Tanja: Informed consent and physical autonomy were taken away from me

I am certain that my first birth experience is not very different from the majority of mums’  who feel traumtised by highly medicalised births at Australian hospital labour wards, where their choice  of a natural and un-medicated birth experience  was completely ignored and where they were coerced into agreeing to unnecessary interventions.

The only difference might be the fact that I have suffered from severe needle/hospital phobia  since early childhood after a traumatic experience at the age of six during a hospital stay in Germany.

I always had wanted  to opt for a homebirth partly due to my hospital/needle phobia and also because I have always viewed birth as a normal,  physiological process, however due to having experienced two early consecutive miscarriages in 2009, my husband and I decided that a private OB was the safest choice for us. After interviewing  three doctors we settled on an OB who had been recommended to be supportive of natural birth and who appeared understanding and empathetic towards my needs. He was informed by my GP in a referral letter  as well as face to face by myself about my extreme fear of hospitals/medical procedures and assured me that if anything would go wrong with my plan for a natural birth and the need for a cesarian arose, I would be given general anesthesia.

This pregnancy was filled with anxiety and fear as was the case with my first two pregnancies before I miscarried. Using the relaxation and breathing techniques I had learned at an independent ante-natal class, I gained confidence in my ability to give birth naturally.

Apart form my anxiety about being admitted to a hospital when in labour, my pregnancy was completely complication free. My husband and I were repeatedly assured by the OB and the hospital that our choice of a natural and intervention free birth would be respected.

This promise seemed to be completely forgotten when I went into labour at 40 +3, after mild contractions the previous night my membranes ruptured the next morning. Not worrying because the fluid that leaked was free of meconium I stayed at home and kept active. In the evening my contractions became stronger and went to the hospital for monitoring. The atmosphere there completely stressed me. The nurse phoned the OB at 11 pm and he told her to book me in for induction without having consulted me first. I refused, we made the one hour drive home again. As soon as I relaxed at home my contractions became stronger and we attached the TENS I had hired to my back and were off again to the hospital a few hours later. Again I was “chained up” to a fetal monitor for hours until we were finally settled into a birthing suite. The OB came to see us and told me that if we wanted to stay at the labour ward we needed to agree to an IV with artificial oxytocin, we were both tired and my husband would not have been able to drive back again so I reluctantly gave in to the pressure from the OB and consented to have my labour augmented.

I was worried about the possibility of experiencing much stronger contractions once hooked up to the IV but the OB assured me that doctors have often “trouble” getting women into labour with syntocinon. At home I had administered topical anesthethic cream to my arms and hands for any possible needles.

I was 3 cms dilated when the IV with antibiotics first and then syntocinon was started, restrained on either side of the bed by the IV and fetal monitor I was unable to move and only allowed off the bed once by the midwife to use the bathroom. Not once at this stage nor any time after the administration of artificial oxytocin had we been informed of the potential serious risks this medication could pose to myself and my unborn child as I was later shocked to learn when I referenced an internet  publication of this particular hospital in regards to induction/augmentation of labour and the possible complications that can arise from this treatment.

What followed next was the classical “cascade of interventions” where I had all control over what was happening to me taken away and which ended in a pudendal block and forceps delivery without my consent. The emergency delivery had been instigated after I had pethidine administered in late stage labour. I had asked for the pethidine to be added to my IV as I believed that I had hours left of this excruciating and sudden pain that was caused by the syntocinon IV dose being increased by the attending midwife against my expressed refusal. She refused to believe me when I told her that I felt my contractions were getting stronger and simply ignored my request not to increase the dose. This all took place while my husband and only support person had left for a short break. Nobody bothered to check how far I was advanced in my labour before the pethidine was added.

Images still haunt me to this day of being “shackled up” to a hospital bed, my legs held up in those awful stirrups whilst I have painful needles inserted into my vagina. I feel I could forgive some of the trauma that was inflicted upon me if anybody had only pretended to care about how frightened I was and had explained to me what was happening; instead I was left in a terrified state wondering if my baby would die and what they would do to me next.

The result of the abuse I experienced at this labour ward where my right to privacy (my genitals were at one stage exposed to a whole congregation of male students who were following a female OB who attended to me, without being asked whether this would be OK with me), informed consent and physical autonomy were taken away from me and where I was in the end treated like a ” piece of meat” and not like a human being left me to suffer from PTSD for more than 2 years. Not only did this birth trauma cause me to suffer from nightmares and flashbacks , it almost destroyed my marriage and our young family.

I felt deeply traumatised, betrayed and violated after the delivery of my baby, but pretended everything was fine until I mentally and emotionally crashed the day after my postnatal appointment with the OB. These days my distrust of hospitals is greater than ever, there are only a very few empathetic health care workers  whom I got to know well and whom I feel I can trust.

Lodging a complaint with the OB against the increase of medication against my consent I was told that the attending midwife had acted according to protocol. My complaint to the Health Commissioner in regards to the uninformed consent was also dismissed because the OB had stated in an email to us that he was sorry we were not informed of all the possible risks of a syntocinon infusion, when in fact he had not informed us of any. He stated that he feels he does not need to inform patients of those risks due to him trying to avoid those side effects/risks by titrating the doses of medication at the lowest level.

After two meetings with the director of nursing and the birthing suite manager I was told that I should be glad I had a healthy baby and that there is no time for niceties in an emergency situation.  Later on I received a letter from hospital management where I was told that the midwife could not possibly have known that I was very close to second stage labour due to me not omitting any grunting noises and that our daughter’s life had never been at any stage in any danger due to her having had an Apgar score of 9.

I felt re-traumatised by those statements and by the dismissed complaint to the Health Commissioner but decided not take my complaints any further as I was pregnant with my second child at this stage who was very lucky to be born at home 14 months after her sister with the support of two very supportive and caring independent midwives and my husband. My husband and I will be forever grateful to them for this empowering and healing experience where I felt in control at all times and for giving our youngest daughter a peaceful and calm entry into this world.

Tanja Kahl
Australia

 Tanja Kahl home birth - small

5 Responses to “Tanja: Informed consent and physical autonomy were taken away from me”

  1. Aubrey True June 14, 2013 at 7:44 am #

    The dehumanization in hospitals is an issue near and dear to my heart. I hate that you had to have your first baby’s start in life marred by such a horrible experience. But I can appreciate the healing nature of a supportive and respectful home birth, because I had one, too. I’m so glad that happened for you. Thank you for telling your story.

    • Tanja Kahl December 23, 2016 at 10:24 pm #

      Many thanks for your supportive comment, Aubrey and I’m 100% with you in regards to the dehumanization of women in maternity hospitals around the world! We need to keep fighting to stop obstetric violence to pregnant and birthing women!

  2. Nancy October 3, 2016 at 11:25 am #

    Oh, how I feel for you. My first birth was very similar to the one you describe. My pudendal block was very painful and, as mothers in the second stage, we are already in so much pain. My doctor was extremely disrespectful. He told me to “quit being fussy.” As the years went by, I heard stories from other women about how they felt violated by him. He told a woman who had just delivered an 11 lb 4 oz baby, “Oh come on, it wasn’t that bad.” He’s a misogynist. The last thing you want when you are delivering your child. I’m a doula now so other women don’t have to go through what I did.

    • Tanja Kahl December 23, 2016 at 10:30 pm #

      Thank you so much Nancy for your supportive comment and for sharing your birth abuse experience. Very sorry you had a very misogynistic OBGYN :( Unfortunately the ‘good ones’ are very rare to find these days and what I heard they are as much persecuted by their OBGYN collegues as home birth midwives are….very sad :( Good on you for supporting women’s birth choices as a doula!

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