Re: cesarean art
From: Anna Meenan, MD (annam@uic.edu)
Thu May 4 15:11:03 2006
At Thu, 4 May 2006, Shell Walker wrote:
>
Again, I object strenuously to the use of the term "non-consensual
surgical delivery". This woman consented to this surgery, and had
several months to think about her decision. She apparently had the
option to have her baby in another country, where presumably VBAC is an
option, and chose not to do so. She also always has the option to wait
until labor begins and show up in active labor (though we obviously
don't encourage that). I would not even call her 1st c-section
non-consensual, though obviously there was less time to discuss options
at the time. In general, most of the docs I have seen getting consent
for a c-section do the best they can to discuss options given the time
constraints they are under, depending on how much fetal distress is
going on.
Note: this woman has added more text to her site since yesterday, with
more explanation.
--
Anna Meenan, MD, FAAFP
>
>Regardless of the circumstances, the first step in healing from
>non-consensual surgical delivery is for the woman to take 100% total
>responsibility for her birth process. I wholeheartedly believe that
>physicians should never be blamed for any cesarean. Ever!
>
>For those that are interested, I would like to point out the simplest of
>many attentions that can be employed to help prevent PPD associated with
>surgical delivery. (accepting that the patient having a voice in the process
>is a given)
>
>When early and uninterrupted contact with the baby is not possible, and mom
>is in 'recovery'- the blankets used to receive and dry off the baby can be
>placed on moms chest and tucked into the crook of her neck.
>
>FYI- Apparently; the woman in question grew up in the medical world and is
>from a family of doctors. Her country of origin is esteemed for it's high
>level of medical care. She has no relationship with the physician in
>question and the physician actually wears a karate belt in her daily
>life(?). Medical quotes used in her artwork were gathered from her
>operative report which was obtained at the request of her mother who wanted
>to compare the techniques of surgical delivery between U.S and that of her
>own country.
>
>Interestingly, the discussion on this forum concerning her art work seems to
>have given her a newfound appreciation for the physician in question- and I
>quote;
>
>"Not even "Dr. A" ..... it even makes me dislike her less :)"
>
>Quote and reference used with permission.
>
>Respectfully,
>Shell
>
>>>----- Original Message -----
>From: "Anna Meenan, MD" <annam@uic.edu>
>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
>Sent: Thursday, May 04, 2006 9:23 AM
>Subject: Re: cesarean art
>
>> Replying through the web archives because my cable company has screwed
>> up my e-mail. If the message I am replying to is all chopped up and
>> truncated, I can't help it. (And why hasn't that been fixed, BTW--it's
>> been going on for a long time.)
>>
>> The reason I suggested that this woman is severely depressed and needs
>> help is the following passage from the text on her website:
>>
>> "I am thinking about it everyday. Every single day. I am obsessed.
>> Unfortunately my husband filmed the scenes and I am obsessed with seeing
>> this horror flick.
>> I went from being depressed to trying to recover as I don't get much
>> support with my problem. I feel ridiculed and disappointed.
>> My immediate surrounding expects me to be happy and especially to
>> function. Most days I am happy and I do function but my obsessive
>> thoughts keep on festering and rotting and fermenting in the back of my
>> mind day in day out."
>>
>> I find the last line particularly disturbing, with the mention of
>> obsessive thoughts "festering and rotting and fermenting". It is not
>> healthy for someone like this to be caring for a newborn. Obsessive
>> thoughts like that could even be a symptom of postpartum psychosis.
>> Apparently, even with her brave attempts to cope through her art, she is
>> not coping and may need more help than what her art can provide.
>>
>> I wondered if her OB had seen the pics because a doc who apparently did
>> a routine repeat c-sec is pictured with blood dripping from her hands
>> and the comment that she "always has her scalpel handy". If I was her
>> OB, those pictures would traumatize ME.
>>
>> This woman freely admits that she made CHOICES, and that her c-sections
>> were the result of a lack of "guts" on her part (though I don't entirely
>> agree with her). She is upset over the fact that she needed a c-section
>> for recurrent decelerations in a 43-week gestation. 43 week gestations
>> carry HIGH mortality rates due to placental insufficiency, and there
>> were clear signs that that was the problem here. Why is the doctor
>> always the one blamed when nature betrays a woman? Is it the doctor's
>> fault that this pregnancy went post-dates? Did the woman refuse an
>> ultrasound early in pregnancy to pin down uncertain dates? For the
>> second birth, she implies that she had the option to return to her home
>> country (wherever that is) to give birth. Would she have been able to
>> have her VBAC there? Why didn't she go? Is maternity care in her home
>> country substandard? Should she be glad she had the opportunity to have
>> her baby here in the good old USA?
>>
>> I understand that a c-section can be an upsetting experience and that
>> some women will have difficulty coping and need more support. I get all
>> that, and I try as much as possible to be empathetic and supportive and
>> give women a chance to vent and process things after a c-section. What
>> I DON'T understand is this tendancy to blame the obstetrician for
>> everything, and to find them somehow lacking if they don't provide hours
>> and hours of emotional support after a c-section. Obstetricians are
>> busy people. Most of the ones I know really are doing their best in the
>> empathy department but are not psychiatrists or trained counselors. They
>> are surgeons, and I think this woman is expecting too much of a surgeon.
>> Just as I wouldn't want a psychiatrist operating on me, I am saying
>> again that this woman needs a psychiatrist, because what she's done on
>> her own to cope thus far, while admirable, is NOT WORKING, and I see
>> serious problems when I read what she wrote. I am not dismissing her
>> concerns. I am saying that she needs more help than she's getting.
>>
>> Anna Meenan, MD, FAAFP
>>
>> At Wed, 3 May 2006, Shell Walker wrote:
>>>
>>>Ugh! I prefer to think of a Cesarean Section as a wonderful surgical
>>>living
>>>is
>>>all good or all bad, but I think the woman who developed this site is
>>>basically a very unhappy human, and I feel sorry for her.
>>>Sorry enough to "get it"?
>>>
>>>"...and don't sue when things go wrong..."
>>>you. Oh, wait a minute, I've already sold it Lake Havasu, Arizona.
>>>"For Sale by Neighbor"?
>>>
>>>I think she has severe postpartum depression and needs to see a
>>>never mind~
>>>There is something very scary about her take on the whole
>>>interest the doc had~
>>>
>>>and didn't get it. Fer duh~
>>>
>>>'spose I should introduce myself.
>>>
>>>--
>>>Shell Walker (new)AZ L.M.
>>>movement. I have 5 children;
>>>hrs... no HA)
>>>#2- Unattended VBAC ( 30 sec to ambulation : )
>>>#3- Adoption (born of my heart...aww)
>>>#4- Necessary C (epi. 2 hr to ambulation, discharge at 6 days....HA)
>>>HA)
>>>
>>>attitudes are well tempored.
>>>
>>>necessary- I am nothing but profoundly thankful for it.
>>>
>>>understand both sides.
>>>
>>>surgical deliveries.
>>>
>>>platform of patient choice+participation and information+education.
>>>
>>>information+education in the birth place.
>>>
>>>unpredictable.
>>>
>>>sexual event rather than a simple medical procedure. (ducking)
>>>
>>>care given to c-sections)
>>>
>>>trauma caused by a sever sunburn".
>>>
>>>not the subject at hand.
>>>
>>>to smile" is especially strong.
>>>
>>>personal 'cesarean experience' I am sure it would be appreciated.
>>>
>>>displays of desire to control and discount her post partum as well?
>>>
>>>women are inherently strong and manage to find their own way.
>>>
>>>Really.
>>>
>>>Shell Walker L.M
>>>P.S
>>>rollin" attitude. Be easy on me ; }
>>>
