I wish what I'm about to tell you was a joke. I wish it was the first time I had ever seen and heard it. I wish it wasn't a semi- regular occurrence.
I just attended the birth of a beautiful first time Mama. She labored quietly through out the afternoon in a busy Atlanta hospital bath tub with her husband close by. Unlike a lot of young first time mothers; this young lady was confident, secure, and well read in all things concerning her birth. Shortly before she was made to get out of the bathtub we saw a discolored cloud spread out from her body into the water. Her membranes ruptured. Meconium.
Completely dilated, calmly laboring her baby down, in rushes the Doctor; not my client's OB, not even the back up OB whom she had met at a previous appointment. This new, unknown, OB's energy instantly permeates the room. As she puts on her gloves and ties her gown, without even introducing herself - she begins to loudly command my client to push. She's never pushed a baby out of her body before. She needs a minute to acclimate herself to the sensations. The baby is nice and low; already trying to work her way under the pubic bone. I notice at the peak of the contraction, during pushing, the baby's heart tones drop, but the heart rate quickly comes back up when Mom stops pushing. Baby looks great, but that isn't what the Doc is saying. The OB starts screaming, between contractions, "We need to get this baby out, NOW. I'm not feeling confident about her heart." My client's eyes are locked on mine. I briefly break her gaze to look at the monitor. 140. 142. 138. She's pushing. 128. 120. 118. 125. Taking deep breaths after her last push. Baby's heart is back in the high 130's easily going into the mid 140s. The OB has been aggressively doing perineal massage. It looks like she is trying to do a manual episiotomy. I'm totally wincing on the inside. There goes my client's gentle birth.... She's screaming at my client, "Let's go! Let's get this baby out NOW. Right Now! Baby is in danger!!!" With the monitor right over my client's shoulder I'm now calling out, loud enough for EVERYONE to hear, heart tones. 129. 130. 132. OB can't help but hear me and calls for a pulse ox for Mom. She argues, to no one in particular, that she can't tell the difference between Mom's heart beat and baby's heart beat. Ummm Okay. Mom is a fit, healthy, very young woman. Her heart rate is hovering around 80 and spikes up to a wild 89 beats per minute as the Doc is screaming about how her baby is going to die if she doesn't push her out NOWWWWW!!! Mom is totally assured as I lean in close, put my hand on her heart, and softly call out her baby's heart tones. It sounds like this is happening over a long period but really it happened over the course of a few contractions. Baby is born. Pink, reactive, and screaming her petite little head off. Mom is bleeding from an obvious tear. I can't tell if Mom tore because of the OB's rough perineal massage or if it happened as baby flew out.
Placenta is born. Ob starts to prepare to suture. She lifts the threaded suture needle and starts to suture. Wait! No lidocaine! My client is not calm now. She is screaming. The OB is actually arguing with her. She insists that my client can't possibly feel her pelvic floor being sutured. I am losing my mind. I need someone to duct tape my mouth shut and get tissues to dab the blood pouring from my bleeding eyes..... Normally I don't interfere but I can't help myself. I ask the OB if there is anything she can give my client. Obviously she is feeling pain. She didn't make a peep through her entire labor or delivery and now she is screaming out with every poke of the needle. The OB is actually annoyed. Finally the RN reminds the OB that our Mama hasn't had an epidural. She also reminds her she hasn't given her any lidocaine. The OB has the nerve to roll her eyes. If you think I'm done; I'm not. The OB's final act of Barbary left me speechless.
My client's labia were torn. The OB took a pair of surgical tweezers out and put the jagged pieces together. I thought, "Great. She's going to restore my client to her original state, prior to birth." I guess my expectations were way too high. The OB holds one side of the labia with the tweezers and picks up a pair of surgical scissors and she cuts. As she is cutting off a piece of my client's labia she says, "I'm just going to cut that off. You don't need it." Then she repeats the same procedure on the other side. I seriously can not believe what I am looking at. On the tray with all the gauze and garbage is 2 fairly decent sections of my client's labia.
After OB the barbarian leaves the room; my client quipped, "Giving birth was surprisingly easy. It was what happened after my baby was born that really hurt!".