Reposted: My surgical records

I posted this a while on my personal blog. It's interesting for me to read my old writing and remember going through the emotional recovery from the c-section. I was still a little bitter at this point.

Wednesday, January 28, 2009

GRRRR

I need to vent here for a minute, as well as raise awareness about another ridiculous issue in childbirth.

I've been meaning to get a copy of my C-section report from Audrey's birth because it will determine my chances of having a VBA2C. If the doctor used a single layer suture to close the uterus instead of a double layer suture I may not be able to have one, so I need to get the report to find out and then prove it to my next care provider. Also, I'm curious if they mentioned anything about my scaring or how my uterus looked. According to my midwife who was with me for the surgery I had "hardly any scaring" and it "looked really good". I remember thinking to myself when she said that,"Then why am I laying on this table getting my baby sliced out of me?"

So I finally called to request a copy of my records. I knew there would be a fee because once it became a legal right to get a personal copy of one's records, doctors had to think of a way to try to prevent it from happening and to make money at the same time. At the pediatrician's office I worked at we charged a $25 flat fee for a copy of the records. After all, a lot of "work" went into it: the secretary had to copy the records, and as the nurse I took five minutes to look over them to make sure all the pages were there. Yeah, how come neither of us that actually did the work saw a cent of the $25 bucks?

My surgery report is apparently seven pages. I wonder what they had to say for seven pages. Did they detail how Audrey nearly died because I had a totally unnecessary c-section? I doubt it because they never admitted to me that her respiratory distress and persistent pulmonary hypertension were results of the c-section, even though those are side effects of a c-section. I read after Audrey's birth that the risk of pulmonary hypertension is 4 times greater in a baby that was born by elective c-section (one with no labor).

But I'm digressing. The point of my story is that my 7 page surgery report costs me $30. My entire records were $38, so I just swallowed it and decided to get it all. It's just really annoying.
I understand a $5, even a $10 fee if the record is long, because paper, copying, and mailing does cost money. But, like I said, it's just another way to make it difficult to get a copy of your records when they charge a large fee.

I think everyone should have unlimited access to their own records, with a reasonable copying fee. Have you noticed how the doctor tends to look at the records as theirs? When Audrey was in the NICU I was looking at her chart that was by her plastic bassinet and the nurse told me I couldn't look at it. She said if I wanted a copy I could call the hospital afterwords and request a copy. I really do want to read what was documented about her condition but I'm sure it will cost another thirty or fourty bucks. For now it was a big step just to get a copy of my records.

(Next post)

I got my $38 dollar records this morning in the mail. Sixteen photocopied pages for $38. I was really nervous opening it--it felt like I was opening a college acceptance letter or something--but relief rushed over me when I read that my doctor did indeed do the double layer suturing. Phew!

I'll share a bit of my records, since they are soooooo valuable, so if you interested in hearing more about the details of a c-section, read on.

I really like having my records and being able to read what was done. I could understand most of the medical jargon (I knew there was some reason I studied nursing!). Still, reading it bothered me in a lot of ways.

My "final diagnosis" was: Intrauterine pregnancy at term, previous uterine scare, unfavorable cervix without spontaneous labor.
Reading that brings back the bad memories of wondering why I am not going into labor. I just felt like something was wrong with me. I believe now if I had been given more time and support, I would have gone into labor with Audrey in another week or two.

Hospital Course: The patient underwent the above-listed procedure, tolerated it well, and was taken to the recovery room, and then to the postpartum unit, where she underwent routine postoperative recovery. And on June 24, 2008.....it was felt she was stable enough to be discharged at home.
Not that I expect them to detail this, but it is just annoying how it looks like everything went perfectly, no mention of the emotional agony, physical pain, extreme dizziness, nausea, constipation (the bowels get a real good SHOCK when they are jostled around like they are in a c-section), nothing about breastfeeding, nothing about my baby.

The Surgical Procedure: An 8 pound 9 pounce female with Apgars of 6 and 8.
That is the only description of Audrey. Once again, on paper it looks like everything is okay. After all, 8 is a decent Apgar. I won't repeat again all her health issues here, but it just bothers me there is not a single mention of the complications to Audrey as a result of the c-section.

Normal tubes and ovaries....An incision was made over an old cicatrix (scar). No mention of "hardly any scarring" or things looking "great". I wish they would have put that so I could have written proof that a uterine rupture would not have been a reality for me. It continues:

Dissection was carried down to the subcutaneous tissue to the anterior rectus fascia, which was incised. This incision was carried to the lateral margins of the skin incision. The rectus muscle was dissected of the rectus fascia superiorly and then inferiourly. The midline was found and split....The abdominal cavity was bluntly entered...The low transverse incision was made in the patient's lower utierne segment....The above-mentioned infant was delivered to the attending neonatal personnel...The placenta was delivered. The uterus was removed from the abdominal cavity. It's cavity was cleared of all debris.......blah blah blah. I hate it.

The word "dissected" is mentioned twice. My baby was dissected out of me. My stomach muscles were split down the middle and pulled aside. My abdominal cavity was bluntly entered. That just sounds disturbing. "Above mentioned infant" is given no further care by my OB, unlike the midwifery model of care where the mother and infant are seen as a whole that must be cared for together. (Not that I expect my OB to take care of Audrey in a c-section, that's why the neonatologist was there, but in normal birth even OBs don't give any care to the baby. Once the baby is born, there are two distinct patients in the hospital, with different providers, and the care given to each patient is totally separate). After they dissected Audrey out, they took the placenta out. I want to see my placenta someday! Lying on a table having all these things "done" to me takes away the reality of birth. The placenta is the organ that nurtured my baby for 9 months and I have never even seen it! (I've seen other placentas, but now my own). Then they took my uterus outside of my body and lay it on top of my stomach. They then cleared out the "debris". The description makes me feel like such a specimen...a piece of meat...a cleaning project...a surgical task. It wasn't anything like a birth should be.

I'm sorry, I really do not mean to offend any of my other friends that have had c-sections. This is just how I feel about mine. And for $38 bucks, I just have to share my report.

I am happy at least that I have double layer suturing. That means if I try this again, I have a chance at a normal birth, not another repeat section.