The progression she’d experienced at home, from two centimeters to four, slowed drastically when she arrived at the hospital. A doctor told her that it might help if he broke her water. So she allowed it. But nothing happened. Her daughter’s position, she says, acted like a stopper, and Dover’s labor continued to advance slowly.
“I should’ve stayed as cool as possible,” she says. “I’d read the books where they say once you get to the hospital, you’re a little bit more tense because you know there’s a clock running. They kept coming in and nothing was happening, and I was getting a little bit more stressed. The only person coaching me along was my doula. Everybody else was, like, ‘Are you there yet? Are you there yet?’”
Dover’s husband, Henry (not his real name), pipes up from the nearby kitchen table, where he’s been listening in.
“As things were not progressing, there was never any inflection or tone of ‘You’ll be all right,’” he says. “It was just more and more concern, more and more concern, like, ‘Things are not going the way we have our script to play out.’”
Dover lists her regrets: Not waiting and laboring longer at home. Allowing the Pitocin at 12 hours. Giving in to the epidural after 8 more hours. But the regrets go as far back as her pregnancy, when she chose to stay with Sharp.
“I should’ve just switched, but it’s so hard with an HMO,” she says. “In order for me to switch to Scripps and go to one of the birth rooms at Scripps, which has a much better record, would have meant changing everything: changing my primary care physician, changing my OBG. I would’ve had to totally change my insurance policy. And at the time, I already had a pediatrician picked out for her and everything. We’d interviewed, and just the idea of doing all of that was overwhelming. I thought I didn’t have the strength to do it.”
Dover’s daughter, who has finished cutting all the purple construction paper available, piles her blanket, stuffed horsie, and stuffed giraffe into her mother’s lap. Then she climbs up on the couch and joins us.
Dover tells me that around the 40-hour mark, she began to cry.
“[The doctor] said, ‘You need a C-section,’” she says. “I said, ‘I don’t understand why I need a C-section. Everything seems to be fine. Her heart rate’s not dropping.’ And he said, ‘Well, she’s stuck.’”
Dover reaches out and runs a hand over her daughter’s hair.
“I’d read all these books where the midwives use their hands and try to help gently,” she says. “But he said, ‘No, I’m not going to do that.’”
When she asked why not, the doctor said he didn’t know what position the baby was in and didn’t want to cause a broken shoulder.
“He wasn’t even willing to use his hands and help,” she says. “And I was totally against using the suction, but anything besides the total hands-off. He said, ‘I don’t want to hurt your baby, and you don’t want to hurt your baby.’ I started crying. And I just finally said, ‘Fine. Cut me open.’”
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“Moms are easily led at the very end because they want to get the baby out. They’re tired,” Messer tells me.
Elizabeth Cooper-Schultz confirms that this was true in her case.
“Go without eating for 27 hours — on Pitocin and with an epidural that’s only working on half of you — and try to make a rational decision,” she says.
Without eating for 27 hours?
The staff at Mary Birch emphasizes the no-food-in-the-labor-and-delivery-unit policy during the hospital tour that most moms take earlier in their pregnancies, Messer tells me. “The first thing they say is, ‘What can’t you do when you get here?’” And the answer she says is, “No eating or drinking.”
“At Kaiser, you can eat and drink,” Messer says. “UCSD, you can eat and drink. Pomerado, you can eat and drink. Palomar, you can eat and drink. But at Sharp, their reason is if you need a C-section, you can throw up, you can aspirate, and you can get really sick.”
When I email Cihomsky, the communications vice president at Sharp, to ask about the no-food-or-drink policy, he responds, “It serves as a precaution in case of an emergency that requires a mother to undergo general anesthesia during labor. Anesthesia is always safest on an empty stomach because of the risk of aspiration. Other factors come into play, such as how long the labor lasts, the mother’s particular condition, etc., so the ultimate guidance on whether or not a mother eats during labor rests with her physician.”
Messer scoffs at this policy.
“How do you expect a woman to run a marathon with no fuel? It’s dumb,” she says.
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The obstetrician a woman chooses plays as large a role in her birth experience as the place she chooses to deliver her baby. Some doctors have a reputation for being more inclined to help with a natural birth, and others for being less inclined. Childbirth books suggest that a woman question potential candidates to get a feel for their practices. Messer and Thompson agree that’s not always enough.
Thompson cites the “bait and switch,” where a doctor claims to support a woman’s birth choices up until the final weeks, when it’s too late to change doctors. Messer says she’s seen doctors who’ve initially said they’d support the hypnobirthing process but later changed their minds.
“All of a sudden it’s, ‘That’s not going to work. No, you can’t be on your hands and knees. That’s not safe, and this isn’t,’” Messer says. “And that’s at 40 weeks. So now, where can I switch?”
Christine Stewart, a petite redhead and mother of twin girls born at Mary Birch in September 2009, says she experienced something similar with her doctor.
We’re sitting in the dining room of her home at the end of a cul-de-sac in Carlsbad. The girls, who will turn two tomorrow, are just up from their naps. Their Austrian nanny ushers them past us and into the kitchen for their snacks. One runs back for a quick kiss from Mom.