labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Thursday, December 18, 2008

How to Handle Bad Care

I am sure some of you have already heard the lawsuit against an obstetrician who treated a woman in labor having her 5th baby horribly, so badly in fact that it caused her emotional trauma. I've written about rude and condescending things I've personally witnessed or heard about, but nothing compares to what is alleged in this particular suit.

The original story broke in the Chicago Tribune. The following comment is from Kathy:

Rebirth Nurse,

I just read
the story originally printed in the Chicago Tribune about how one doctor allegedly abused a patient because he was angry at her for not calling him before going to the hospital. (You can click on the link for the allegations, but they include denying her request for an epidural for hours, not allowing her to speak [even to ask questions], making her lie in stirrups in an extremely uncomfortable position for hours, telling her in no uncertain terms that she was going to hemorrhage, and suturing her without anesthetic.)While I am extremely upset at even the possibility of something like this happening, I wonder if there is anything that the woman or her husband could have done to stop this. Assuming all of the allegations are true, what could the woman have done while in labor to have kept this from happening? Could she have requested another doctor? Could the nurse have done something? Surely there was *something* that could have been done. While people like me can get angry at such treatment, I would like to go deeper than that and work at preventing that, rather than just "file suit afterward" if something like this happens.-Kathy

Kathy, you ask such good questions. I can answer these questions as if it happened to anyone, and what women can do in situations where they feel they are treated with a lack of respect, not given analgesia or anesthesia when requested but it would have been safe to give, or generally feel as though they are not given any choice in their care. I can't answer specifically in regards to this particular story in regards to what this woman and her husband could have done, but I think it would be helpful to discuss what any woman and her support people can do in such situations.

First off- much of what can prevent this sort of situation is education. I've written plenty on the importance of educating oneself on their provider, their philosophy, their partners and philosophies, the hospital or birth setting, and the process of labor and birth and choices available to them during that time. (Sorry, you'll have to search my archives for these posts because I am really lazy and not linking these days). Knowing what is considered "normal" labor and birth, what the policies and procedures are in your chosen birth setting, and how your provider and their covering partners "manage"or approach birth. This can help prepare you for what to expect, as well as knowing if will even be comfortable with what you desire.

In a hospital, there are always "back up" providers. Even in small community hospitals, there will always be someone else on stand-by call in case all hell breaks loose, or if the covering provider falls dead, or whatever. Larger places may even have a second provider in the hospital. So, if you do not like the provider caring for you because they are being disrespectful, performing interventions without asking permission, declining requests for pain medication, or otherwise you can always ask to have that provider take over.

But, and its a big but, is that before you get to this, start asking questions. For instance, why can't you have pain medication if you are requesting it? There may be a very good question as to why its being declined. For instance, anticipated delivery will occur in a time frame where it may not be safe for baby, or in the case of an epidural it may be because there are no anesthesiologists available at that time and you will deliver in 10 minutes. If a provider says, "You need XYZ" and starts to just do it, you have the right to say, "Can we discuss this first?" Things to ask when presented with procedures or interventions are:

  • Why is this being recommended?
  • What are the risks to myself and my baby?
  • What are the benefits?
  • What could happen if we didn't do this?
  • What are the alternatives?

Then you can ask for time to discuss it over with your support people in private. The only time I can think of where this is likely not going to happen is cases of true emergencies- like prolonged fetal bradycardia (baby's heart rate drops and doesn't come up), major maternal hemorrhage (you're bleeding out like a sieve), or the umbilical cord hangs our your vagina, for instance.

If you can not get answers to your questions, you can ask for the second provider. You can even state that you do not like how you are being spoken to if you feel its disrespectful. You can speak with your nurse as they are also your advocate. And if you don't feel like you can personally do this, have your support people ready to step in.

Remember, as the patient you have the right to informed consent, informed decision making, the ability to say no, and the right to ask for another care provider that you feel would better fit your needs and treat you safely and with respect.

As a follow up, contact the hospital's patient services/patient advocacy department, risk management, the department director (both nursing and obstetrical), or even the president/CEO- if not all of them.

This sort of stuff angers me, too, and I've been pretty fortunate not to see what was alleged in the lawsuit. I have seen things that are disrespectful, or comments that leave a woman feeling inadequate on occasion, but fortunately not often and not to the degree this lawsuit mentions. I hope my tips and thoughts are helpful.


Rita J. said...

Just speaking as someone who had some inconsiderate care in the hospital after the birth of my baby, during labor and afterwards are an incredibly delicate and sensitive time for a mom (and dad). There were things done that ordinarily we would have requested much more information about, but at the time we were sort of in a daze. During labor and right after is a very difficult time to advocate for yourself. In that vein, I can better understand how something could happen that would ordinarily result in a well-deserved punch in the nose being unmentioned or complained about as it's happening.

MomTFH said...

Great post!

One more thing you can do, if you can afford it or have access to one: hire a doula. Doulas (hired birth attendants) should know what is normal standard of care for uncomplicated births and most major complications. They should know your wishes and be able to communicate them to your providers when you are possibly scared, exhausted, and in pain.

Mama to Monkeys said...

I've heard a lot of this before from many, many women--just different versions. Kudos to this woman for doing the right thing and blowing the whistle on this guy. I wonder how much hate mail his office is getting these days via his website.

What gets me about this one particular woman is that she was a Chicago police officer for TEN years. I think that specific detail highlights just how entrenched in our society the mysoginism and barbarity of modern obstetrics has become. If anyone should have recognized assault, it should have been this woman.

But, alas, we are not our normal selves in labor, as illustrated by her husband holding her down at one point.

Sad, sad, sad. Maybe one day women will wake up and realize that birthing year care providers don't have to be surgeons in order to be the most qualified provider.

Anonymous said...

I just finished watching the piece on channel 5 with Nesita Kwan re: Dr. Scott Pierce.
My daughter was delivered by Dr. Pierce some 25 yrs ago, April 22, 1983, he was th e MD on call. At that time he was with the practice of Lehrer, Pildes and Pierce. There was a 4th doctor, but I do not recall his name. His office was on Peterson Ave and also one on Michigan Ave. She was delivered at Edgewater Hospital on Ashland Ave in Chicago.
I believe that he was still a new doctor at the time and that maybe he did not have much OB/delivery experience, at least that is what I have told myself all these years, until I just saw the piece on channel 5.
When I was listening to the young women who had the horrible delivery with him for her 5th child, it gave me chills and goose bumps, because everything she described was exactly how my experience was with him.
I went into labor at approx. midnight and got to the hospital at around 1 am. This was my second child. I was doing ok with my labor pains until he came into my room. He told the nurses and if I remember correctly a young resident that " I have places to go, so lets hurry this up." I don't recall the time, but the nurse started me on an IV drip of Patocin to speed up the labor. Well needless to say, instead of letting nature take it's course and I had no medical conditions or any delivery related problems that would suggest that I needed Patocin, I went from being OK=2 0with my labor to screaming in pain within a matter of what seemed like minutes. He was in such a big to get the baby born so he could leave, that he had no concern for me. And during the intensifying of the labor pain, I repeatedly asked hi m to please give me something for pain. He kept saying in a cocky manner, "you're ok, you're ok."..It was so bad at the end that I could actually feel my self spreading open and he still had not given me any pain relief and if he had, I never even knew it the pain was so bad. After she was born at 5:32 am and the placenta was out, he spent what seemed a long time stitching me up because of the tearing that had happened. Later my husband asked our regular OB..Dr Lehrer about the stitches, he said that I had like 70 stitches. But I don't know for sure.
I guess it never had anything to do with his youthful inexperience, he is just a horrible person who does not care about his patients. I hope no other young women ever has to go thru such a horrible ordeal as the young women in the peice and myself experienced with Pierce. I wish her and her family all the best.
Thank you

Anonymous said...

Dr. Pierce should be sued 100 times over. He delivered my child at Gottlieb Hosp. in 2004 and was rude and arrogant. He was a total jerk during my c-section delivery. Through an outside source, I learned that he had spoken about me like I was a dog. He was 7-8 hours late for a "scheduled" c-section and tol d me that he would not deliver my child if I left the hospital. In hindsight, I should have left. Between him and the anesthesiologist, who was also rude and obnoxious, I had to gather myself and deliver my child. This guy should not be practicing medicine. I went back to him to receive a return to work notice and was never seen in that office again. His office also sent me numerous letters requesting that I continue to be his patience. I didn't step forward because of the source and I didn't want them to get into trouble. Otherwise, I would have filed suit against him four years ago. This had been eating me since 2004. I hope more women come forward and maybe a class action lawsuit will be filed.

Anonymous said...

I have much sympathy for this women and wish I had spoken out 25 years ago. I blamed it on him being young then, but I guess 25 years of practice did not mellow him any.

Dr. Pierce was my doctor when I delivered my first & only child back in 1983. I also have to say he is not the most sympathetic doctor when it comes to delivery. I had to be induced, which made me vomit and gave me seve re diarhea during labor. Dr. Pierce had to leave the hospital during my labor, because he had to go to another hospital to deliver babies there. While he was gone the nurses kept in contact with him by phone to tell him my progress and after 12 hrs of labor he told them for me to start pushing and if he didn't feel I was pushing hard enough when he got back he would have me push some more. The nurses felt awful having to relay this message to me, but we proceeded to push for 3 hours. By now I have been in labor from 6 am to 9 pm when Dr. Pierce came back to the hospital to say that the baby could not be delivered naturally because his head was stuck so he did a cesarean section finally. My husband was furious with the doctor by this time.
First thing I did was find another gynocologist when I could.