Our Vancouver Birth Trauma group has recently begun organizing a series of Birth Rallies to raise awareness of obstetric violence against birthing women. Our goal is to achieve greater transparency and accountability of medical staff and hospitals in how treat birthing women. We want to build a system for independent quality control and human rights protection that will protect birthing women from obstetric violence and human rights violations during childbirth. We want to make sure that what happened to us never happens to other women.

As part of our rallies, one of us, Kalina Christoff, has chosen to hold a sign naming the doctors who played part in her childbirth trauma and subsequent PTSD.

Here is, in short, a description of the events that this sign summarizes.

 

Kalina's story:

"I gave birth in a very traumatic, abusive circumstances. When I was 38 weeks pregnant, my prenatal doctor, Renee Hall, performed a membrane stripping procedure on me without my consent and without telling me what she was about to do. This was not the gentle, slow membrane sweep that some practitioners perform. This was a hasty, brutal, sudden prodding deep at my membranes. Renee Hall must have known that I would recoil away from her in shock and pain (from what I have gathered since, she must perform this routinely on her patients). So she did it as forcefully and as quickly as she could. My baby inside me jumped away from her too, pressing against my lungs, adding fear for him to my own pain and shock.

The most recent research on membrane stripping shows that contrary to commonly held beliefs among obstetricians, it does NOT increase the chance of labour beginning spontaneously. (Hill, M.J., et al., The effect of membrane sweeping on prelabor rupture of membranes: a randomized controlled trial. Obstetrics and Gynecology, 2008. 111(6): p. 1313-9.) Instead, it can lead to premature rupture of membranes, which in turn leads to artificial labour induction. This is what happened to me.

Because of premature rupture of membranes, I was induced two days later. Michael Farmer was the doctor on call at BC Women's at that time and he supervised my induction. I was only told the risks of NOT inducing. No one told me the risks of induction (for example, it almost doubles the risk of C-section for first time mothers). Induction was the first procedure Michael Farmer performed on me without proper informed consent. But even worse was a vaginal exam he performed on me. Without asking me for consent or permission, he performed a vaginal exam on me when I was 8 cm dilated and in transition, having extremely strong contractions, and was unable to stop him from doing so. This exam caused me extreme pain, was degrading and insulting, and was extremely detrimental to my labour and subsequent childbirth.

Last November I wrote to the Patient Care Quality Office at BC Women's Hospital to ask for an in-person meeting with Michael Farmer at which I was hoping to obtain his explanation and apology for his behavior. I never heard directly from him, but the Patient Care Quality Office informed me that "Dr. Farmer elected to not meet with you" and that "Dr. Farmer believes that his care was appropriate".

The most traumatic and abusive part of my labour came at the very end of my birth. A senior obstetrician who I had never met up to this point suddenly walked into my room and declared "We'll have to use forceps."

I started asking questions, hoping to understand better why forceps was necessary and to find out what the risks of forceps were. But my questions were mostly met with aggressive silence.

The senior obstetrician was Petra Selke, though at the time no one bothered to introduce themselves to me or even talk to me much. I kept asking "What are the risks?", hoping she would say something like "There are risks to the baby, but I will be extra careful". Instead, she kept repeating in a cross, angry way: "I have been doing forceps for 30 years; I have hurt mothers, but I've never hurt a baby."

There was so much pride in her voice that I started mistrusting her motivation to do forceps. I felt that she had something to gain for herself from this and it had nothing to do with my baby's or my own well-being. 

In response to my question about why forceps was necessary, Petra Selke nodded to the monitor's readings and said "I don't like what I'm seeing", to which the nurse who had been attending me continuously said "This was a technical problem with the pick up". At this, Petra Selke stormed angrily out of the room, as though the nurse had committed a cardinal mistake by contradicting her.

Few minutes afterwards, medical staff including Michael Farmer stormed back into my room and started urging me to start pushing -- continuously and strongly -- as though my baby's life depended on it. (Five months later I would learn from my records that my baby's heart beat was perfectly fine.)

I couldn't feel my body, my contractions, or whether or not I was pushing. I now know from my records that at least once someone had pressed my patient-controlled epidural button without my knowledge, giving me additional dose of epidural anesthetic -- and making sure I would be unable to push my baby out on my own. Even before that additional button push, I was already under such a high epidural dose that I could hardly keep my eyes open. No one asked me about the dosage I wanted (I wanted the absolute minimum) and no one informed me that I had a choice for how much epidural to receive -- and that I had the option to request that it be reduced or altogether stopped.

After 15 minutes of pushing, Petra Selke walked back into my room and stared angrily not only at me, but at Michael Farmer too. Her stare towards him seemed to be saying "If you don't get your patient under control, I will really get angry." He looked at me and said, "stop pushing, the baby's heart beat is going down" and then started talking about forceps again. 

I was still not convinced that forceps was necessary or that the baby was in real danger. I wanted to know how far the baby's heart beat was going down, so I asked. No one told me. I kept asking, and I kept getting no answers. They kept the monitor right behind my back, so I couldn't see it. I also kept asking my question, "What are the risks", hoping that someone would acknowledge that there are risks to the baby from doing forceps. No one did. Instead, Michael Farmer started talking nonchalantly about his field trips: "I've seen women in New Orleans give birth on floor mats; you don't know how good you have it here".

The room started getting filled up with medical personnel. People were streaming in, waiving surgical instruments and preparing tables with strerile sheets on them. At the same time, Petra Selke -- the obstetrician who, I had no doubt, was about to perform the forceps -- was getting angrier and angrier. This was the woman who was about to place forceps inside me and around by unborn baby's head. Even though I didn't believe that there was a real need for forceps at that time (and now that I have read my records, I KNOW that there wasn't), I started to feel that I couldn't do anything to prevent them from using forceps. There was no way that I could physically fight away all the 15 people who were streaming into my room. I couldn't even feel the lower half of my body.

All I had was my ability to ask questions and delay as long as possible the procedure -- but I started to fear that if I said anything more, or if I asked any more questions, Petra Selke's anger towards me would reach a point when she would deliberately hurt me and my baby during the forceps. And so I said "okay". Something I will regret for the rest of my life.

At the sound of that "okay", all 15 medical people in the room swarmed onto me; one person covered my raised legs with a blue sheet, so I couldn't see anything of what was happening. Because of the epidural I couldn't feel anything either. I didn't see, hear, or feel the birth of my child. No one told me he was born and no one showed him to me. Instead, the first thing I saw after that blue sheet was removed from me was Petra Selke, Michael Farmer, and a young woman talking to each other. Michael Farmer was congratulating the young woman. "You did a great job. Are you a 5th year resident?", he said to her. "No, I'm a 4th year resident", she said.

That's when and how I found out that a resident trainee, not Petra Selke, had performed the forceps. The resident's name is Erin Adams.

BC Women's is a teaching hospital. Each obstetrics resident has to perform certain number of obstetric procedures, including forceps extractions, in order to graduate. Without my consent or knowledge, and against my will, my body was used as part of the hospital's teaching program.

Both my baby and I sustained physical injuries from the forceps that we struggled with greatly during the first month after the birth. But much worse and longer lasting were the psychological injuries.

My son will never be able to put words to his experience. But I will. And I do.

And that is, in short, what lies behind the text of my sign."