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A new voice on patient safety in maternity care

I’ll be the first to admit—I feel a fish out of water on this blog, and am still scratching my head wondering what Amy and I must have been smoking when she invited me, and I agreed, to join Science and Sensibility as a blog contributor.

I’m not a midwife and, aside from Amy, have never met one. I’m not an obstetrician. I’ve never been to a Lamaze class. All three of my children were born in a tertiary care hospital. Doulas were discouraged by my ACOG-certified, impressively credentialed, upper middle class suburban obstetrician group that authoritatively practiced “active management of labor,” so I didn’t even bother considering one. I did have one “natural” childbirth, but not by choice (more on that later!). I was the kind of woman who, in labor with my second child and still smarting from memories of the birth of my first, loudly and repeatedly demanded an epidural from the minute I lumbered through the doors of the hospital until the minute the needle went in my back. I confess to eyeing adherents of groups like Lamaze, Bradley, and La Leche League askance as anti-establishment militant hippies—while secretly clutching my dog-eared copy of The Womanly Art of Breastfeeding and desperately stuffing cabbage leaves down my shirt during my daughter’s first painful weeks of nursing.

And then the house of cards on my perfectly controlled life all came down with the birth of my third child on October 1, 2005. A series of medical errors occurred, snowballing into a catastrophe that nearly cost my son and me our lives. I recently published a narrative in the online medical journal, Pulse recounting my birth experience and the frustrating search for answers from my doctors and the hospital afterwards . This personally traumatic event opened my eyes to the tragic shortcomings of our health care system, maternity care in particular, in a way that four years of medical school, three years of a pediatric residency, and six years in private practice as a pediatrician never did.

In the coming months, I will be blogging about issues of patient safety, patient-centered care, medical errors, and support for clinicians, patients, and families in the aftermath of an unexpected adverse medical outcome. I will speak from the viewpoint of a pediatrician and a patient who has been on both sides of the table. I don’t know all the answers, but I hope to provide some useful information and generate your thought-provoking feedback. Your comments and suggestions for future topics are most welcome.

Joking aside, thank you Amy for welcoming me on board to Science and Sensibility, and I look forward to working with you and your readers to create a safer, healthier, and more compassionate health care system for all our moms and babies.

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  1. June 28th, 2010 at 15:58 | #1

    I have a half hour left of babysitter time, so I’m going to waltz up to the counter of the coffee shop and buy myself a brownie & get to reading your piece for Pulse!

    Welcome, I’m looking forward to reading more!

  2. June 28th, 2010 at 16:03 | #2

    Holy crap. I’m so sorry.

  3. June 28th, 2010 at 18:30 | #3

    It will be great to see your contributions to the blog!

  4. avatar
    Endre Richards
    June 28th, 2010 at 19:55 | #4

    I just finished reading your story in Pulse. I am so sorry for your suffering and for the abuse you survived. I am grateful however, that you are sharing your story and contributing to this blog. It is one of my favorites.

  5. avatar
    Carolyn
    June 28th, 2010 at 20:10 | #5

    I am looking forward to reading more of your blogging posts. As a patient safety advocate in maternity care in Australia, I have heard your story many times. Women and their families are submitted to this type of treatment frequently, but are so disempowered they do not complain. I also think the job of coping with a newborn and obvious joy involved in this is a factor that prevents women from expressing their concerns with treatment. It is a sad indictment on health delivery systems when the care factor has been removed. Women seem to be particularly vulnerable to this form of abuse and in your case as a health professional it could be seen as bullying.
    Sharing your story is an important step towards improving things for all women. Thank you for being so generous.

  6. avatar
    Carol Van Der Woude
    June 28th, 2010 at 20:45 | #6

    I read your story–I am sorry to hear about the trauma of your experience and your son’s return to the hospital. I’m very glad that you and your son survived. Could it be that some doctors have become so accustomed to inducing labor that they no longer recognize physiologic patterns of labor? I am a labor/delivery nurse and see the MANAGEMENT of labor overtaking observation of labor and birth. All of us in the medical profession need to be good listeners–unfortunately that did not happen at time during your hospital stay. I am glad that you that you have signed on to Science and Sensibility and look forward to your posts.

  7. avatar
    Another Rachel
    June 28th, 2010 at 21:23 | #7

    Thank you for sharing your story. I am so sorry for what you experienced. I look forward to your blogs! You bring a great perspective to the table.

  8. June 29th, 2010 at 11:35 | #8

    Oh my goodness what a story on Pulse. I had a manual clot extraction following my first son’s birth and my uterus actually HURTS while reading your story and remembering that experience. I was at a birth center and had a very gentle, caring doctor who was wincing as she did the extraction saying, “I’m sorry, I’m sorry. I know this is hurting you.”

    I had an intense amount of clots following my third birth (second trimester miscarriage at home)–”only” the size of grapefruits though, not frying pans–and when I finally went into the ER about it they acting like I was making a big deal out of nothing (“people have miscarriages all the time. They’re very common.”)

    On that “cheery” note, welcome!

  9. June 29th, 2010 at 15:42 | #9

    Whatever we were smoking, I think it was good! :) I’m so happy you’re here. People often speak of “fish in water” syndrome in birth – the “medical model” can’t see the water they’re swimming in, and sometimes the same is true of natural birth advocates. So a fish out of water may be just what we need to shake things up and get the ball rolling for safer, healthier birth. Welcome!

  10. June 29th, 2010 at 18:22 | #10

    I read your birth story experience with your third baby. I am so sorry that you had that experience. It sounds so very scary and how horrible it was not acknowledged.

    I am glad you are here to share your knowledge with us!

  11. avatar
    Suzanne Wertman
    June 30th, 2010 at 11:33 | #11

    As a midwife fish trying to see the water I am swimming in, I thank you for your fantastic piece on Pulse and I am looking forward to reading more of your blog posts here. Just when I thought it couldn’t get any better, one of my favorite blogs just did it. Thanks!

  12. avatar
    Greta
    July 1st, 2010 at 21:04 | #12

    Absolutely loved your piece on Pulse. It illustrated so well where the disconnects are in maternity care. So excited to see what you have to say!

  13. July 2nd, 2010 at 00:53 | #13

    Welcome to the conversation, Tricia.

    When I first saw your name, I confused you with Trisha Torrey of the About.com Patient Empowerment blog. I went to my feedreader just now and saw that that Trisha just wrote about you this morning.

    I’m looking forward to your posts.

  14. avatar
    Tricia Pil
    July 2nd, 2010 at 20:17 | #14

    Thank you so much, everyone, for taking the time to read my story and for your welcoming and supportive comments this week. Clearly this is a well-informed, inquisitive, and vocal group. I am so excited to be here, and will blog again soon!

  15. July 4th, 2010 at 19:28 | #15

    i’m saddened, sickened and in tears about your experience. i cannot read past the accounts from Sunday at this point. i am truly and deeply sorry for your tragic experience.

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