“No human should have to withstand Pitocin contractions on their own. It’s awful,” Cooper-Schultz says. “They weren’t honest with me. They didn’t say, ‘If you get the Pitocin, you’re probably going to need an epidural.’”
Thompson, the doula, says that the lack of informed consent is a big problem when it comes to the medical interventions doctors use to manage labor and delivery. When women ask for her services as a doula, the most common statement she hears from moms who have had previous births is, “If I would have known this, I would’ve never done that.”
Many doulas, including Thompson and Care Messer, who is also a hypnobirthing instructor, believe that a large part of their job is to help inform the patient about the effects of Pitocin and other interventions. They see themselves as advocates, helping to remind the mothers that in a hospital setting they are the customers and they have the right to say no. But Cooper-Schultz didn’t know any of this before her experience at Mary Birch, and she chose her doula for her nurturing characteristics rather than her strength of advocacy.
“I needed somebody to be like a mom for me because my mom wasn’t going to be there. And that’s what she was,” Cooper-Schultz says. “I didn’t go into this situation thinking I have to be an advocate for myself. I didn’t know I had to do that.”
Cooper-Schultz withstood the pain of Pitocin contractions for eight hours before she finally gave in and got an epidural. “I was in so much excruciating pain I couldn’t move. All I could do was just sit in the chair. Every time I would get up, I would have one contraction on top of another on top of another.”
The epidural worked on only her left half.
At one point, the doctor came in to check on her and alerted the nurses that she was going home to take her kids to school. Sometime later, she returned with wet hair, checked Cooper-Schultz, found her at nine centimeters, and told her to try pushing.
“I pushed, and [the baby’s] heart rate went down, which I now know can be in a normal range of labor. But she said she’s worried about it. She said, ‘He’s not in distress, but he’s a little bit stressed.’”
The doctor told Cooper-Schultz it would go one of three ways. In the first scenario, Cooper-Schultz would push for 20 or so minutes and the baby would come out. In the second, she could push for 20 or so minutes, the baby would not come out, and they’d have to do an emergency cesarean section. Or, the doctor said, they could do a cesarean section right now.
Cooper-Schultz chose the cesarean.
“I was really afraid [of the emergency C-section] because my husband wouldn’t have been able to be there with me,” she says. With the nonemergency C-section, her husband was allowed in the operating room.
Cooper-Schultz had never been hospitalized or had surgery before. She recalls the anesthesiologist as a kind and concerned man who offered her a shot of Demerol, but that’s all she remembers.
“I kind of passed out, and basically, I missed my son’s birth,” she says. “The next thing I remember was them holding up a baby on the other side of the room that could’ve been mine, could’ve not been mine, who the hell knows.”
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Dawn Thompson, who has been a doula for eight years, no longer provides her services to women who plan to deliver at Mary Birch because, she says, the environment is particularly unsupportive of the natural birth process. A doula can only provide information and support to a mom; she can’t make decisions for her. And to deliver naturally at Mary Birch, a mom has to be prepared to fight.
“I couldn’t handle the emotional ride,” she says. “As a doula, if I don’t invest with these moms, I’m not doing a good job. So, to feel their disappointment and their devastation and knowing that I had all the information and could have offered them something different is just huge.”
In eight years, Thompson has overseen 134 births. Of those, 17 took place at Mary Birch, 12 of which resulted in a C-section. That’s 71 percent. Of the remaining 117 births, only 9 resulted in a C-section. That’s just under 8 percent.
“When the guidelines are so stringent, you know that you’re working uphill,” she says. “The moms shouldn’t have to battle to have a normal childbirth.”
∗ ∗ ∗
Helen Dover (not her real name) welcomes me into her North Park apartment shortly after the dinner hour on a Tuesday evening in mid-September. She tells me she’s an unlikely candidate for natural childbirth.
“I’m like Woody Allen,” she says. “I am a New Yorker who likes living in the city, who likes creature comforts. And for somebody like me to be embracing [natural childbirth] is humongous.”
We sit together on her couch, she with one foot tucked beneath her. Her two-year-old daughter hacks away at purple construction paper with a pair of plastic scissors on the floor near the coffee table.
Dover’s story is similar to Cooper-Schultz’s in that it begins with a desire to give birth naturally at Mary Birch and ends in what she considers an unnecessary C-section. One difference is that when Dover started out, she did know she might have to fight for what she wanted. When she began to labor, she called her doula first, not the hospital. She stayed home and labored for 10 to 12 hours before she went to the hospital, avoiding “the clock” for as long as she could.
When she arrived, armed with her research and her hopes for a natural birth, she found that the environment at Mary Birch had a greater impact on her than she’d imagined it would.
“There’s so much fear on their part when you walk in the door that something’s going to go wrong, and it’s overwhelming,” she says. “It was never, ‘We’re so excited. You’re going to have a great birth.’”