Maternity Care in the Rio Grande Valley-From one Mother to Another

Maternity Care in the Rio Grande Valley-From one Mother to Another

I am Nicole Hoff but I am better known as "Mommy", "The Birth Lady,"
or "The Boob Lady." I have my Bachelors in Maternal and Child Health,
am a Certified Doula (a certified professional that assists mothers
during pregnancy, childbirth, and the postpartum period), a Certified
Childbirth Educator, an International Board Certified Lactation
Consultant, and a Midwife Apprentice. As a mother and healthcare
professional in private practice in Harlingen, I have helped families
from all walks of life, from each end of the Valley, during a special
time in their life.

Despite good-hearted intentions of many dedicated and educated health
professionals, the maternity care system across the US, including the
Rio Grande Valley of South Texas, has many shortcomings. A recent
report by Childbirth Connection and The Milbank Memorial Fund, called
"Evidence-Based Maternity Care: What It Is and What It Can Achieve,"
explains why the state of maternity care in the U.S. is worrisome. The
care practices that have been proven to make childbirth easier and
safer are underused, and the many interventions that may increase
risks to mothers and babies are routinely overused. The report points
to the "perinatal paradox" of doing more, but accomplishing less. I
have witnessed this first hand in the Valley and I am truly worried.

Every year Valley women are suffering in silence from birth trauma
that results from their treatment during labor and delivery of their
child. The feelings of their negative experiences are overwhelming,
and sometimes so much so that they suffer from major depression
afterwards. Some women consider it "birth rape", especially if they
had instruments or hands placed inside them without their consent.
Because of my education and experience, I feel that I know
misinformation, maltreatment, and abuse in this field when I see it. I
have had the honor of attending many amazingly beautiful births here,
but I think some of my "birth stories" at local hospitals would
surprise you and many would just sicken you. I wish I could forget
each and every demoralizing abuse these mothers and babies faced, but
some were just so shocking they will always linger in my memory.

I want to put these following phrases I have heard over the years out
there in the open so our community can know what is taking place. I
think everyone involved in birth needs to read these, so that they can
be more attuned to what they are saying and what type of care they are
providing. These are just a few phrases from the many well-intentioned
nurses, doctors, staff, breastfeeding "helpers", and childbirth
"educators" I have heard but I will never repeat. While some of these
phrases could have the correct time and place to be said, and may
really hold true for a mother, there have been more times that I have
heard them said when it was inappropriate or not factual than when
really necessary. Mothers have been mistreated, lied to, given
incorrect information, coerced, manipulated or deceived so that one
will be obedient and go along with treatments, and have had procedures
done when there was no reason or consent to perform them. Dfferent
locations, different staff, same ABUSE.

From their lips, to my ears, to my typing fingers:

Was this a planned baby or just a mistake?
I'm a rough doctor, but I know what I am doing.
You don't need labor support.
No one can birth naturally.
C-sections don't hurt.
Wow, you're huge, you need to get that baby out now!
You're too small for this big baby!
You're seriously pregnant again?
Be quiet. Hush. Shhh. You're too loud!
Our hospital is best- even with over 50% c-section rate.
Your spouse/mom/doula can't come in with you.
We throw away birth plans.
We laugh at birth plans.
You're too sick/weak/tired for birthing your baby.
OB: I only come to catch the baby.
Give up and go with the c-section.
You can't have a VBAC (vaginal birth after c-section).
That won't work!
You can't...
Since you have medicaid...
I only speak English, this is America!
You're worrying me, stop that.
I have to do this to you because...
That's not important. Forget about it.
I don't have time. I've got other patients.
That's normal. I see that all the time.
You're wearing me out
I'm not here for you, it's just my job.
Good girl.
C-sections are safer and better for you and baby.
You're not strong enough.
That's in the past, move on.
Don't move.
I can't help it if you don't understand.
Oh relax!
You're fine!
Hold your pee and poop!
You can't get up!
No time to explain this to you.
Oh gross!
Sit still. Lay still. Be still.
Why would you want that?
Well that's a first!
You ask too many questions!
You have to do what I say.
I know your body better than you do.
Only 1 person allowed in room.
I'm cutting you open.
Push now even if not ready.
It doesn't matter what you need.
Oops! We....
Your epidural didn't work because you....
Let's induce now at 37-38 weeks.
Hurry up!
Start pitocin she's not progressing.
You have to be alone for 2 hrs.
I'm taking your baby away for 4 hrs.
You have no choice.
Even if you say no, I must...
Ob:Plan a c-section or induction for when I'm in town.
Ob:I know what's best, not you! Who is the doctor here?
You're here so I can't let you leave.
Just get pain meds already!
You can't do this anymore!
You're not pushing right!
Spread your legs! Wider!
Lay flat even if it hurts.
Did you pay your deductible yet?
I cut you even though you didn't want it.
You will hurt your baby unless...
Emergency c-section was you're fault.
I forgot to wear gloves.
Your baby needs a bath, it may have swine flu.
Your baby is dirty.
The doctor decides...
Your baby needs more than your breastmilk.
Your breasts won't work.
I have to hurt you.
I forgot and fed your baby for you.
Formula is better.
You need a catheter!
You need pain meds!
You need an IV!
You need pitocin!
You need monitoring!
You need to just chill out!
Your baby doesn't like that.
You can't go to the nursery.
You're not dilating fast enough.
I got you too drugged up to hold baby.
The baby needs the nursery more than he needs you.
Epidurals have no side effects.
You're not breathing right.
We can't do that for you.
We do this because it works for us.
Your doctor won't be here for you after all.
Follow our rules.
We have policies and protocols.

Now you know why videocameras are not allowed in labor rooms! They
would be too embarrassed to let this get out, and honestly I am
embarrassed for them. This list doesn't even include the sighing, eye
rolling, storming out, finger pointing, paper waving, bribing, rough
handling, withholding, lack of privacy, lack of respect, and other
abuses. Because such practice and sayings have become routine, few
maternity providers consider them abusive or inherently inappropriate.

It needs to stop... but I fear it won't.

Still, someone needs to speak up for these moms and babies and I hope
someone out there cares. No local maternity professionals or hospitals
have responded yet to my plea to contact me about ways to end this
system of poor care. And no one has apologized to these mothers or
babies-many who feel traumatized by past births. I would like to
apologize for them and my apologies go out to the mothers that have
had this abuse, and my hope for you is that you find healing and
closure.

I will get some harsh feedback from this letter and some will deny the
existence this abuse to mothers or believe that I am exaggerating, but
this is because misconduct is rarely reported. I know that, sure, some
births go "fine" and there are a handful of "good" staff out there,
and hospitals are "working hard to accommodate mothers". I have seen
that too, just not often enough to right a passionate letter about it.
Maybe someone will respond wanting to know how to help make the birth
experience better? The answer is easy! Birth professionals need to
empower women to prevent birth trauma. Give her control through
education, support, and your time. Don't make decisions for her, make
them with her. Show her that she is valued and that you will give her
your all to give her the best birth for her. Treat her with respect
and give her privacy. Ask permission anytime you are performing an
intervention, treatment, or even touching her. If she asks you to
stop, do so immediately, and always explain what you are doing in
detail. Above all, listen to her, and show her that you care about her
AND her baby. No one deserves to be treated any differently than this,
especially when in pain, when in need, and at a precious event in life.

Attention-RGV Families: You're not free from serious risks at Valley
hospitals when giving birth. You will hear many of these phrases
above, whether you believe it or not, it is a sad fact. The c-section
rate is high in our area. You risk so many interventions that can lead
to a c-section or a sick mom and baby. You face the risk of
unnecessary induction, which can turn out to be too early or fail and
lead to a c-section. It is a fact that you will receive care from
some, if not all staff, that have amazing skills but lack natural/
normal childbirth and breastfeeding education. I have seen this at
about every Valley hospital location. You will probably be made to do
what they say and not what you need or want. You become their property
and your baby becomes their responsibility!

There is an alternative. Escape from this abuse. There are a number of
different ways for you to have a safe, happy, and healthy birth. Here
are the four most common:

* With an "enlightened" doctor at a hospital
* With an "enlightened" midwife at a hospital
* With a midwife at a birthing center. Locally: Holy Family Birth
Center in Weslaco.
* With a midwife at home. Locally: Beth Overton, CPM who does all
prenatal care and home birth.

Seek many options, weigh the risks and benefits, and choose the birth
plan that works best for you. If you are considering a natural
childbirth, you should definitely educate yourself, consider taking a
childbirth class not associated with a hospital or similar natural
childbirth class. You really can have a beautiful birth experience
even if you have your baby in a hospital, but you need to find a
doctor or midwife and doula who will support you in your point of
view, and you need some training to help you prepare yourself.

Attention-Doctors, staff, hospitals: If you think this isn't happening
in your birth facility or practice? Prove me wrong. Show me your true
support of these women and babies. Hire me as a Doula to be on staff
and respected at your birth facility or clinic for 1 month. Allow
video cameras into your center and take evaluations from your
patients. Not brave enough for that? Show me the information on how
these phrases and this type of "care" you are providing helps mothers
and babies. Are you that "enlightened" doctor or midwife out there
that can help Valley families, then contact me and let me know and I
would be happy to share that information.

For now I, as a Valley mother and maternal and child health
professional, will continue to advocate and support Valley families,
and I hope that I will no longer continue to see and hear mothers and
babies being abused at what should be the most joyous time of their
life.

My main goal is to open a family friendly birth center, resource center, & recreation center here in the Valley. "A place where families can find answers to their every need." I need to meet a major need and offer women more choices, education, and support during pregnancy, childbirth, and while parenting. This is my passion, my calling, and my ministry to help support, educate, and advocate for women and infants during this precious time of their life.

We really need change in the Valley (for the reasons in my article above) and I really need support because I can't do it alone. Can you please help my cause in some way? I wrote a post not too long ago about ways people can help:

http://hoffhouse.blogspot.com/2009/04/help-south-texas-families.html

Contact me for more information.
www.BlessedBirthDay.com
nicole@blessedbirthday.com
956-245-1787