Thank God for the Shift Change: Sara's Story
Monday, April 18, 2011 at 8:16AM 
By Sara
My Labor Story
Disclosure: I will do a lot of complaining in this story. I was overall unhappy with my experience with the hospital and staff, however I am totally elated over having a little girl and satisfied that I did everything I could with the options given to me.
Characters:
Sara- mommy to be
Seth- daddy to be
Celeste- Doula (birthing coach)
Sarah- day shift nurse
Karen- night shift nurse
Dr. L.- my OB
Once Upon a “It’s Time!”…
On January 3, 2009 at 2:41 am, I woke up thinking, I might have to use the bathroom. I got up and water started gushing. On my way to the bathroom, I called to Seth “Seth, my water just broke.” He moaned from bed. “I am NOT kidding!”
Seth jumped out of the bed “Are you serious?!” He threw on some clothes and got into gear. “Do we need to call the hospital? What about Celeste, should we call her?” He came to the bathroom where I’m still sitting on the toilet. “Is that your mucus plug?” he asked pointing to the bathroom floor.
I’m still half asleep myself and don’t have my glasses on. “I guess it is, give me my glasses.” I verified that indeed it was my mucus plug. “Ok, this is real,” I think to myself, “What next? I’m not having contractions, so I guess we can call Celeste, just to let her know what is happening.” I told Seth to call Celeste and I would find out what I should do. Since I was GBS (group b strep) positive, I knew the baby was at a higher risk of infection, but that I could try to labor at home for a while before it became imperative that I go to the hospital to be treated with antibiotics. The antibiotics should be administered at least 4 hours before delivery and since I wasn’t having contractions, I knew I had a while before I delivered.
We called Celeste and she said if I felt comfortable (and since I couldn’t feel the umbilical cord (which would have changed everything) I could try to get contractions to start at home. I got up and began walking and stimulating my nipples (just another way to get contractions going). I sent Seth to Wal-Mart to get some last minute things and breakfast. I knew that I should eat while I can since the hospital won’t let you. While he was gone, I called my mom and sister and Seth called his mom who was in Florida.
Seth came back and made me eggs and toast. Contractions had started but weren’t very strong. However when Seth was timing them, they were lasting 1 minute and were 4- 5 minutes apart. Seth was getting very anxious, so I agreed at 6:00 that we could leave for the hospital.
I called a good friend on the way to the hospital to let her know so she could take care of our dog. She was super excited. I called and updated my mom also, to let her know we were on our way to the hospital. On our way to the hospital, I saw 3 shooting stars. Seth and my mom joked that we should name our baby Star if it was a girl. Ha… no way… I got hungry again before we got there, so we stopped at McDonalds and I had an egg sandwich. It was almost 7 before I got up to Labor and Delivery to check in.
The Pre-Labor Saga Begins:
So, we made it to Labor and Deliver and there is a LINE! Once it was my turn, I cheerily said, I’m here to check it, my water broke around 3 this morning. They put me into the triage room to get me checked in and wait for the doctor to come check me to see how far/if I had progressed.
The Triage room: This room is about 8x10. In either side, there is a reclining chair, a cart with monitors on it, and a second chair. In the middle of the room, there is a desk where the nurses can enter their information and monitor the entire floor’s contractions.
They put me in the section on the far side of the room (not so far). The do the routine questions and then take me into a different room to be examined. When Dr. L. came in, I let him know that at my appointment on the previous Monday, I wasn’t even a cm. dilated. He checked me and said, I still wasn’t a cm. He asked if I wanted to be put on Pitocin to start later, and I told him, my plan was to start contractions on my own by walking. He said that was fine.
So, back to the pre-labor room to be hooked up to antibiotics via IV. Now, I’ve never had an IV before, so I’m not sure what I’m looking at. In my birthing plan, I state that I want a hep. lock so I don’t have to be connected the IV the entire time. So, when the Charge Nurse starts connecting me to an IV bag, I assumed it was the antibiotics. Needless to say I was caught off guard when she gets up and says she will be right back with the antibiotics. Confused, I ask, “Then what is this?” She says “Oh, that’s just saline to help keep you hydrated.” WHAT?! Who said I was dehydrated? I can’t believe that this nurse just gave me an IV of saline without my consent! So, the nurse comes back and connects the antibiotics. I go for a good 30 minute walk around the ward while my antibiotics drip through. Once they are done, I let them know and tell them that since they are taking off the antibiotic drip for the next 4 hours, I would like for them to disconnect the saline also. “I’m sorry, but we can’t do that”. Excuse me? “Your baby just doesn’t seem perky enough, so we want to make sure everything is ok.” This made me mad. The baby’s heart rate has been between 125 and 135 the entire time I was on AND off the saline. Around this time, I get assigned a nurse, Sarah. I don’t think she deserves the name. As you will see, she is not so friendly and nice as Sara(h)’s should be.
So, once again, I suck it up. I need to be monitored another hour before I can walk again. The monitors are not consistently picking up the baby’s hear rate. It is only working if I stand or if I’m reclined. However, since the recliner is broken…. I need to hold onto the recliner so it stays reclined. This experience just gets more fun! After an hour, they allow me to get up and walk for 30 min. with my trusty IV stand.
When I get back to the room, Sarah informs me that before they can let me go on another walk, they will need to do an internal exam to make sure the baby’s head is engaged because of the risk of the umbilical cord prolapsing (coming out before the baby). I told her, I don’t want to do that. I want to minimize the number of internal exams because the baby is at a higher risk of infection since the water has broken and internal exams increase the risk of infection. Well, she needs to check with the doctor, but feels that if I don’t get checked, that I won’t get to walk. She comes back about 30 min. later and says “Absolutely not! If you do not get checked you cannot walk. And if you do get checked you can walk as long as the head has engaged and you are head down.
Great! I have to suck it up again! Walking is important because it brings on contractions, which lead to good labor, which means I can have a baby! Sitting in their broken recliner does not bring on contractions, which means active labor does not start, which means I have to get on drugs to get things going. Not at all what I want to happen. Soo… FINE I will be checked. Sarah checks me and says it doesn’t feel like the head is down or if it is, then it is not engaged. So she takes me in the exam room to see if she can get a better feel and to use a sonogram to see if the head is down. We find out that yes, the head is down, and no it is not engaged, so I need to stay in the stupid broken recliner. The doctor comes in later after Sarah checked me to see if I still want to try to get started naturally or if I want some pitocin. He also makes sure to mention that after my initial examination, he told the nurse that I would be a c-section. Nice. At barely 1 cm, he has already written me off. Not only that, they are doing everything in their power to keep me from doing things naturally.
By now it is 1 in the afternoon. I’m hungry, but since I’m at the hospital, I can’t eat. Contractions are not consistent, but since I’m at the hospital, I can’t walk. Oh, and since I’m STILL in the triage room (yes, still) I am only allowed to have one visitor. Seth is the only person allowed in the room with me. Even though my parents are there, even though I have hired a doula to help me make decisions, even though they have kept me in this crypt size room for 6 hours, I am only allowed to see Seth. The baby has been doing fine, there have been no signs of distress (even after coming back from the walks which means the cord was not prolapsed). I have not had a fever, which means no infection for me or the baby. Still, I cannot leave my broken recliner or see someone who I have asked to be a support to me and help me make decisions. The nurses and doctor have quarantined me and asked Seth and I to make these decisions with out our support team (I don’t feel that the staff is part of that team since they have done nothing to help me with what my original plan was).
So, time goes on. I’m getting more frustrated because I’m stuck in this room. Seth is getting frustrated because we are stuck in this room and he is my only source of support. Around 4:30 (yes, still in triage) Seth tries to get my mom to come in. Of course the nurses don’t let her back. Seth starts demanding to speak to someone in charge. It’s ridiculous that they have kept me in this room for so long and they have not allowed anyone else to come back. Meanwhile, Sarah is in the room with me saying “I just can’t help getting the feeling that you are mad with us.” I looked at her in disbelief. Are you kidding me?! Would anyone be happy with they way they were treating us?! Cue the breaking point (and me trying to still be courteous at the same time): I start sobbing! “I’m just really frustrated right now. You all are keeping me in this room. I can’t eat, I can’t walk, and I can’t have the people who I have gotten together as my support team in this room to SUPPORT me!”
Sarah’s response: “Well, this is all part of being a parent. Sometimes your child doesn’t do what you want it to and you have to just go with it. If you want to talk to someone for support, we aren’t keeping you from using the phones. Why don’t you just call them?! As for a room, we are doing the best that we can, but people are coming in further along than you, so they need the rooms more. If you have a problem with the visitor policy, you need to write a letter to the hospital board, we can’t do anything about it.”
My response: nothing. I can’t say another word without wanting to get in her face screaming and cussing at her. I couldn’t believe she was acting like this wasn’t out of line! We have been stuck in this room for almost TWELVE hours!!!! How can that be OK for any hospital?!?!?! AND the entire time we have been there we have been the only ones in the two-patient triage room, so where are they getting these other people?!
So, Sarah leaves and Seth comes in after his tirade with the nurses station to find me in tears. Around 5 the charge nurse (same one that administered the non-consensual IV) to inform us that we are getting the next room. She has already alerted housekeeping and they are moving the patient out of the room as we speak. Seth and I don’t have anything to say except, it’s about time. She apologizes and leaves the room.
So, somewhere between 6 and 6:30 we make it to a labor and delivery room. Yes, that’s right, almost 12 hours in a triage room tied to a broken recliner. I was having minimal contractions the entire time (however their machine couldn’t pick them up, so they kept saying I wasn’t having them…. I think I know my body better than their machine) at most, one every 15 minutes.
Shift Change:
Thank GOD for change, and thank GOD for this shift change! At 7:00 evil Sarah left and an angel of a women, Karen came to rescue us.
Now that we are in a labor and delivery room, Seth, Celeste, and my mom are allowed back in the room with me. I was so relieved just for the change of scenery. Once in that room, Celeste went to work. She is my hero! She informed Karen of what my desires were (natural labor and walking as much as possible WITHOUT the IV) and asked what the possibility of this happening as well as gathering laboring equipment (birthing ball, birthing stool, water, etc.).
Karen’s response: “Absolutely not a problem. Let me check the baby to get a feel for how he/she is doing and if everything looks ok she NEEDS to start walking to get contractions going.”
WHAT?! REALLY?! Can someone please re-educate Sarah?
Karen checked, the baby’s head still wasn’t fully engaged, but was far enough down, she felt like it would be ok if I walked. Checked the baby’s heart rate and my temp, both fine (like they had always been). “Ok,” she said, “you can walk.” Someone (Celeste or Seth) asked about the possibility of capping off the IV so I could walk without it. “Absolutely, I’ll put a saline lock on it, and you’ll be good to go. You’ll just need to be hooked up when we administer the antibiotics.” NOT a problem… again, can someone please re-educate Sarah, and perhaps the charge nurse as well.
Well, what a surprise when I start having regular, strong contractions!
Everything starts becoming a blur for me here. I remember laboring really well with the support of Celeste (and sometimes Seth, poor guy got nervous when I started having strong contractions and moaning). The experience is a little less of a blur when I reach 6 cm. All of a sudden this labor that was going really well, starts to go down hill. My body decides it is time to push.
Now, I’ve seen the baby story shows where people say they need to push and I think “no way, you can stop yourself. If they say ‘don’t push’ DON’T PUSH!” Easier said than done. There is no way that I could stop myself from pushing. I was so upset with myself. I just couldn’t control my body. For several hours, Celeste and Karen tried to get me in different positions to help minimize the urge and to help the swelling in my cervix to go down (caused from pushing too early). Karen knew that the monitor wouldn’t pick up the baby’s heart beat unless I was in a horizontal position, and since that wasn’t comfortable for me, she stayed at my side and held the monitor to me so it would pick up the heart beat. Seth told me Karen was in our room for 2 hours helping me labor. What a blessing to have her.
Another Shift Change:
Another shift change, another change in plans…
Around 7:00 am January 4th, we needed to make a decision. My body still wanted to push, even after the interventions we tried, I was still swollen and staying at 6 cm. This was also shift change, so, Karen let me know that Sarah would be my nurse again since she was with me the day before.
The options we had were: 1. Continue laboring without intervention and hope the swelling goes down. 2. Try getting an epidural to see if that helps take away the pushing urge or 3. Get a c-section.
As with the previous decisions we made, Seth and I asked everyone, except Celeste to leave. We asked Celeste for her recommendations then, asked to speak privately. Seth was so scared by then. He had watched me labor for 29 hours and was scared with the recent events that I might not make it. He said that he wanted me to get the c-section. This was the last thing I wanted. But, I was scared that if I tried the epidural, and it didn’t work, I would either tear my cervix or I would end up with an emergency c-section (even worse than a regular c-section). That along with the fact that Sarah was back on shift and the possibility of her tying me to the bed again, lead me to agree with Seth. I was spent. I had barely slept and eaten in the past 29 hours and barely had the cognition to say a few words.
Seth filled out the necessary paper work and I signed. I was wheeled out of the labor and delivery room into the operation room at 8:00. I remember getting the spinal and holding an interns hand. I remember Seth being let in and saying “are you excited?! We’re having a baby!” I remember saying no, that I was scared. I remember a big blue sheet in front of my face. The rest is a blur until at 8:44 am they brought the baby around and Seth got to announce “It’s a…… girl? and I think it’s a Penny!” After that, I remember how excited Seth was and how much he wanted to be at his little girl’s side. I was still scared but started to relax with Seth’s excitement.
I didn’t get to fully appreciate how beautiful Penelope Jane was until after we left the recovery room (one because of how scared I was, and two because Seth forgot to bring my glasses into the OR). Thankfully the hospital allowed her to stay with me (a request in my birth plan). They warmed the recovery room so she wouldn’t get too cold, and I got to do skin-to-skin contact with her to help raise her body temperature so she wouldn’t have to go into the nursery. Finally, I was able to leave the dreaded labor and delivery unit and spend time with my precious new family.
Side note:
If experiencing all of that was not difficult enough, the doctor decided to add fuel to the fire. When he came to follow-up on my progress after the surgery, he apologized, “If you had only agreed to pitocin, we would have put you in a room a lot sooner”.
Conclusion:
The doctor and the place of birth will change. A midwife and my home will hopefully replace them.
I got a beautiful new daughter, whom is a blessing from God, and whom I love more than anything in the world. Welcome to the world, Penelope Jane!
Reader Comments (10)
Wow, that was heartbreaking. :(
What a tale! Yes! Please labor at home... and read up on the Strep B test... it is only in the last 5 years that the test has been routinely given, and the basis for the testing and real risks are *very* low. In your case you could have labored, maybe, for much longer at home before ever getting to the triage room and might have been able to avoid the unpleasant experience you had. Also, I have to tell you that I am pregnant with my 5th child, my first girl... imagine my surprise to find her exact name is shared by your daughter. My mother is Penelope and my MIL's middle name is Jane... so we have name twins! : )
i wonder if sarah the nurse has ever been a vulnerable laboring gal in a triage room for 12 hours- what an unfortunate choice of words she used. did you ever follow up and try to find resolve in her lack of compassion? write her a letter? it seems like if someone would offer her some perspective, she might learn and then not proceed to treat another in this way.
Have heard so many stories like this. But we need to keep telling them until they are heard.
I do want to say for the benefit of readers: ***the hospital cannot force you not to eat.*** You can, in fact, take out a big old sandwich right in the middle of labor and shove it into your face. Ditto juice, or water. They don't *want* you to eat because it's been the custom since the days when full anesthetic was more primitive and more widely used, and aspiration was therefore more of a danger. But it's not a law, and neither is any other procedure (although medical workers are often remarkably ignorant of this fact). And nowadays, the chance that you willl be put under general, much less aspirate while you do, is vanishingly small. Much less than the chance you will get tired and need energy.
Legally, you cannot be tied to the bed; you cannot be forced to be monitored; you cannot be denied the right to move, or vocalize. Nor will your insurance company "refuse to pay if you break the rules." These are lies that women are told, and they sound very scary, but they are still lies.
We have covered here the times when hospitals have physically violated women's rights and performed procedures against their will, but part of those stories is the fact that the hospitals were found to be at fault, consistently, and lost the lawsuits. Because it's illegal to do that.
is an excellent breakdown of your rights in labor and during birth.
(This is not a slam at Sara by the way; I didn't know these things either when I went into the hospital. I still regret not taking out the peanut butter sandwiches II brought with me when I needed it and eating them slowly and defiantly right in front of my nurse. If I had it to do over again, I'd also finish by licking my fingers and belching, for good measure).
This story makes me cringe. We'll all be happy with our beautiful new babies but that doesn't excuse the mistreatment we receive before the babies are born! I get so sick and tired of hearing "well that's the way it is" or "it will all be worth it in the end". I would walk into a burning building or swim across a lake to have my baby born well and healthy...but neither of those things are necessary either! This story infuriates me but it and comments give me the courage to JUST SAY NO. There is NOTHING, not even the "mandatory" things they tell you about - short of a state law - that they can force me to do. My birth plan is going to say simply, "leave me alone unless there's an emergency or you're needed" and "do absolutely nothing without my permission first". My sister had a horrible L&D nurse. She had no personality and did things without even informing her first, least of all asking her consent. But I now know that if a nurse can't obey my wishes I can ask for another.
Sara---what a nightmare! I cannot even conceive of not having your family with you for 12 hours. Typically we just have them step outside for a few minutes---just long enough to ask about any domestic violence issues--which we are not allowed to do with the partner present. I would definitely talk to the Director of department---Sara is in need of some communication classes!
I LOVE the idea of taking out a peanut butter sandwich and just eating it in front of your nurse--and licking your fingers for good measure--that is something I will have to "suggest".
Just had a woman with prolonged rupture like you----finally started having contractions after 18 hours--during which time she was allowed to walk liberally, continue eating and drinking. I suggested nipple stim or breast pump since she planned to BF. At 18 hours I am getting phone calls form every nurse---"You know her membranes have been ruptured for 18 hours---20 hours---24 hours---do you want antibiotics?" She was doing fine with no pitocin and not mucking around with her cervix for curiosity sake.
No--I don't -- she is GBS neg and has no fever and we have only done 2 exams--of course all this is charted "Dr. S called and notified of prolonged rupture and antibiotics requested--no order for antibiotic given"
She delivered after 31 hours rupture---lovely baby, no stitches, no signs of infection---
Your next delivery I hope will be better---maybe your husband will get to help the baby out--that is always cool to do with a family--the men get so excited and it is hilarious to hear them on their phones after telling everybody they delivered the baby.
Sounds like you hit an overburdened hospital---that's why I like the smaller hospitals---waiting in a "closet" for 12 hours is just wrong and your post explains it perfectly--copy and paste it to the CEO of hospital, department chair and Directors of OB--you may just help the next Sara!
I'm a big advocate of 'don't ask, just do it', when it comes to walking, getting into a tub/shower, eating/drinking, lowering lights, raising/lowering the temp in the room as needed, changing position, getting into whatever delivery position you want to deliver in despite the doctor's comfort/demand. The doctor/nurses comfort and convenience is NOT on the top of my priority list when in labor, and I will willingly tell them this if that is what they need to be told. But I'm not planning on delivering at a hospital...this is simply what I'm going to do if it ends up I have to.
I really lucked out, my nurses AND OBGYN were VERY supportive of ALL of my wishes and desires. With my first child my daughter we lost her heart rate (as in it went down to nothing) and instead of ordering a C Section my doctor went up and got her and they were able to resuscitate her, the cord had wrapped twice around her neck. I heard of the same thing happening three days later at the same hospital but different doctor and he opted to prep for a section and they lost the baby :( Now my second child was a section, because we discovered during the first birth my hips were too narrow to deliver even the 6 lbs 3 ozs little baby that was my daughter. Now I would rather go natural any day, but for my son the section was safest for both of us :) I am SO sorry you had such a terrible experience. I am finishing up nursing school myself and want to work labor and delivery and perhaps on as a midwife or dula.....I would never dream of acting like that to a woman in labor! Shame on you Sarah!
Sara - I was so frustrated for you reading your story! It can be so hard getting the 'timing' right with our first baby - I actually talked out loud to the computer "go home Sara and Seth - where you can walk and eat and begin labour!" LOL I love the pic of you and your family that accompanies this story.
Julie - commenter above - I would love more than anything for you to apply your nursing studies to learning a bit more about nuchal cords. Perhaps check out Judith Mercer and Rachel Reed's work?
Also, I am confused about the comment the doctor 'went up and got her' except then you say your hips were too narrow to give birth to your baby? Maybe I am misunderstanding you, but if the baby came out of your body, and maybe accommodated hands, forceps or vacuum as well, then I dont' understand your comment? Not trying to be critical, just don't get it?
Like the others, I was getting pretty hot reading this. :) I'm so sorry you had to deal with this. I understand why you went in when you did--just to be sure the antibiotics were done at the right time. I would have probably been the same way. Reading this, I felt like shouting at the nurses for you. I'd like to pretend I would have been able to, if it were me but if I am being realistic, I would probably have had the exact same reactions. Because how we are in real life and how we are in labor are different. Women in labor, and especially in hospitals, are or can be very vulnerable, especially when it's the first time and your only support is your loving husband who has never had the experience either. Sounds like the entire staff, with the exception of Karen, was horrendous. These people obviously think giving birth has nothing to do with your mental state (or that Dr. would have shut his #$% mouth in the first place).
In reading a few other comments, I am also confused, as Kate was, about Julie's--if your pelvis was too small, the baby really wouldn't have come out. I have a feeling you were laying on your back since the Dr. was either using forceps/suction/his hands to pull that little one out. Laying on your back actually closes your pelvis and makes the angle more difficult for ascent of the baby's head so technically...your pelvis is just fine. The position was not. (This is based on my assumption of how you were laying). It's actually quite difficult/impossible to judge the size of a woman's pelvis because our bones/tissue actually expand and shift to accommodate the cargo. :) The only time in history that I believe "too small" pelvis' existed was when extreme malnutrition was common-place (in Europe/America) and women suffered from Rickets, which malformed their pelvis (it effectively caused a woman's body to maintain the shape of a toddlers) and the bones even fused together. While I'm not saying that babies don't get stuck or issues arise, this excuse is used FAR too often these days by lazy Drs and horrible birthing techniques.