Between Contractions and Epidurals

Women’s rights are important to me, not because I am a woman, but because I value all women. Labor and delivery gave me an inside glimpse of how real the disparity is. Some women can’t afford birth control, prenatal vitamins, or prenatal care. Testosterone dominates the c-suite, governs the laws that regulate the rights to my body. My period is a punishment, I’m taxed for buying the basic essentials that remind me monthly that I’m female. When my husband is assertive, it’s considered attractive and his aggressiveness is considered normal, because he’s a man. When I’m assertive, I’m considered bossy or a bitch. If you work in OB, you face this disparity every single day, with every single shift. If you don’t know what I’m talking about, you’re busy eating lunch while you can, in between your patient’s contractions and before she wants an epidural (but more on that later). 

My first maternal death didn’t open my eyes to the fact that we have a problem. It was my fifth. I remember that day in the OR very well, even though it wasn’t my patient and I wasn’t even scheduled to work that day. I can still feel my hands placed on her bare chest, I can still feel the effort of every push as I willed her to live, as I willed her heart to start beating again. Surrounded by physicians, and nurses, and a code team, I somehow simultaneously prayed with the whirlwind around me, begging God to save her life. I pushed with such force, not even the breastmilk that slipped around my hands and in between my fingers could weaken the grip I had planted so firmly on her chest. Two minutes felt like a lifetime, 30 seconds felt like forever. But the adrenaline and God’s will and God knows what else fueled me to keep compressing until I heard someone in the background call time of death.

I stood on that stool, looking down at her naked body on the OR table. In that moment, the lights above us glared down, unrelentless and unforgiving, illuminating every issue and all of our empty efforts. Suddenly, everything was so transparent.  Everything was right there in front of my face, exposed across the patient lying on the OR table. My hands were trembling. My body was shaking from the inside out. It was then, it was that delivery, it was that maternal death that I really knew something was very wrong. I stared at her for a second, the wound from her cesarean delivery gaping and glaring back at me, angry and red from the cut of a fresh incision. Breast milk dripped down the sides of her breasts, met and mixed with blood and amniotic fluid, and pooled on the OR table. Blood was everywhere. Instruments were everywhere. And for a fleeting moment, time was deathly silent and still. Everyone just stood there, staring. The floor was littered with drapes that hadn’t been used and packages that had been.  Looking at the floor, images from the past 43 minutes flashed vividly in my mind. In that moment, I could trace everyone’s bloodied footprints trekked fast and furried around the OR. They were testimony to one of the best and worst events that we had all just witnessed.

It didn’t take long for people to scatter, and that day I remember being thankful that I wasn’t the charge nurse and that it wasn’t my patient. This time, it wasn’t my job to comfort the patient’s family after the physician broke the news, or immediately get an update on her baby (even though we all did). After all, that was our only condolence…at least the baby was okay. As I walked out of the OR, I gave a reassuring look to my coworker, the patient’s nurse who would bear the brutal burden of whatever hours remained of our shift, and then—yes, even more than that. We didn’t have to speak for her to know what we were trying to say…we were all so sorry, and this just sucked. I hugged the physician, who was rambling from disbelief  and overwhelming sadness before I quickly headed out the door to check on my own patient. And I vividly remember wanting to eat before I planted myself in front of a computer to chart, because the code had been called mid-morning, in between breakfast and lunch.

“There is no single cause of death amongst men in the same age category which is comparable to the scale of maternal mortality and morbidity.”

I don’t know how many more maternal deaths I’ll see in my lifetime. All I know is that we don’t report how many women we see come so close, saved from death by the grace of God and good providers and good ever-changing processes and good ol’ fashion luck. It shouldn’t be this way. All women should be afforded the basic human right to safely give birth, to have access to everything that makes pregnancy and labor and delivery uneventful.  

So yes, women’s rights are important to me. Not because I’m a woman, but because I value all women. I think about that day in the OR, I think about all of the days in labor and delivery yet to come. I think about how I left that OR so quickly that day, how I washed my hands in the bathroom, careful to rinse off any remnants of her blood before going to eat my lunch. I think about how I walked back into my own patient’s room, as if nothing had happened…because I still had a job to do, because my patient was still pregnant, and because no one other than my coworkers knew that someone had just died right in front of my face. I think about how I didn’t even cry until I got home that day, even though the grief continued to shake my body from the inside out the moment I stopped compressing.

Think of everything we see in between contractions and epidurals, in between busy days and complicated patients.  Think of everything we witness from patients who deserve better. Don’t we deserve better? So you don’t understand why I marched? Why I speak? Why I protest? Because I can. Because less than 100 years ago, I couldn’t have. Because change doesn’t happen overnight, and I know that we have to push to move forward or else we all risk standing still, or even worse, moving backwards. If you don’t understand it or get it, that’s okay and that’s your right and I’m not here to change your mind. I’m happy knowing that you have a voice and an opinion. But if you’re a nurse, if you’re a patient, never forget that you have a voice. And never be afraid to use it. 

 

Until my next delivery ❤


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Diane
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You are amazing my friend. I love reading your blog. I have witnessed death and my own patient has passed, but I have not witnessed a maternal death and dread the day when that comes. :(

vpena54
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vpena54

I should never take life for granted.

Has a man ever died from erectile disfunction? I doubt it…yet look at all the medications available for that!

jen
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jen

A moving & inspiring post. Yes, that is why we march!

Lisa
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Lisa

Gut wrenching post. Every wannabe L&D nurse should read this. THIS is what can happen. THIS is what keeps us awake at night. THIS is what makes us want to punch someone when they say “Oh, you’re job is SO easy” (especially when it’s said by another nurse….)

Sylvia T Martin
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Sylvia T Martin

Did disparity take her life? I acknowledge that disparity is present, but that is another topic. Amniotic fluid embolisms or severe preeclampsia or massive hemorrhage are not limited to financial class, only the fact that we are female! I have experienced maternal death over the years, leading to probable PTSD and a job change from management back to bedside nursing… There is much focus on quality improvement and prevention/treatment now which weren’t there twenty years ago, but the tragic case is that women who are pregnant face risks that increase their mortality. Every maternal death affects the loss of a… Read more »

Tory
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Tory

As a nurse × 22 yrs, & L&D for the last 17, I couldn’t march. Because I’m pro-life, I was neither welcome, nor represented. As a labor nurse, and mother, and Catholic, I see no difference between a fetus minutes before she travels through the vagina and the “baby who is ok” minutes after. There are real disparities in healthcare, especially in maternal health. We absolutely don’t do birth best in this country. Pardon me, but neither of these things is going to be fixed by forcing nuns to pay for contraception & supporting the killing of those you &… Read more »

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