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Saturday
Jan202007

It's Time to Tell the Story

(I have permission to share this story in its entirety. The language I use is my own and might not seem politically correct to you. It presents no discomfort or anxiety to any of the African-Americans or the Anglos in my close circle of the story.)

In September, I was the midwife at the birth of a 23-year old black woman and her 24-year old black husband, both of whom are veterans of the Gulf War. The labor was rather long and I was assisted by my apprentice (who is white) and my assistant (who is black) and the dad's mom was also there. The other person there was a Home Health Nurse (HHN), a white woman who was about 58 years old, that the mother had gotten to know during the pregnancy. When mom (I'll call her Mary) wanted to invite the HHN, we had a session of exploring why she wanted her there and Mary said she was a sort of surrogate mom and she really wanted to show her what a home birth was like. In the first part of the discussions, that was the true reason that had come out... that she'd seen hospital births, but the prospect of being able to see a homebirth was fascinating to her.

At the home visit, we let the HHN know that birth wasn't just walking in and the baby dropping out. She nodded her understanding, but she still looked at us with a glazed semi-smiling look on her face.

When Mary was in labor, the HHN was bored shitless. Originally bounding in at 3am, by 20 hours later, she wanted to go home and wasn't shy about letting us know with her body language. She had gone home at one point to sleep, but when things picked up, we called her back as she'd asked us to. (Oh, if we could only go back.)

During labor, we laughed a lot. Mom spent time in the tub, wandered around the apartment and we listened to a lot of different types of music. One of the most amusing and memorable parts of the earlier labor came when dad put Sade on the cd player. I learned the pronunciation of the artist was "Shar-day" and when I, who was extremely tired anyway, said I knew every word of that particular cd and loved "Shar-day" so much, it set off howls of laughter from the black folk in the apartment. My apprentice and I, baffled by the cackles, didn't understand until they explained the pronunciation was actually "Shah-day."

An entire separation of cultures began, lovingly and humorously, as, over and over, differences were pointed out or given friendly winks and any word that could be twisted around, was to cause gales of laughter. One of the funniest was when mom got out of the tub and I got some Shea Butter to rub all over her very dry skin. Almost in unison, the black folk in the room said, "You mean the 'Sharrrrrrr' butter?"

Interestingly, once labor got really tough, mom coped really well with my assistant, so she spent most of the time doing the support. Having done labor support with several different cultures, I have often seen the most welcome support come from someone of the same culture and/or language. I was not of this mother's culture and my assistant was.

Mary started pushing and she really didn't like it one bit. Loud, raucous and wiggling, mom fought ever contraction and we, her support team, stroked, loved, cajoled, teased, directed, ordered, laughed, barked, whispered, waited, sat quietly, and offered her whatever we could as the head showed itself with a palm-sized amount presenting at the vagina. Thank goodness, the heart tones were holding their own during this one hour plus experience, but we didn't know how much longer that was going to be the case.

Mary screamed over and over that she was done. She was not going to do it anymore, to just pull the baby out. No amount of explaining could convince her the baby wasn't coming without her help and finally she exhausted herself and her body stiffened, her eyes rolled back in her head and she began to faint. To the uninitiated on-looker, it would probably look like the beginnings of a seizure, and surely could have been, but she shuddered slightly and when we took her blood pressure immediately, it was absolutely normal, her pulse fine and she was merely unresponsive verbally.

The HHN had her fingers on her cell phone and had already dialed 9-1 and I looked at her and said, "Call 9-1-1" and she hit the last 1 of the number, stepped out and within 2 minutes, two police officers were in the room. A few minutes after that, EMS was there and mom was a little more responsive.

All vitals remained normal as I explained the situation to the paramedics. We could still see the same palm-sized amount of head when she had a contraction and the EMTs were delighted that they might get to see a homebirth. Everybody was very respectful with each other and as the mom said she did want to stay home and birth there, the EMTs asked if they could stay and watch. Mom said, "sure" and the guys hung out and cheered behind me. I had to stop them from hollering at her to push (maybe I shouldn't have!) and they remained excited to possibly see the baby born. I explained things quietly, so they knew what was going on and the discussion in-between contractions was quiet and respectful between the Captain and myself. At least one of the young guys hadn't ever seen a baby born before and a couple of them hadn't seen a homebirth. He was giddy with excitement.

Then Mary started screaming again and no amount of trying to calm her down was working. In front of the EMTs and the HHN, the screaming wasn't going to go over very long so the EMTs asked if she wanted to go to the hospital and she cried, "Yes!" When I asked her what the hospital was going to do, she cried, "They will take it out!" I tried to explain that she would still have to push and I don't think she heard me as she began a mantra of "No, no, no, no..." and the EMTs brought the gurney into the room that had been sitting in the living room waiting the whole time.

If none of these people had not been there, we would have put mom in the car and gone to the hospital by my office. Instead, she was taken to the hospital the ambulance took her to.

There's this thing with midwives and EMTs around here. When we did In-Services, we asked about going in the back of the "rigs" with our clients and some of the guys said they would never let us in and some said it depended on the situation, but they all said to never ask... that they would pick who got to go. So, even though I had made it distinctly clear in speech and actions that I was the Licensed Midwife and Mary's husband was right behind her the whole time, the EMT in charge pointed to and said to my assistant, "Do you want to go?"

In a 5-minute conversation that lasted 20 seconds with our eyes (and just our eyes), the assistant and I looked at each other and said:
She: May I go?
Me: It'll be a great learning opportunity.
She: Shouldn't you go?
Me: But they asked you.
She: But maybe if you asked to go.
Me: Then no one will be with her; they'll get mad and she'll be alone.
She: I want to go.
Me: Then go!
She: I'll go!

And off she goes in the ambulance with my client. Dad and grandma follow behind in the car. My apprentice and I, having 2 other women post-dates, have to put the birth kit back together exactly correctly, but it doesn't take more than a few minutes and then we dash to the hospital ourselves.

What I learned later is that in the ambulance, the EMTs were terrified Mary was going to deliver and kept asking the assistant to look under the sheet to see if the baby was there. Praying the baby would be there each time she looked, it wasn't and the assistant had to tell the guys it was fine, the baby wasn't there yet. Mom was screaming with contractions and it sounded like she was pushing, but the baby wasn't progressing past the same place as before.
When one EMT tried to take mom's BP during a contraction, the assistant suggested they might want to wait until a contraction was over. When he was able to do so, he merely obtained the systolic and the person writing on the chart said, "That's enough for me!" It was certainly an odd ride.

Getting to the hospital, they were taken to L&D and the EMTs pointed to the assistant and said, "She can tell you what happened," and gave vitals before leaving. My assistant explained the labor's beginning, rupture of membranes, vitals throughout labor and mom's decision not to continue pushing at home - hence the decision to transport to the hospital.

Instead of continuing in narrative form, I diverge into a more official capacity. Follow along if you will.

Below, you will find the letter I wrote as the official complaint sent to JCAHO (pronounced jay-coh) - the Joint Commission on Accreditation of Healthcare Organizations - an organization that hospitals voluntarily join because it looks so great on their records since JCAHO supposedly is an outside organization providing an objective view of a hospital's performance in a variety of areas. From JCAHO's website:

Joint Commission evaluates the quality and safety of care for nearly 15,000 health care organizations. To maintain and earn accreditation, organizations must have an extensive on-site review by a team of Joint Commission health care professionals, at least once every three years. The purpose of the review is to evaluate the organization's performance in areas that affect your care. Accreditation may then be awarded based on how well the organizations met Joint Commission standards.

Coincidentally, within 2 months after I wrote my letter, the hospital in question had their review. This gets confusing, so please follow the bouncing bureaucratic ball.

First, about The Letter.

I was implored (by the Powers That Be That Shall Remain Nameless) to keep as much emotion out of it as possible. I had to write about 10 versions before I got to this sterilized version. No words can explain the amount of anger I felt during the recovery with this mother and trying to help her while having no one hear any of us screaming for help. I chose to use the mother's first name in the letter (not here, the name used is not her real name - anything in italics has been changed, not to protect anyone, but just because at this point) because I felt it would make a much more personal impact... that she was a real person and not just some "patient," but a woman with a baby and a husband and a life. I chose each word very carefully. It took me about 3 weeks to complete the letter.

So, here is the sterilized version and I will continue below the letter after that.

---------

October 11, 2006

To All It May Concern:

I am writing to notify you of a serious breach of care in That Hospital on September 11, 2006 between the hours of 2:00pm and approximately 6:00pm. Because this is a long and convoluted story filled with emotion, I will attempt to bullet point where the neglect occurred with the hospital staff and try to curb the intense amount of anger and disgust I feel towards those that interacted with and were supposed to care for my client Mary Morris and her newborn baby. Having attended well over 500 births in hospitals around the United States and Germany, I am well aware of the standards of care for a maternity patient and a newborn. I have also attended births in eight other hospitals here in Our County so understand the standard of care for this county in particular. What I experienced at That Hospital was anything but the normal standard of care.

• During the birth, I was, apparently, being summoned by Dr. Colon (quite loudly and angrily according to my client and my assistant), yet I was forbidden from entering the labor and delivery suite. I identified myself to the nurse at the front desk twice as Mary Morris' Licensed Midwife and she summarily dismissed me saying, “No visitors. Sit over there,” and pointed to the waiting room. I was permitted to enter approximately twelve minutes postpartum and never saw Dr. Colon.

• Dr. Colon stood against the far wall with his arms crossed as the baby was being born forcing the nurse to do the delivery. No explanation was given for this behavior. While I did not witness this, my assistant, the baby’s father and grandmother did witness this happening.

• Dr. Colon approached the delivery bed after the birth of the baby to pull the placenta out, causing excruciating pain for Mary. She still, many weeks later, remembers the pain in detail.

• Dr. Colon, while raising the bed, stated that he was sure Mary tore (in her vagina), but upon inspection, stated surprisingly there wasn’t anything but a skidmark (a common term for a slight abrasion). He then stated that he was going to suture it anyway and sutured her perineum without any Lidocaine or medication of any kind. Mary did not have an epidural. He placed one stitch in the lower left inner vagina. While the records state it was a first degree tear, his words in the delivery room stated otherwise. In 24 years, I have never seen even one suture placed without anesthesia.

• Dr. Colon never introduced himself to Mary, never addressed Mary, never asked permission to touch her nor even congratulated her for the birth of her son. He merely pulled her placenta out, sutured her without medication and then threw the gloves in the garbage and walked out of the room.

• No vitals were ever done by your staff on Mary during the time I was in the room which was approximately 3.5 hours.

• No one on your staff checked Mary’s fundus or her blood loss during the time I was in the room.

• The baby never went to the warmer.

• The baby never received Erythromycin eye ointment despite the parent’s desire for it. The hospital never offered to place the ointment within the first two hours of the baby’s birth despite it being the law. The parents ultimately signed a release that I would give the ointment at home, which I did, but they had not been offered it within the legal time frame.

• The baby did not receive a Vitamin K shot despite the parent’s desire for it. The hospital never offered to give the injection despite it being the law to give it very shortly after the baby’s birth. The parents ultimately signed a release that I would give the injection at home, which I did, but they had not been offered it within the legal time frame.

• The baby had his temperature checked twice – once at birth (which I did not witness) and once again about three hours postpartum. This is not the correct standard of care for a newborn.

• The baby had his heart and lungs listened to twice – once at birth (which I did not witness) and once again about three hours postpartum. This is not the correct standard of care for a newborn.

• The baby did not have his identification band placed on his ankle. After obtaining Mary’s medical records, it states in the records, “parents refused placement” which is incorrect since no one ever tried or came near with a band. The mother is a Licensed Practical Nurse and absolutely knows the vast importance of security in a hospital, especially of a newborn baby and would never have refused such an important detail.

• The parents were not told the baby’s birth time and only learned it when they went to fill out the birth certificate four days later. We had to piece it together via cell phone logs and were two minutes off for those four days. No one considered it important enough to tell the family the baby’s birth time, something that is a normal course of events in a typical hospital birth.

• The baby was given one hat. When asked for another hat, we were refused and told another would be given on the postpartum floor.

• The baby was given one blanket and it was wet from the birth and the baby had also had a bowel movement at the birth (meconium), so the blanket was covered in that, too. When we asked for another blanket, that request was ignored. We cleaned the baby with a chux pad as best as we could and used the sheet Mary was wrapped in (bloody and wet from the birth) to keep the baby warm until we found a blanket in the isolette tucked under a chux pad. We’d searched the room for a towel, washcloth, sheet, gown – anything – and there was nothing. I’d used my skirt at one point, too, to keep the baby warm. Once we found the blanket, we used that until my apprentice and the grandmother went home and got the baby some clothes.

• The baby was weighed only after the parent’s requested it several times.

Mary was never given a gown.

Mary was given one pad to wear during the entire time in her bed. The only time she was offered another pad was when we were leaving and the nurse brought a postpartum pack in and set it down by the sink in the room, not helping Mary, who was in the bathroom, in any way.

Mary was not offered a frozen pad as women typically are after a vaginal birth.

Mary’s sheets were never changed. She never received a blanket change despite our asking for something that wasn’t bloody and wet.

Mary and her husband wanted to leave the hospital with the lack of care they were receiving, but I explicitly told them I felt it was important to at least stay the night and make a decision in the morning. And then the next event occurred that ruined any chance of their consideration of staying in That Hospital.

• A woman who never identified herself entered the room yelling and proceeded to demand Mary’s chart from me. I identified myself and explained that HIPAA regulations forbade my being able to give the chart directly to her, but I was glad to share the information with the mother’s permission. She became increasingly agitated and her voice escalated and the father and grandmother all began yelling together. At a birth! My best guess was the woman was the Charge Nurse since she, at one point shouted, “I’m in charge here!” She had a Caribbean accent (the baby’s grandmother was from the Caribbean so recognized it easily). The woman stated she needed information from the chart and for me to give her the chart immediately and I once again said I could not and said I had the lab information and flow sheet of her prenatals I was glad to share with her and if the mother signed a records release I was glad to copy the chart for her. The mother shook her head no and the woman left the room very angry.

• As she left, Mary said she would crawl out of your hospital before being subjected to the lack of care she was receiving by staying in. I could no longer disagree with her decision to leave.

• A woman entered the room and said she was a neonatologist, but she never stated her name. She said she was there to examine the baby. The parents said they did not want an exam and that was when the doctor left the room and left the door completely open with the mother naked on the bed and the curtain open. Those in the hallway stood staring inside the room until we realized the doctor was not returning and my assistant went to close the door. At no time did the doctor state risks of leaving Against Medical Advice or any concerns she had regarding the baby’s birth as has occurred with other clients who have opted out of routine hospital procedures in any other hospital over the last 20+ years in my experience.

• When Mary went to the bathroom for the first time, no nurse accompanied her.

• No final vitals were done on either Mary or the baby before leaving the maternity floor. This is in direct conflict with standards of care in my experience.

• When we left the maternity floor to leave, no nurse checked to make sure Mary had the right baby – in fact, no acknowledgement was made whatsoever of her presence and that she was leaving the floor with a newborn baby. No nurse accompanied her from the room to the elevator, from the elevator to the ground floor or from the inside to the outside of the hospital. She left the hospital unattended completely. No nurse was there in case she was bleeding or felt faint.

• When the baby was put in the car seat in the car, no nurse checked to make sure the baby was put in the car seat correctly.

• When we arrived home fifteen minutes later, the Local City Police were blocking the family’s garage and said the hospital asked that they come and check on the baby’s health and well-being. We were quite surprised considering how little That Hospital seemed to care when we were IN the hospital. They asked for proof that I was a Licensed Midwife, which I showed them immediately and they quickly left. I am not sure why Dr. Colon, the Charge Nurse or any number of others at That Hospital did not ask me for my identification while we were still at the hospital instead of sending the police to hinder the safety of the mother and baby; I would have complied happily.

• Child Protective Services was called on the family and came to visit on day two postpartum as well as have a lengthy phone call with me regarding the Morris’ parenting style and choice to leave That Hospital Against Medical Advice. She also stated there were issues with meconium staining the hospital mentioned. No one at the hospital had mentioned the concerns the day before. Her quick assessment that That Hospital’s accusations were “unfounded” speaks volumes regarding the lengths That Hospital went to discredit a perfectly respectable young married couple.

As a Licensed Midwife in Our County, I understand circumstances might not always be the most comfortable for me when I have a transfer or a transport to a local hospital. However, never have I seen a client punished in the way Mary Morris was punished for wanting a homebirth. And she transferred without any complications! I shudder to think how she would have been treated had she come with a life-threatening complication. It is beyond comprehension how human beings can treat a birthing woman and a newborn baby with such disdain and cruelty. There is no excuse for this type of behavior in a hospital in any city in America. For God’s sake, I recently returned from working in a hospital in New Orleans and their care was so tender and so loving - Hurricane Katrina had changed their emotional lives so dramatically that those nurses and doctors have found renewed spirituality in their care-giving skills. Does That Hospital need a disaster to re-awaken to human kindness? I pray not.

I will continue to work diligently in my profession to maintain the utmost in integrity. If any doctor, nurse, board member or staff member has any questions, please do not hesitate to call and ask me to answer it for them.

My Name, Licensed Midwife, Certified Professional Midwife
Ph# My Number Email: My Email

----------------

So, I know it sounds unbelievable. If I read it, I would blink and have a hard time believing it, too. My apprentice and the assistant for that birth will look at each other all these months later and still shake our heads wondering if what we saw was real. It was.

It was so real, the hospital staff had to lie about it all.

When JCAHO was in town, we discovered we had an ally in the hospital. That person (whom we will call The Mole) became our inside information about the JCAHO hearings going on and tried to help us get into the hearings so our side could be heard.

You see, this is the interesting part about the JCAHO hearings, they are public, but unannounced. Well, The Mole let us know when they were, but the segments where the public can speak is minimal and specifically scheduled - and UNscheduled - if that makes any sense at all. (It probably does in bureaucracy world.) So, the parents and I called the JCAHO and hospital people in charge of the hearings asking to speak and we were told, over and over, that the hearings were unscheduled for the public. At one point I asked if I just needed to come down and sit 24 hours a day because I would. It was then that, of course, the public hearings were completed, so it wouldn't be necessary to come at all.

So, JCAHO never heard our version of the story beyond what I wrote and what the family wrote and an extensive interview done by some government man who didn't understand birth one iota.

JCAHO did, however, get to hear the entire story from each of the players involved on the hospital's side. Weren't they lucky? seething even now

The doctor, the head nurse (yes she was the head nurse), the "nice nurse" (whom I will speak about later), the bitch nurse, the neonatologist and every bit player involved got to have a say. And did they ever have their say.

The nurses said the mom was so out of control and so crazy, they couldn't get near her to give her a gown or to take the baby to put him in the warmer. BLESSEDLY, we have pictures (thank the Universe for my apprentice taking pictures!!!) of mom serenely holding her baby and the "nice nurse" holding the baby at one point on the way to the baby scale - gee, 3.5 hours postpartum, the baby still had meconium where we couldn't wipe it off of him... wonder why that was. Anyway, the nurses said we were SO mean and SO snotty to them that THEY CRIED at the nurses station!!!!!!!!!!!!!!!! They could hardly wait until we left because we were so mean. They'd hardly met any group of people so horrible. blinking in utter disbelief

If they cried, and I hope they did, it was from the amazing realization of the cruelty to another human being that they inflicted - TWO human beings. I hope they are crying right this minute.

Mary and her husband came to the hospital with a camcorder. When Mary was in the bathroom before she was leaving, I was in there with her as was her husband. My apprentice and assistant were getting the baby dressed on the bed. The "nice nurse" came in, gave us a "going home pack" by setting it on the sink in the room... not giving it to us in the bathroom (where we could have used it since it had pads in it) - and she walked out without saying a word. I had to walk out to the sink to go get a pad for mom.

It was days before we realized the camcorder, which had been sitting at that sink, was gone. The "nice nurse" had surely been instructed to kindly remove it from the room lest there be evidence on it. I am sure she is crying the most. She tried to be nice, but it was obvious she was told to give only the most cursory of un-care and words to us.

How did this end with JCAHO?

The hospital received a brand new Gold Seal of Approval! None of the nurses, nor the doctor were disciplined for their horrific behavior, BUT, the one thing that was found was the doctor had not explained the risks and benefits of lidocaine to the mother before suturing her (he claimed she refused the lidocaine). The hospital was fined a delightfully hefty fine from what I hear, but other than that, my mom is left out of any anything.

- No one to listen to her side of the story that would be able to do anything to the doctors or nurses directly.

- No lawyer will take her case because she can't show permanent damage to her or the baby (apparently fear of sex and the excruciating pain of being sutured without pain meds isn't worthy of a lawsuit - not to mention utter neglect in a hospital) .

- No restitution for her bills, pain and suffering or therapy she has needed to work through this experience.

HOWEVER, a New Mole has come out of the hospital steering mom into a new direction that might lead to a better sounding board than JCAHO. We'll see if it works out.

So, dear readers, you who know me can understand why I was so traumatized in September when this birth occurred.

Although I couldn't say it in the letter, in the investigation, we did state that race and socioeconomic status had a very big part in Mary's care. It was apparent they thought she was a single black woman coming in with her sister, when, in fact, the woman who accompanied her in the ambulance, was my assistant (who happened to be black). My client was having a hard time keeping control initially, but my assistant was able to calm her periodically and once the mom realized she was going to have to push the baby out in the hospital without assistance, she began to push in earnest and the baby was born within a few contractions.

(This brings me to the interesting concept we espouse about babies coming out even without a mom's active pushing. Apparently, this mom fought so hard against the baby, she maintained a location of homeostasis as far as where the baby remained in the vagina. The uterus, during the entire 90 minute pushing/un-pushing production remained extremely active and we could see the baby's head presenting more at the entroitus, but the baby receded each time the contraction ended. The thought that something might be holding the baby up crossed our minds, except there were none of the tell-tale signs of decelerations that would occur with a short cord or a nuchal cord. The whole thing was so odd.)

Immediately upon arrival, a nurse said to mom, "We're not nice like those homebirth midwives. We're gonna get that baby out." This was the Bitch Nurse. She continued being snotty and curt with Mary and was rough with her body and then with the baby as he was born. My assistant has an amazing capacity for recollection and I am thrilled she was allowed into the ambulance so she could make meticulous notes of every single thing that unfolded while I couldn't be there.

The doctor did, indeed, stand in the corner of the room yelling about me, asking where I was, why wasn't I there, that he knew there really was no midwife, that I had just ABANDONED my client and what kind of midwife is that. The whole time, the nurse is asking him to come to the table because the birth is imminent and he stood in the corner of the room with his arms crossed, not budging, in his street clothes. The nurse "delivered" the baby and the doctor strode to mom, shoved the nurse aside, put gloves on, yanked the cord so hard mom screamed until she nearly fainted, pulled the cord out, shoved his fist so hard down on her abdomen she had tears streaming from her eyes and then raised the bed to look at her while commenting that he knew she tore. Surprised, he said she just had a skid mark, but he was going to stitch it anyway. He grabbed the suture, placed the stitch while my mom screamed to the heavens and then he took his gloves off, threw them on the floor and turned and walked out the door.

That entire time, I was in the lobby trying to get in and was not allowed in. The nurse placed a faux call to the room and turned back to me and said, "No visitors," and pointed to the waiting room and told me to sit down and wait. I called my assistant's cell phone, but she didn't answer. Brilliantly, my apprentice called the hospital and asked to be put through to the patient's room. My assistant answered and she told me the baby had just been born (this is the way we pieced together the incorrect time of birth until we saw the hospital birth certificate work sheet 4 days later) and that mom needed her, she had to go. This was right when the doctor walked up to the table to yank the cord out and the assault began. It's too bad we weren't on a cell phone to be able to tape it.

12 minutes after the answering of the phone call, dad came out and brought us into the room. I walked right past the doctor, but he didn't say a word to me; I didn't know he was her doctor or I would have said something. Nobody ever asked me who I was, but I introduced myself each time a nurse came in, even the screaming nurse. Incredibly, I remained professional and civil (perhaps I should have gone berserk and run around the hospital floor screaming my disgust at their behavior? they would have kicked me out, surely.) and was very proud of my behavior with the staff.

I believe I would have been more demanding of "things" next time. Even though we asked for things like towels and gowns and washcloths and blankets and were turned down each time, something in me thinks I could have been more aggressive. I look at myself and wonder what I could have done to not have my client be punished in this way and in my heart of hearts know they were treating her this way because they just have an evil place in their heads for people of poverty.

When mom's husband came in during the delivery, he was shell-shocked, so didn't speak until after the birth and once he started speaking, the nurses started taking notice... the couple is extremely well-educated and don't "sound black" (according to how our society would consider blacks to sound). It threw the nurses off. And what was even more shocking to them was when, 3 hours into the horror, the insurance chick came in and snottily said, "I suppose you don't have insurance either, do you." Dad said, "As a matter of fact, we have Famous Great PPO Insurance," and the insurance chick about swallowed her tongue, threw the papers at them and rushed out of the room embarrassed as hell.

Having mom sign the papers to leave was our biggest mistake. Mom just wanted to get out of there and she didn't look at anything she was signing and signed too many things that ended up saying she didn't want this (Vitamin K) or that (Erythromycin). If you all are ever in a similar chaotic situation, do not EVER sign anything without reading it first - even if you can't wait to get OUT of there. It isn't worth it in the end. And, for the record, it isn't any of those papers that are keeping a lawyer from taking her case. The papers are the least of it in the grand scheme of it all legally, but because they are a legal document, in these investigations, they meant a lot. And it sucked to give them anything at all.

I am exhausted from writing this for 2 days and I know I could continue writing for 3 more because the 5 of us have picked this apart ad infinitum - we have considered and re-considered every nuance of this case. I have played and re-played every detail over and over, asking myself what I would have done differently.

You might wonder, what happened to the HHN? When the ambulance took mom out of the apartment, she left and didn't call for 5 days. She was "tired." The mom is very sorry she ever invited her to the birth and very much feels she had a hand in the demise of her homebirth, or at least, a peaceful birth in a location that would have treated her with respect and dignity.

Mom will have a homebirth next time. She says she will never be afraid of that pain of pushing again. She will find strength in that experience and not be afraid of most things in her life that are seemingly unbearable challenges. She has found enormous strength in her birth experience. Her husband loves her and while he was extremely sad to not have the homebirth he wanted so badly, he has supported and protected her in this healing in ways many men would never have known how to do. His words, his deeds, his tenderness and love ooze from his heart and cover his family in a way I don't see coming from most 40-year olds, much less someone of his young age. I am honored to know them both.

The assistant and apprentice have found healing easier than I (or so it seems to me) and they continue loving me through my pain. Is it always so different for the midwife herself? I want to erase the experience. I wish I could turn back time and find the magic words to make her push that baby out in her bedroom. I wish I never knew there were nurses and doctors who were so evil and cruel in my own city. I wish I still believed people could never be so evil to a birthing mother and a newborn baby. I wish I had never been witness to such horror. I feel like my illusion of hospital care has been raped... and my illusion wasn't even all that glamorous! I hate that I might have to go back to that hospital and have to find a way to work with a liaison to make the experience better.

Because those nurses can sit in front of the investigators and boo hoo and say this and that about us, but the absolute truth is - they know The Truth. They know who neglected whom, who assaulted whom, who stole what from whom. And I will stand with them, toe to toe, staring them in the eyes, also knowing The Truth.

I know The Truth.

And today, I finally speak The Truth for you all to hear.

Reader Comments (52)

I'm very sad to say that this story didn't shock me the way that it should. I'm glad that your client had someone who loved her and took good care of her while she was so badly mistreated in the hospital. I hope that you each find healing after this terrible experience.

January 21, 2007 | Unregistered CommenterAshley

I.....I cannot find the words. The term "Hell on Earth" is far too mild for what you all, especially that poor mama and her baby, were put through.

Seriously, there's drool on my lap. My heart and mind are so utterly confused. These words mean absolutely nothing, but I am just so, so, so very sorry. Ugh!

How is mom now? Baby? You?

January 21, 2007 | Unregistered CommenterRebekah

Wow. I'm crying for the family and for you. What is encouraging is the fact that she wants more children, I certainly wouldn't blame her for not wanting anymore children. She is blessed with a wonderful husband, for sure.

It's a shame that insurance professionals (and in our case, an emt) are so quick to judge based skin color or what type of home you live in. When our youngest was 1 1/2, she choked to the point where I had to call 911. Thankfully, what she choked on, she vomited in the ambulance. But the emt was talking to me about the ambulance bill & what not & he *assumed* we had our state's version of crappy government insurance *because* we lived in a trailer!

The reality was this: we lived beneath our means for many years so we could become debt free & have a huge downpayment on our wonderful new house! We also have the fabulous ppo (that we pay an arm & a leg for too) that you spoke of.

I love your blog. I'm now going back to delurking satus, because I'm guilty of "blogging" in the comments section of other people's blog.

I hope that 2007 brings healing for you concerning this birth.

January 21, 2007 | Unregistered CommenterAbby

Sadly, the experience is not a-typical. I have seen ladies transported for nothing but pain medication (absolutely nothing wrong!) and the on call ordering a section without checking her or even looking at the woman on the bed. I've had a doctor refuse to even examine a transport until we left, not the room, not the floor, but the hospital grounds. I've seen every intervention in the world employed without reason, (episiotomies on a nicely stretching perineum, pitocin on a contracting every 2 minute woman, Demerol given (without permission) to a 9 cm, 100% effaced,+2 multip who gave birth 20 minutes later to a severly distressed little guy who spended days in NICU, simply to "punish" the woman who dared to choose a midwife and home birth instead of a doctor.

No matter how many times you witness these atrocities to women, it cuts like a knife, you bleed, and you cry.

I am so grateful each and every time birth works perfectly, and I'm so grateful I can still feel pain and outrage each time I witness something horrible.

I never want to get used to it.

Don't beat yourself up about the "should haves". You honored her wishes and it was a lesson to be learned for everyone involved.

January 21, 2007 | Unregistered CommenterColleen

Thank you. The more people who read this will hopefully be more people who are on guard to ensure this doesn't continue to happen. I hope for healing for you as well.

January 21, 2007 | Unregistered CommenterAnonymous

I cannot find the words to express the horror I felt, reading the words you wrote regarding this horrendous hospital/birthing experience.

I firmly hope that the mom and her husband find peace, and can work out the grief from this entire experience.

I wouldn't know where to go next for complaints regarding the atrocious care that this couple received. How about the Department of Health in that state? Filing formal complaints against the doctor to the state medical board? Or complaints to the state nursing board about the nurses involved?

There needs to be some major attitude adjustments at that hospital.

*Thinking* something not-so-nice about a patient is one thing, but *acting* the way they did? Inexcusible.

January 21, 2007 | Unregistered CommenterAtYourCervix

I am absolutely speechless. It is heart-wrentching to read....let alone LIVE it. However, I am thankful that this couple had you as their midwife & for postpartum support. Thumbs up for writing the letter, for being their voice & for not letting the "higher ups" intimidate you. You go girl!!!

~Judy

January 21, 2007 | Unregistered CommenterAnonymous

My jaw is on the floor. I cannot believe that doctors and nurses could rationalize behavior that inhumane. Sadly, (racial/class)stereotyping is something that happens way too often. My heart goes out to this young family. It seems appropriate to hope/pray that they will feel remorse and repentence for their terrible behavior.

I would find it so hard to forgive such ignorance, violation, and cruelty. I wasn't even part of the story and I feel angry about it! I can totally see how this birth has been eating at you for so many months now. Thanks for sharing the story.

January 21, 2007 | Unregistered Commenteramelia

Bless you for speaking the truth. I grieve for all of you for experiencing that, but I believe that healing comes with speaking truth. Continue speaking it, because we are listening.

January 21, 2007 | Unregistered CommenterRG

Thank you for sharing this with us all.

January 21, 2007 | Unregistered CommenterAnonymous

That is one of the most upsetting things I have ever read in my life. My own hospital expierence, while a tale of torture and abuse in its own right, can hardly compare.

I hate to admit it, but part of my going so far the other way has to do with not really wanting to know that things like this happen.

I hope mom can recover emotionally from this birth and use it for future strength. Do you really think you'll have to possibly work with/at this hospital for future births? I couldn't do it, guess that's why I'm not a midwife, I couldn't stomach all the heavy emotions that go along with it.

January 21, 2007 | Unregistered CommentercreepyUCmama

Wow.

I scanned this post. Still. Wow. There has to be lawyer fermenting some sort of class action about this kind of thing.

Racism? Anti-home birth bigotry? Sheer stupidity?

Mom seems amazingly composed throughout all of this.

Best wishes to her and the baby and hopefully that hospital wises up.

January 22, 2007 | Unregistered CommenterAnonymous

WOW, I am speechless. I don't think homebirths are supported here where I live. However, the hospital advertises certified nurse midwives. They work in my ob's office. I think homebirths are great for those that want them. I'll never be able to have that as I have had severe PE and severe PIH twice now and I have to be monitored. Butthey shouldn't have treated her that way. Her birth was so unlike my daughters and they were born in 2 different countries! I can't believe the dr let the nurse deliver!My dr took care of me the whole night. I never had a labor nurse check me, not once. My dr did all of the checking. No pain killer for a suture? I had two and got lidociane and it still hurt with the lidocaine. I could feel him suturing with a pain killer! This was after a shot of demerol about 5 minutes before she was born. OMG, I hope that she gets restitution.

January 22, 2007 | Unregistered CommenterAnonymous

I am crying from this story. I am at a loss of words. You are all so strong to come out of the experience. The hospital staff involved should have been severely punished.

January 22, 2007 | Unregistered CommenterShelly

I'm in total shock. I think I need to go vomit. As a doula, and a mother who birthed in a hospital (a homebirth transfer no less), I'm absolutely- there are no words.

January 22, 2007 | Unregistered CommenterAnonymous

A couple of side-notes:

We wrote letters to *everyone* that could possibly be involved... the Medical Board, the Nursing Medical Board, the State, the County, etc. There are at least 20 letters similar to the one you see floating around the country about our experience and apparently it is such a yawner that no one seems to care enough to do anything about it. The county is the ONLY postive movement so far and the agency that enacted the hefty fine spoken of in the piece... specifically because of the lack of informed consent about the lidocaine - that was it.

Next, mother and baby are amazing. Mom continues with residual pain in her body - physical and emotional and spiritual. We talk often and discuss "next time" and have worked through issues such as walking without a limp (her legs were *shoved* back during delivery, causing nerve damage that lasted weeks postpartum) to her concerns about making love again and the pain and fears of getting pregnant.

I also did not mention that I went to retrieve to stitch her body did not need to have about 4 days postpartum, but the doctor put it so deep, I couldn't get it out. I could feel it deep within her labial folds on her lower left side (which was verified by her husband and the assistant where the stitch had been placed), but I couldn't access it at all without breaking the skin, further verifying that the suture certainly did not need to be placed at all or it would have still be accessible at 4 days postpartum.

The baby is so beautiful. Mom was very upset that he was born in a place of such hate and I lovingly and gently laughingly told her that people work for 6 months on birth plans that create the birth experience she had! She had her baby and no one touched him again! She had her baby the whole time, he was with no one else but people that loved him completely. She had been with people that loved her completely. He didn't go to the warmer. He didn't have the erythromycin and Vitamin K and she didn't have to fight about it. She got to nurse him immediately and completely and didn't have to fight about it. She got to leave the hospital within 4 hours postpartum. When I was able to turn it around this way for her, she was able to smile and see there *was* a positive to it... and it was the ONLY way we were able to smile in the midst of the shit that was the entire experience.

One of the things I should have written and didn't was that we didn't chart while we were sitting there. We should have asked for everyone's name that walked in and what time everything was done. If you are in the hospital, *discreetly* do this. I say discreetly, because the hospital CAN toss you out on your ear if they want to and that was what was in my head if I considered rocking the boat and getting obnoxious about getting my client the things she needed. Believe me, we considered screaming in the halls about gowns and such, but we knew we would be thrown out and she would then be left totally alone. We couldn't have that.

Thank all of you for your kindness and love. It means so, so much. The family will be getting the link to this today, so they will read your kind words. Thank you for loving them so much.

January 22, 2007 | Unregistered CommenterNavelgazing Midwife

Oh Wow. I am so upset reading this, and wondering how the family is now? Baby? Mom? Dad? You?

Thank you for writing and sharing...as hard as it is to read, it's important to know such discrimiation and abuse happens - another type of Inconvienient Truth.

I marvel at your strength.
Sending prayers/light to all of you.

Part of me is so horrified and saddened but part of me isn't shocked at all. Hospitals seem to be diverging farther and farther from true patient care and much closer to an industry. I am so sickened for this beautiful family and their horrifying experience. Racism rocks me to the core and leaves me twisting in pain. The blatant racism cuts me far deeper than the poor patient care. I am so glad that this family has you and that you are all working together toward healing. I have so much respect for this mother's strength, integrity, and raw power. May they find their way to healing and a beautiful, healing birth experience next time.
Wendi

January 22, 2007 | Unregistered CommenterAnonymous

I felt really shattered by this story.

Sometimes, living in Canada, where diversity is encouraged, I can be pretty sheltered to the realities of racism. And, of course, when combined with such physical abuse and illegal conduct by the medical staff - well, it just sort of blows your mind.

Some people, well, there is something missing in them, you know?

I send my happy wishes to the family. And I send my wishes out into the universe that we who work with birthing women can effect change so these things never happen again.

January 22, 2007 | Unregistered Commentermamaloo

The most frustrating aspect of this story, and of all the stories that have elements like this one in them, is that nothing can be done about it legally. Have you and the birth team and your client considered shifting focus and writing letters to the media instead?

I have a couple questions. Was their camcorder actually stolen? Did anyone ever confront the hospital about it's whereabouts? As petty as it may seem, some legal action may be able to be taken about that, especially if they lost footage of the labor and birth. Also, it wasn't clear to me just how the HHN affected the outcome of the birth? You asked her to call 911, correct? Once 911 is called, isn't it the EMT's call what happens? Or am I missing something obvious?

January 22, 2007 | Unregistered CommenterJennifer

My heart hurts for her, and you. FYI, I posted a link to this post in the comments at pandagon.net; along with feministe.us.blog, and feministing.com, they are blogging the NAPW conference right now...all young women, mostly without kids, hearing stories just like this one and connecting them to feminism/body integrity/self determination in a new way.

January 22, 2007 | Unregistered Commenteremjaybee

To Mary: I am so sorry for what you went through. No mother (and/or baby) should bear that sort of abuse and neglect. I send you many healing thoughts and wishes for a lovely, joyous and safe homebirth in the future. Safe in the hands of your midwife from the horrible things which you were subject to at that hospital. I hope you, your husband and new baby son grow strong and happy together. It's for women like you and stories like yours that I work to join Navelgazing Midwife's ranks.

To dear bloggie NG Midwife: I cried about this story as much for you, and the midwives and doulas who bear witness to this sort of abuse too frequently. I know personally how it can tear your heart to shreds. I sit here quietly cheering for your fight to bring justice to the folks who acted so eggregiously.

As they say: "Evil flourishes when good (midwives) do nothing." You though, did something. I hope that if the time comes I will be as brave as you were. I wish you healing too.

The universe is wiser and a safer place because you are in it. This student midwife holds you in her thoughts.

January 22, 2007 | Unregistered CommenterLouisa

I just don't know what to say. Love and love to this mama and her family. I hope that her next birth, should she choose another, will bring healing and peace for her and her husband.

Why oh why would a woman ever choose to birth at home? It's so much safer in the hospital. Don't you know that? A woman should be grateful for the 'safety' afforded by a hospital, even knowing that she could be treated like worthless crap, she will still be 'safe', so should always deliver in a hospital.

Please help Mary to feel the goodwill and strong hopes of all the people who have read your blog and are touched and moved by her painful story. The well wishes and compassion will help speed her recovery and buoy her in her next birth, light a candle for each of the comments here so she can visualize us all.

January 22, 2007 | Unregistered CommenterLeosMama

Horrific. Shame on everyone (in the hospital)involved. May they, or their loved ones, never experience this kind of abuse. But what, I ask, will it take for them to learn, to digest the vastness of what they were part of? How often do they do this to other women, low-income, transports, no insurance, etc? I can only hope that the Dr's name (and his staff's) will be smeared in your local community and their reputation totally shattered. It must for other women and their babies to be protected...
My heart is with your client and her family, with you and your birth team. It bleeds and cries and offers hope for healing.
XOXO,

January 22, 2007 | Unregistered CommenterLeigh

I am so livid right now on your behalf, and on the mother's, and on the child's, and the father's... on everyone's behalf. The racism, the ignorance, the -evil- perpetrated by those people supposedly sworn to heal and take care of other human beings -- it's beyond words. It's infuriating and heartbreaking all at once. I don't even know where to start with it.

At the risk of sounding excessively self-centered, though, I will tell you this: I have been struggling with my decision to be here in med school (again). Reading this makes me remember why I decided to go this route -- so I can fight for the Marys and the midwives who I come in contact with. Thank you for posting this, as difficult as it must have been. In doing so, I hope a tiny sliver of good comes out of the whole ordeal.

January 22, 2007 | Unregistered CommenterSarahScott

Absolutely unbelievable! I can't believe that there is nothing you can legally do about this!! There are so so many things in this story that it seems one should be able to sue over! What is wrong with our legal system (as well as the medical)? I am truly shocked and horrified to learn that something like that can happen. How could you be so cruel to a woman, a family, going through that? It's a birth-that's supposed to be such a joyful time. Maybe that child will grow up and because of it's birth story, will become someone who will change the system!

January 23, 2007 | Unregistered Commentersajmom

I don't know what the laws are in your state but would it be possible to have the doctor charged criminally with assault, if he never had consent or introduced himself, I would also look into making a complaint with your state medical licensing body not to mention the nursing organizations. I'm sure you've probably thought of all of that but...wow its so frustrating....

January 23, 2007 | Unregistered Commentermum2midwife

I'm sure you have probably all thought of this but is it not possible to have criminal charges made against the doctor for assault, and making compliants to the medical licensing body in your state, not to mention the nursing regulators... I'm so disgusted...better yet the media...morgan spurlock and his partner recently had a homebirth he might be just the sort of person to approach

January 23, 2007 | Unregistered CommenterAnonymous

Am in tears. So. Very. Sorry. There really are no words right now, just disgust. I second the media suggestion.

January 23, 2007 | Unregistered CommenterJillian

I read a quote recently: if men were treated in hospitals the way birthing mothers often are, it would be against the law.

Thanks for fighting the good fight. It stirs in me the desire to take this story and shout it from every mountain top.

January 23, 2007 | Unregistered Commenterladyelms

I am sick to my stomach and sick at heart after reading this account. Thank you for writing it, and I hope to God that your letter and any other complaints that can possibly be filed (in this ridiculous "sterile," emotionless language, if need be!) will get those medico perpetrators right where they live. There should be consequences for such cruel behavior! I hope both mama and baby are doing well now. Godspeed to that family, and I laud them for already thinking ahead to the next time and knowing that they want to try a homebirth again. What I just don't get: What can possibly compell such evil-spirited human beings to ever want to enter the healing arts, much less the principle area in which joy plays (should play) such a huge part? Why would such a heartless bastard as this doctor ever become a doctor to begin with, and how is it that such an individual can be permitted by the institutional medical system to treat women (at their most vulnerable time) and tiny innocent babies?? I am baffled. I write this in shock, but also in joy for the birth of this new baby and the beginning of new life in this family. And all power to you, Navelgazing Midwife. I know this must have been hard to re-visit here. Thank you.

January 23, 2007 | Unregistered CommenterMelissa

I'm speechless. So sorry for your patients and you.

I rarely advocate this, but it seems like a case (a litigible case) of Negligent Infliction of Emotional Distress, if not also Battery.

January 24, 2007 | Unregistered Commenterdoulicia

OMFG. There's a special place in Hell for people like those.

January 24, 2007 | Unregistered CommenterMinty

I was reading through all the comments and I thought after someone mentioned going to the media that it sounds like a good Oprah show--addressing racism, classism, and injustice women can receive at hospitals. I don't get to watch Oprah much anymore--due to limited tv time with my little ones but I would set up my vcr and tape that one!

January 24, 2007 | Unregistered Commenteramelia

I can't begin to describe how upset I was when I read this post. Thank you so much for posting it! I would like to put a link to this story on my xanga blog if that's ok with you? I think every woman and man should read this story. People need to be informed that this could happen to them! It's really great that you took a stand as a midwife for your client, her family, and as a decent person unlike the horrible hospital staff! You are a wonderful midwife in my eyes!

*Shayla

January 24, 2007 | Unregistered Commentermidwife_dreamer

Oh my God.

I don't know what else to say. I cannot believe the amount of patient abandonment that occurred in that hospital and the extend to which it was covered up.

Not a shred or human decency. No morality. Well, we can only hope one thing...that they never find themselves or their loved ones on that side of the table because Karma is a bitch I don't want to answer to.

January 25, 2007 | Unregistered CommenterLyndseyG

This left me speechless and enraged at that hospital. I cannot believe nothing was done. It is disgusting that they treated her that way simply because she chose to birth at home and then wanted to go to the hospital later on, even though everything was fine. That is heartbreaking. :( I hope some kind of action is taken against those people so that they cannot treat anyone else like that.

January 25, 2007 | Unregistered CommenterHeather B.

This just brings tears to my eyes, sad for that momma having to go through that, sad that any human would be treated that way, shame at my profession for doing what they did.

January 26, 2007 | Unregistered Commenterjenny

It is AWFUL how so many "failed homebirth" (their words, not mine)transfers are treated poorly in hospital. Nurses' biases against them (before they've even set eyes on the woman) are deep and cruel. I would recommend having the family take this story to the media. Do you have a homebirth activist community in your area or state? They can be powerful allies. On a little side note, many midwives I now (myself included) sometimes do a few stitches without anesthesia. If it's done quickly, I've never had the mom feel a single thing (and they do feel the lido going in). Don't think that is so unusual or awful in and of itself -- though if she felt the suture, and asked for anesthesia, it is a different story of course. Blessings to you and the poor family...

January 26, 2007 | Unregistered CommentermidwifeMB

OMG!!! How aweful!

Lacking legal recourse...I would encourage this mom to write a press release and send it to local papers "THAT hospital gets JCOA approval despite displaying racism" as a title might be catchy.

January 26, 2007 | Unregistered CommenterJenn

I'm having a hard time digesting the brutality and reality of it all and I'm just reading the events. I cannot imagine the deep rivers of emotion the strong Mama and Daddy team, you, your assistant, and apprentice are having to swim through.

Thank you for sharing this story. I believe similar situations are more common than we would like to know. I saw that lack of concern, judgement, assumptions and cruelty at my sister-in-laws miscarriage 4 years ago. The anger and sorrow I have still linger. I hope you are able to find some level of peace by finally being able to tell the world (or at least those willing to read).

I pray that Mama and Daddy continue to stregthen their bonds and find the healing and peace they deserve.

BIG cyber-Hugs to you all.

January 26, 2007 | Unregistered CommenterShana

I too would recommend a press release. People should be aware of how these "caring professionals" behaved and treated this woman, in direct violation of their Hippocratic Oath. I would be calling newspapers and stations, maybe even arranging a protest. That's the activist in me though!

January 26, 2007 | Unregistered CommenterHeather B

Thank you so for sharing this story. Sadly a deep painful reminder of the violence that persists. May healing come with grace and joy...

January 27, 2007 | Unregistered CommenterAnonymous

I truly felt sick to my stomach with rage and bile for the hospital staff.

You are such a committed person to tell this long and painful story.

All your words touched my heart and will forever remind me how lucky I am that I had the positive birth experiences that I had.

Blessings to that little family. I hope they are all on the path to healing.

January 27, 2007 | Unregistered CommenterAnonymous

I am speechless....but why npt make the hospital name public? Have you thought about going to the news with this? I know they are always ready to get thier hands on a story like this.
You are so right. They know the truth and unless they are totally heartless assholes which I fear they may be then that truth will eat them alive or maybe they actually are beginning to believe all the lies they have told? But I know in my heart there is someone greater than them that hasnt forgotten and they will be judged later.
Horrid. It should never have happened. Never.

January 28, 2007 | Unregistered CommenterLisa

That is un-be-liev-able!

January 28, 2007 | Unregistered CommenterMary

My dear strong sister. This is why I will never give birth in a hospital, despite the fact that I am an RN on a midwife unit. My first son was born at home almost nine years ago, the baby I'm carrying now will be born into the hands of a lay midwife as well. And if anyone I work with so much as dares to treat a transfer with such disrespect while I work here, I will personally take their heads off!

I wish you and the mother and her family swift healing.

January 29, 2007 | Unregistered Commenterpomegranate

The most horrifying thing about this story is that it's probably not uncommon. Without a doubt this entire family suffered incredible cruelties at the hands of people who are supposed to be there at our time of greatest need. I shudder to think of what else may have happened had you not been there postpartum.

I was home birth transfer as well...and was also punished by the staff of the hospital I went to. I thank whatever gods may be that my midwife was in the room with me the entire time. I think it would have been much worse if she wasn't. I have to wonder what these "caregivers" are so ANGRY about. What is it about homebirth that enrages them to the point of abusing their patients?! And why do they feel they have the right to do it?

February 1, 2007 | Unregistered CommenterJo

i wish i could say this is unbelievable. unfortunately, after my hospital transfer, i know it is not. what a shame. what a fucking nightmare, what an injustice. i am glad you are telling their story. i just don't even have words for the anger this inspires in me.

February 4, 2007 | Unregistered Commenterchristine

This is sooo terrible. Having recently given birth for a second time, I just can not imagine what this poor woman, you and your assistant went through. Unfortunately, it is not always a racial thing. My sister, a white, pretty (valdictorian of her class) unwed mother was given very sketchy service. A nurse even said, in front of her, to another nurse, "Oh, don't use that tape, she's a medicaid patient, use the other kind!" Her embarassament and shame were beyond belief.

February 5, 2007 | Unregistered CommenterAnonymous

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