pregnancy

'A midwife yelled at my wife to "get with the program" during birth. It was just the beginning.'

Content warning: This story includes descriptions of sexual assault that may be distressing to some readers.

Every woman and their partner hopes for a magical birth. The ones you see on the screen, where lights twinkle and fairies sing and it’s wonderfully transformative experience.

Unfortunately, this isn’t what happens for everyone. And it’s not what happened for me and my wife.

This is my story as a spectator, when burnout came alive in the midwife, exhaustion showed in the obstetrician and red tape prevented adequate pain relief from being provided in time.

Weeks after the birth and we started therapy, Luce shared her story, the term obstetric violence became a common one. What did that mean for me? Was I not only a complicit bystander, but an active participant?

Watch: COPE's The Truth campaign unveils the profound and potentially long lasting emotional impacts following a traumatic birth. Post continues after video.


Video via COPE: Centre of Perinatal Excellence.

Please consider your mental wellbeing as this piece may be confronting  for assault survivors and those who have endured a traumatic birthing experience.

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The start.

We were two weeks early. A little ahead of schedule, but no major drama. A routine OBGYN check-up surprised us the day before, identifying Luce was three-centimetres dilated. She wasn’t feeling a thing. The advice was to prep for the hospital trip, but just take it easy at home and enjoy the little remaining time we had as a duo.

The following day was much the same. I called the private hospital we were destined for to let them know what was happening and that we’d be there sometime in the near future. The unidentified nurse/midwife asked if this was our first before, saying it could be days or weeks before the baby was actually born. “I should know, I’ve had enough and delivered enough of them,” she quipped.

That evening, the mucous plug dislodged, Luce’s waters broke (we thought) and we were finally advised to come in around 8:30pm. I plopped Luce on a towel in the passenger’s seat and we sang our way to the hospital playing some pop music mix. Some contractions were happening, but nothing that caused more than a blink from Luce.

At the reception desk Luce’s waters really broke, like the movies, quickly darkening her navy-blue maternity pants. Both of us laughing in hysterics, Luce toddled off to find the nearest bathroom to do a quick outfit change while the staff sorted our paperwork and got the room ready.

From there we were shown to the assessment room. Effectively a broom closet with an ensuite. Our OBGYN popped in to say hello. She was wearing dirty scrubs from another birth, her umpteenth for the day, and was heading home to have a shower and quick nap as we figured Luce would continue to slowly dilate. I played solitaire on my phone while trying to get comfy in a standard issue waiting room chair.

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The escalation.

Next minute, Luce’s contractions and associated pain skyrocketed. Within the next half hour, she’s vomiting. There weren’t even sick bags in the room because it wasn’t set up for anything like this. I had two nurses running about trying to find some… this was a sign of everything to come.

Image: Supplied.

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I kept having to leave the room to find staff and advise them of Luce’s quickly deteriorating condition and escalating pain. They were at least easy to find - all huddled at the nurses’ station for handover, but leaving no one actively looking after us. I was trying to get her meds, she hadn’t even been given Panadol and was only using the gas which doesn’t seem to offer pain relief as much as a head spin.

I felt fear beginning to creep in. It was when I began urgently requesting morphine (that’s about as demanding as I get) that I was told Luce hadn’t technically been admitted yet, so nothing could be given. They couldn’t even call the anaesthetist for an epidural (which we’d heard always took ages to happen).

I went to update Luce and try to give her some reassurance, even if it was just platitudes. She was rocking on the chair, moaning. I felt my chin tremble and raced back out telling everyone to get our OBGYN and call the anaesthetist NOW NOW NOW. Luce couldn’t stand and was having extreme pain down her lower back and legs. She kept asking me to furiously rub them with damp wash cloths, leaving her skin red and raw, but I just thought “whatever helps at this point”.

I’d planned to take photos throughout the birth, something that I thought would be a nice reminder of our magical moment as we welcomed our daughter. But it didn’t take long for me to abandon that idea – this was not a time to ask for a ‘cheese’ and a thumbs up. Instead, I desperately tried to distract Luce with music, funny animal videos, TV… I even googled Dad jokes to try and lighten the quickly darkening situation.

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Attempted relief.

After what felt like hours, but was around 30 minutes, the anaesthetist showed.

The tiny room was already overcrowded with two midwives, the anaesthetist, me and Luce. The anaesthetist’s machines couldn’t even fit without moving a trolley table and our little amount of luggage into the corridor. It seemed all hope of the spacious, well-equipped birth suite we’d been expecting was not to be. We later found out they were all full, anyway.

The thing with epidurals is they’re kind of tricky. The anaesthetist has to explain everything to you and make sure you understand. Then they need to access your spine to do all the things – local anaesthetic and then the canula and whatever else to make sure it’s in the right place – all based on your feedback. They tried to tell Luce this as she sat wobbling on the chair, face scrunched in pain, but it was hard to tell how much she was absorbing.

So then they tried to get Luce on to the bed.

She slowly got up, still huffing on the gas and gave an obvious push. The room goes quiet and Agnes* (not her real name) says to stop pushing or she won’t get the epi.

Luce says, “She’s right there, I can feel her!”. The midwives force, literally push, Luce onto the bed and drive her legs apart. One checks and agrees she can feel the baby’s head. Agnes doesn’t believe her and pushes her fingers inside Luce before agreeing.

Then the anaesthetist is trying to make Luce get up, off her back, and sit on the very edge of the bed to talk her through the epi again, which Luce is not comprehending at all she was in so much pain, pretty much paralysed with it.

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As Luce was manoeuvred to the edge of the bed, it became clear she wasn’t able to hold the required position for long enough. Her back and leg pain was still plaguing her, as were the contractions.

Tired and frustrated, the anaesthetist gave up.

Agnes simply told Luce “It was time to get with the program, and just start pushing.”

The shutdown.

But it’s all too late, the damage is done. It’s all been far too much, far too fast and Luce stops speaking. Becomes totally mute. Not even moaning anymore.

It was terrifying.

Agnes is telling Luce to keep/start pushing now. Agnes is then forcing Lucy’s legs open – holding them open when Luce tries to close them. Agnes starts complaining that she “managed to have three children, all without pain relief”.

Luce is then forcibly rolled onto her side and her legs spread vertically – I even held the top one up, trying to help.

Agnes continues to comment that “women in Africa have been doing this for millennia”.

Finally, our OBGYN arrives and is a nice and comforting presence. She confirms what we’d already been told that Luce was fully dilated. She went from three centimetres to the full 10 within half an hour. That’s extremely fast.

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By now Luce is done. Wiped. Totally exhausted. And she stops pushing after about half an hour.

Luce is just dragging on the gas. I can still hear the rattle of it now, one year later.

The commentary.

All the while, Agnes is saying horrible things constantly, like how this is bad for her back, how “Missy needs to get with the program”, that “women are made for this”, “we’ve been doing this for centuries without fuss”, “that women give birth in grass huts today even”. Just constantly huffing and puffing at Luce and her so-called “uncooperativeness”.

I’m trying to talk to Luce, an attempt to drown out Agnes’ running commentary. I’m holding her hand, stroking her hair, saying positive and encouraging things – everything every podcast told me to do (and I listened to MANY). She won’t even look at me. Won’t say anything. Won’t tell me what’s going on or how to help.

This continues for another two or three hours.

In the heavy silence, Agnes and the OBGYN talk about how bad their backs are. When their last and next physio appointments are. How it’s time to retire… I know Luce is listening. She’d occasionally give me a slight nod, just, so I knew she was still with me.

At some stage Luce has ended up totally naked. I think the pants were first to go, early on. Then underwear as the internal exams began. I don’t know when or why she ended up topless…

I’m constantly saying encouraging things to her. Telling her I’m here. That it’s ok. That our trusted OBGYN is there. That she is safe. That she is supported. That we are all there for her.

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Eventually, she starts quietly pleading, begging for a c-section. The OBGYN says it’s too late, the baby is too far down the vaginal canal, it’s too risky having to then pull them back through the pelvis, that there aren’t the facilities available at our hospital and she’d have to be transferred to major public hospital (which still doesn’t make sense to me).

My naked wife just keeps quietly, occasionally, begging for anything to help. Pleading to be knocked out. Every suggestion I had was denied. There was no relief to be offered here.

The thoughts and questions.

Finally, something clicks with our doctor. She recognises that Luce is having a huge trauma response and quickly yells for everyone to get their hands off my wife. She approaches Luce, quietly reassuring her that she is in control, that nothing will happen without Luce’s consent, that we are all here to support Luce.

Our OBGYN had then asked me to leave the room so she can ask me directly if Luce had been sexually abused in the past. It was so hard letting go of Luce’s hand to step away... and then I was left with thoughts swirling around my head wondering if my wife had been abused before.

Eventually, the doc starts to worry about the baby’s pH because sitting so low for so long can cause a build-up of acidity.

With no other option available, and every request and avenue to help Luce so far denied I gave permission to use the forceps.

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The delivery.

Our doctor urgently recalled the anaesthetist for another attempt at the epidural. This time, my wife likes a ragdoll, they were able to position her correctly and for long enough to reach her spine. I had to give all consent that Luce understood what was happening and for the procedure to go ahead before the forceps could be administered.

Luce whispered, “Just put me to sleep, I don’t want to be here anymore.” The vulnerability and desperation in her small voice still makes my heart ache.

The forceps looked like oversized salad servers to me. Even watching them be linked together, they looked so out of place. I never let go of Luce’s hand, but came back up to her head as I saw they were going to force these metal claws inside her.

Little Willow was dragged out, in a cascade of blood and bits.

She was so purple. She flung her arms out as a startle response, so I knew she was alive... but she didn’t make a sound. Willow was born at 1:34 am, 12 August 2022.

Lucy with our daughter, Willow. Image: Supplied.

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Agnes brusquely bustled her out of the room into the corridor to a warmer area - there wasn’t any space inside the assessment room. I tentatively followed, asked if she was ok, Agnes sort of grunted at me so I went back in to be with Luce.

When I returned, there was blood everywhere. Our OBGYN was literally covered. Her face, neck, body, arms. There was blood on the walls, the curtain, even the ceiling. My eyes were drawn to the ever-expanding pool under the bed, starting to creep towards the back wall. Luce still isn’t moving or talking. Just pulling on that gas, but less now.

I later learned something broke as our OBGYN tried to pull the placenta out and that’s what sprayed everywhere. I thought we were going to need a transfusion.

The OBGYN remained busy with Luce, laying in stitch after stitch, on layer after layer. Trying to repair the immense damage the forceps and somewhat ineffective episiotomy had done.

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The aftermath.

The following weeks and months saw Luce get individual therapy to process the birth, dealing with feelings of guilt and shame that she couldn’t push and the potential risk to Willow as a result.

She also attended a group therapy, where women shared their harrowing stories. I think there is value in knowing that there are other women who haven’t had an easy time of it as well. While the stories and specifics may be different, there are similar feelings afterwards. The most important thing to come out of the group sessions was a feeling of solidarity that they are not alone. This is one of the reasons Luce and I wanted to share her story.

It was from these sessions that I was first alerted to the term obstetric violence.

Questions pounded my brain; was I part of this? Should I have done something to stop something? Does my wife feel like I harmed her? Does she feel like I didn’t do anything to stop it? Does she think about this when she looks at me? Was my wife raped while giving birth to our daughter? How are we supposed to be intimate ever again? What have I done?

The damage from the delivery also caused a bladder and bowel prolapse, which have required extensive physiotherapy to try and improve. Considering everything Luce had gone through up to this point, I cannot express how unbelievably strong she was to allow a new medical practitioner to give vaginal exams and even internal massages to try and loosen some of the scar tissue help with the symptoms. I attended every session with her, making sure she was alright and knew she was in control.

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Through couples therapy, Luce and I were able to talk through the birth and think through some tough questions we may not have asked ourselves.

Have we resolved our traumatic experience? Not completely, I don’t think. Luce still can’t look at any photos, and it’s something that remains difficult to talk about. I’d say we’ve both been able to compartmentalise it, but it is in a box on a distant and dusty shelf in our minds.

Day to day, we focus on enjoying our wonderful, happy daughter. And that’s not really a bad outcome, is it?

CEO and cofounder of The Australasian Birth Trauma Association, Amy Dawes says:

"I have heard too many stories where health professionals did not provide adequate care, and women were left feeling unsupported, ignored, neglected, and mistreated by medical staff during labour and postpartum care.

"This can result from a lack of information or communication from care providers, a lack of compassionate care, being spoken to rudely or inappropriately while in labour or trying to care for a new baby, and being dismissed or not believed by health professionals when they report or seek support for their symptoms. This extends to instances of being denied medication, including pain relief or not being believed when they are requesting pain relief, not giving consent for invasive procedures, such as vaginal exams, and feeling coerced into procedures.

"Birth-related trauma can occur for a number of reasons, many of which are linked to systemic challenges in the maternity care system, such as ‘best practice’ clinical approaches that do not put the mother or birthing person's physical and psychological safety at the forefront, lack of clinical supervision, high workloads, and under-resourcing, all of which contribute to burnout and compassion fatigue, and can result in occurrences of psychological and/or physical trauma. I'm pleased to see a parliamentary inquiry into birth trauma in NSW but we have been contacted by hundreds of women across the country asking whether there will be an inquiry in their state. We recognise that there are many contributing factors to birth-related trauma which is why we want more research and evidence into the causes, more data collected on maternal outcomes, and investment in referral pathways and support systems.

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"It is really important that we see this as an issue with the system, and invest in improvements including mandatory trauma-informed training for maternity care workers. I strongly believe that the individuals in maternity care all want the same thing - which is safer births and better healing.

"If you have experienced birth-related trauma please visit the Australasian Birth Trauma Association’s website for resources and support."

If this has raised any issues for you, or if you just feel like you need to speak to someone, please call 1800 RESPECT (1800 737 732) – the national sexual assault, domestic and family violence counselling service. 

Feature Image: Supplied.