I was at Mt Auburn today with a client for the birth of their baby, as their doula. I've attended…read moreupwards of 150 births in my doula role as well as in my homebirth midwifery role, and I've had the pleasure of coming to Mt Auburn many many times in the doula capacity. Normally it's a pleasure, as you are known (and I recommend you) as a facility that largely promotes evidence-based care practices. Which is why what I saw today shocked, saddened and concerned me. The treatment my client received at the hands of nurse Patricia M. was patronizing, belittling, domineering and at times dangerous and squarely in the category of birth rape.
As an experienced birth worker, I am in the habit of researching the tools and practices I employ, and pride myself on having solid evidence as to efficacy before recommending them. Which is why I reached for the peanut ball as soon as my client was cleared to roll onto her side after her epidural taking effect I was quickly informed by Nurse Patty that she "doesn't use those. I appreciate what you're trying to do, but no." Not only is this a clear disregard for a well-known highly effective laboring tool, it was incredibly inappropriate to place herself in the ownership role in the room, which belonged to my client. My client wished to use the peanut ball, and that should have been all that mattered. Additionally, when my client asked me if she could eat and drink once the epidural was placed, I started giving the standard answer of "water, apple juice, jello, clear fluids." I was once again promptly interrupted by Patty and told that ice chips were the only thing that was allowed, full stop. As I'm sure you're also aware, there is actually zero scientific evidence that eating and drinking during labor-especially for a mother at low risk for general anesthesia-poses any danger whatsoever. In fact, starving a woman in labor is only detrimental to her physical and mental well-being throughout the process. In addition, since the implementation of the NPO rule, localized anesthesia has become the norm, and even general anesthesia has advanced to a point where it poses no great risk of aspiration during surgical procedures.
As concerning as this domineering attitude and disregard for evidence based care is, however, none of the above would usually merit a letter to Patient Relations. But well after Nurse Patty placed my client's Foley (urinary) catheter, my client was inquiring about how and when she would know that she was fully dilated, ready to push, etc. To which Patty casually informed her that when she'd placed the catheter (an hour previously) she had also done a vaginal exam, and as she'd been 9cm at the time, she expected that she was complete by now. A vaginal exam that was done without my client's knowledge, never mind her consent.
There are no words for the violation that this was. Under NO circumstances is it acceptable for a complete stranger to penetrate a woman's vagina, with their hand or anything else, without the woman's knowledge or consent--that is rape. What Nurse Patty perpetrated on my client today was rape. I'm unclear as to whether she thought it didn't matter because she had an epidural and didn't notice, but if this was her reasoning, it is akin to a young man taking advantage of a young woman who is passed out drunk. Neither scenario is ok; both are rape. Not only did Patty perform this vaginal exam without consent, she didn't share her findings afterward (that my client, who had been 3cm at last check, was now 9.) Later on she again shoved her hand roughly inside my client's vagina during pushing without consent (since saying "I'm going to put my hand inside you to see where baby is", while doing so, is NOT consent.)
This is only my first step toward trying to right the wrongs that I witnessed today. It is my sincere belief that no woman should be subjected to this kind of infantilizing and outright dangerous behavior. I implore you to consider the many birthing people who carry heavy histories of trauma, abuse and rape with them into the delivery room. Surely you can understand the effect that this kind of treatment at the hands of someone like Patricia would have on this vulnerable population.
