February 23, 2012

Carol

My first encounter with a delivery occurred when at the age of 11 I begged my mother, a midwife, to let me help her with a home delivery. After graduating from medical school in Mexico, I did a year of internship at Cornwall Regional Hospital in Montego Bay, Jamaica where I learned to do natural deliveries with certified nurse midwives. I then returned to rural Mexico for one year of community medicine where I performed deliveries at home, often with no running water. I then came to the US for my post graduate training in obstetrics and gynecology.

It was a culture shock. From seeing and treating women as a whole entity, a woman’s body was now divided into segments that had nothing to do with one another. But I learned the Western ways while preserving my old ways and planned to do the same for all my patients when in private practice. I also made a promise that I would uphold the “whole person” belief.

My first baby in private practice was born on April 21, 1983, no episiotomy. I stayed with her most of the time she was pushing instead of waiting in the doctors’ lounge for the head to appear. I was so elated.

A picture of me holding the first baby I delivered in private practice kept me going through the tough years. That picture was my mantra. I had delivered many babies as a resident, but no joy could equal that moment.

In many cases it was a battle to resist performing C-sections on my patients. I always KNEW that there was nothing wrong with the baby and that THE SYSTEM was geared to ignore the simple fact that birth was natural. Too many machines were invented to tell a healer what is wrong, and everyone was trying to protect themselves against malpractice.

It was in 1991 when LDRP – labor/delivery/recovery/post-partum were now in one room. I was called to do a C-section because Carol was having fetal distress. It was Carol’s third baby – two teenage sons and she was expecting a girl, the first for her husband Scott. The whole family was planning to be there and I promised them that we were going to make it a celebration of life.

I got to the hospital at 1 PM, quickly changed into my scrubs and rushed to the OR. Scott was in his scrubs, waiting outside the door. When I got in, they were ready for me. The anesthesiologist had already numbed her abdomen, the assistant surgeon was there as well as the pediatrician with a white towel to catch the baby for when I handed it to him.

I looked at the tracing, which looked good. There were no signs of distress. I was told that Carol was now 6 centimeters dilated. For a woman having her third baby, it meant that delivery would be eminent.

Don’t touch her, my intuition told me. How could I do the c-section? It was true that everyone was ready, that I was very skilled at performing a safe C-section – 25 minutes from skin to skin – opening her belly, delivering the baby, sewing everything back up. It would have taken only three to four minutes to get the baby out.

But I felt paralyzed and could not cut her. I asked everyone to wait and whispered to Carol what was going on in my head. “You have to do what you have to do,” she whispered back. I went outside and explained my dilemma to Scott. I told him that my gut feeling was that mother and baby were okay, and cutting her up would be like an assault to her body. He looked into my eyes and told me that he would stand by me no matter what.

I went back into the room and dropped the bombshell. I wanted Carol to be taken back to her room. I called and cancelled my patients at the office so I could stay by her side. Since she was totally numb, she did not have any contractions for a while, but they resumed by 4 PM. By then, I had become very close with the whole family.

Beautiful Kate was born naturally at 7 PM, instead of forcefully being removed from her mother’s womb, and there were no complications.

But soon afterwards, one of my colleagues was sued and a $5 million judgment was awarded to the plaintiff. It was for failure to do a C-section that resulted in some harm to the baby. When I was next asked to do a C-section for fetal distress and I got into the room, I was in complete turmoil. I KNEW that there was nothing wrong, but I was overcome by fear. I saw myself in the courtroom trying to defend myself playing God.

I took my patient’s hand and told her that indeed she needed to have surgery. “I trust you,” she said. “I know that you will always do the best for me and my baby.” The nurse looked at me a little surprised, like saying: “What is going on, no fight?”

After this C-section, I started to feel nauseated on the way home and when I got there I could not stop vomiting violently.

I had betrayed the trust that my patients placed in me. I had given in to fear. If I continued delivering babies, my judgment would not be the same. I would not know when it was that inner voice that I trusted and that had never proved me wrong, or the voice of fear. I had crossed a threshold of no return where I let fear drown out my intuition. Something got broken that day. I could no longer look a pregnant patient in the eyes and promise her that I would be my best. I was a coward. I had given up to the system at the expense of those I promised to care for. So at the prime of my life, at the age of 41, I continued on as a gynecologist, but I quit delivering babies.