31 years ago. Most of all, however, I feel a sense of guilt that I wasn’t better prepared to meet this experience with hard questions or to obtain satisfactory answers, both before and after the birth. This was my only experience of childbirth, so to have it marred by disappointment and a sense of injustice is difficult to this day. However, I repeat that I am very grateful that I was able to bring my child into the world.

My son was due to be born on the 4th of July. About two weeks before that, I somehow contracted Haemophilus influenzae, a bacterium that usually infects children under 5 years of age and can be deadly. Although it doesn’t cause influenza (which is viral), its symptoms in me were very flu-like, and I also had bronchitis. This bacterium has six main types (a through f), the most familiar being type b, or Hib. A vaccine is available for only this type and is recommended for children.

I felt deathly ill and was also deeply worried about the health of my baby, although the doctors said the infection would not cross the placenta. They could not give me antibiotics, though, which apparently would affect the fetus. So all I could take was Tylenol. At my weekly prenatal visit, I asked the doctor I was scheduled to see that day—the only woman on the team—how they would help me during the birth process if I was so sick. She said, “We certainly won’t give you anesthesia just because you have a cold.” So much for empathy from a fellow female.

Around the time of my due date two weeks later, I was just starting to feel better. But I had no signs of labor. The days passed, and I grew increasingly impatient, desperately wanting my body back and my baby in my arms. Then, in the early-morning hours of July 18, I had some spotting and started to feel mild contractions. How exciting! And I wasn’t sick anymore, so I was more than ready to put my natural childbirth classes to good use. I never foresaw that I would not need to use them.

After a few hours, the contractions were occurring every 10 minutes and then more frequently, so I went to call the doctor’s office to find out when I should head for the hospital. Oddly, our phone was out of order, and for no apparent reason. It hadn’t been broken previously, and later it somehow corrected itself and was fine. But when I needed it the most, I heard no dial tone . . . which turned out to be a sort of bad omen. So I sent my husband next door to call (we didn’t have cell phones then), and he said they told him I should walk around the block a few times and then come in when the contractions were 5 minutes apart. So we walked (I waddled), and after I got home and tried to rest a bit, it was time to go. The neighbors were at work, so we couldn’t call the hospital to say we were on our way.

When we arrived at the hospital about 4:00 PM, one of the obstetricians on the team saw us in the elevator and said, unsmilingly, “How come you didn’t call?” I told him what happened, disconcerted at the less than warm welcome. I don’t recall the specifics now, but I seem to remember that it was a busy day in the maternity ward. They put us in a room by ourselves and got me situated as comfortably as possible. The contractions became increasingly vigorous, and I remember feeling startled by the way my body just took over. After two hours, I was still dilated to only 3 cm, so the obstetrician (the one from the elevator) came in at 6:00 PM and broke the amniotic sac with a fourchette to speed up labor and dilation of the cervix. He noted some meconium staining as the amniotic fluid started to leak out and inserted a fetal probe so they could monitor the baby’s heart rate.

Over the next hour, while my husband and I were in the labor room alone, the contractions became more powerful. At 7:00 PM, the nurse came to check on me and gave me some Demerol, telling me I had at least another six hours of labor and that I couldn’t have an epidural until I was almost fully dilated. I was still only at 3 cm. I said to my husband, “If this is what early labor feels like, just kill me now!” Over the following hours, with no one coming back to check on me, the contractions started ejecting the amniotic fluid quite forcefully, and I felt as if I was urinating all over the bed. I screamed for my husband to go get help as I saw and felt my body heaving, unable to believe I was still hours away from giving birth.

My husband came back with a tired-looking, indifferent resident, a woman, who said dismissively, “So, you think you have to push, huh? Let me take a look.” A moment later she said, “Oh, my God, you’re crowning!” My cervix had dilated 7 cm in only an hour. Then the resident looked at the fetal monitor and saw that the baby’s heart rate had slowed down to a dangerous point. Next thing I knew, they were flying me down the hall to the delivery room. It was 8:00 PM.

The doctors quickly administered a pudendal block, and the senior obstetrician on call pretty much yanked my child from my body with forceps, tearing the length of the left side of my vagina, as my husband held my head between his hands while I screamed. I looked at the clock—it was 8:15 PM—and then at the small, blue, limp form in the doctor’s hands. “It’s a boy,” he said matter-of-factly. We hadn’t had any prenatal ultrasounds to determine the baby’s sex, but I just knew he would be a boy . . . after all, I had already painted his room blue and bought baby-boy clothes. I managed to say, “Is he alive?”

Again, the doctor responded matter-of-factly: “Yes, but he has asphyxia from swallowing and inhaling meconium in the amniotic fluid. He’ll probably be brain damaged and need to take phenobarbital for the rest of his life.”


Also See: Part 2 – After-Birth
______________

*My son’s father, my first husband, died of lung cancer a year ago. I remembered him in a repost yesterday.

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