Prairie Wife of the Week May 23, 2014

Posted May 23, 2014 by Prairie Wife - 3 comments

I’ve know this week’s Prairie Wife of the Week ever since we attended High School together. In High School she was a bright and motivated girl who never took things too seriously…and I remember her having the best laugh ever! Any time she would start to laugh it always made me smile and laugh right along with her. As we moved to separate sides of the Mississippi for college we lost touch but, a few years ago we reconnected on Facebook. When I learned that she was beginning her residency as an OB I wasn’t surprised in the least. I felt like it was a good fit for the girl I knew from High School. When it came time to schedule this month’s Prairie Wives I kept my fingers crossed that she would be willing to do an interview. As the mother of four children I have only been on one side of the stirrups, and the challenges that have faced Women and Women’s health care in the last few years, have really started me thinking about how my OB makes her decisions. I was pleased when my request for an interview was accepted, and I was thrilled that I got to repeatedly hear her familiar laugh over the phone. I was so captivated by what she had to say that I went well over my usual 45 minute interview! Her passion and honesty about women’s health care, and more specifically her views on labor and delivery, made me see things a whole new way. We really do have a lot of work to do when it comes to women’s health care. I felt empowered after I talked with her, and I hope that you feel the same way. She made the choice to see her personal labor and delivery story as a lesson in how she would never treat her patients, her honesty about the ways that our health care has failed women and her passion for righting the wrongs, make her the perfect Prairie Wife of the Week.

Prairie Wife Nikki Sandels

PW (Prairie Wife): First tell us a little bit about your family.

N: I was born and raised in Milwaukee and I am the youngest of 6 children. I have four brothers and a sister. I busted out of the tiny Midwest and went to the Big Apple for college. I lived in London and studied economics for a year; and afterwards I bummed around and spent some time in both Costa Rica and Israel. I met my husband David when I was in school in Boston in 2009 and we were married in 2010. My son was born in 2012.

PW: What led you to look at a career in woman’s health?

N: I actually stumbled upon it; you could say it was blind luck. Thinking about it, it probably began when I choose to attend Barnard, a Liberal Arts all woman college in New York City. I feel like this environment helped to shape me as a strong woman, I always felt empowered by it! I think of myself as a feminist, and throughout my life I have always felt connected to woman.

Medical school was actually my backup plan, which sounds crazy I know…I had a variety of jobs through my early 20’s and, as the child of a doctor, I eventually decided that it was a good choice. Frankly it was an easy choice for me. In retrospect it probably wasn’t the best way to make the decision! Taking care of women was the only part of medical school that I enjoyed, so I picked the one thing I enjoyed, contributing to women’s well-being on the planet.

PW: What have been some of the challenges and joys of your job?

N: There are so many joys! When you think about it, being an OB is a strange job; you just run around and deliver babies. Most of the time, I’m delivering babies for people that have never met me before. I have literally delivered hundreds of babies, probably about 300 at this point. Even with all this, I still feel such awe in being a part of the experience. You look at this mom who has just brought a life into the world, and when you see her holding her baby, on her chest…you can just see the love and that they are over the moon! I feel so honored to be there. It’s such an intimate experience, and to be a stranger and be a part of that is amazing. I am watching the course of their life change. Sometimes I even find myself taking ownership and feeling so proud of how well it went, when really it had little to nothing to do with me.

For a funny story…Episiotomies are just not really done anymore, its standard (and better) practice to let the woman tear. Yet at a recent birth the doctor (a very old man) was getting ready to do an episiotomy on this poor woman. The attending resident just reached out and slapped the scissors out of the doctor’s hand…which is just not done! Luckily the doctor took it well and nothing happened to the resident.

One of the main challenges for me is when you see a doctor mismanaging a birth. It’s so hard to step back. Sometimes you are asked to do things that you don’t agree with, and we get creative and find little ways to take back control of the situation.

PW: I know that you are now a mother yourself; can you share your story with us?

N: Long story made short, my OB was very easy going, I thought she was a perfect fit for me. Until she decided that my baby was big. Then she got scared which in turn made me get scared. I can see now that she was planning on me having a C-section long before my baby was even due. I went to the hospital in labor and I labored for a long time, which is normal for a first baby. My husband was no support and completely uneducated and couldn’t support me. The doctor and nurses used scare tactics on me as I was in labor. Every two hours the doctor or a nurse would come in, and tell me all the bad things that could be happening or would happen to my baby if I continued to labor. I got scared, and even though I knew better, I knew what she was saying was wrong…I was in labor and vulnerable. Finally, I just burst into tears. I just felt like everyone wanted to cut me open, and no one was thinking about me. I felt more alone than I had ever felt in my life. I just couldn’t speak for myself. Ultimately I ended up having a completely unnecessary C-section.

In retrospect I can see that a C-section had been their goal all day, if not for months, and of course they won. Looking back, my traumatic birth story is not about having the C-section. It’s that I felt that my rights were violated. I feel like I was completely taken advantage of emotionally and physically, at a time when I was the most vulnerable I have ever been in my life. No one stood up for me and no one fought for me when I couldn’t stand up for myself.

PW: How has your experience changed how you look at your patients?

N: How it has changed me…I listen to the women who are my patients. For example, if a woman comes in with a birth plan I take a look at it, and talk to them about their overall goals and desires. We all know that a baby doesn’t read the birth plan, and anything can happen. But, reading it can help me to know if I should encourage her to work through the pain and deliver naturally, or if an epidural sooner rather than later is best.

I never want a woman to feel helpless. When a woman is having an emergency C-section the mother is all alone, and no one is talking to Woman in Laborher, she is all alone. Everyone is busy getting things prepped and ready for the baby, her family isn’t allowed in. You better believe as the resident, I am up there with her talking to her while everything is unfolding. Trying to let her know what is going on, and giving her as much knowledge and control of the situation as I can.

Everyone forgets that there is another person involved besides the baby. Let me tell you, we as the doctors are scared too. I can get a baby out in 45 seconds if I have too. It’s scary and intense, and can seem like the longest 45 seconds of our lives. Even though we are so worried about the baby, that mom still matters! At the end of the day she is going to be a changed woman, a mother. I want her to feel empowered and cared for, even though it was traumatic and not the birth experience she may have planned.

PW: What advice would you give women who have had a traumatic birth experience?

N: Get help! You are most likely going to have another baby one day, and if you haven’t taken the time to heal, process and prepare, it could be even more traumatic the second time. Childbirth is more mental than anything, and you need to be in the right place. You need a community of support to help you. Talk to someone you trust who can help you reflect on your experience. There are so many options; there are a lot of groups out there but be careful because you can get caught up in all their terror stories. If you come from a place of blame it won’t help you, and it can take a long time to get past that. Have someone walk through what happened with you. Being at peace with the experience will end up strengthening you.

PW: Being a working wife and mother has its challenges, what are you doing to find your balance?

N: As the child of a doctor, when I became one myself, I realized that I am doing the same things that upset me as a child. I am always gone, I work odd and late hours, and I battle constant exhaustion. All of those things were hard on me as a child, when they were happening with my father. I am feeling my heart break every day I am gone, and I see how it affects my son. You can’t have it all. I can’t be a great wife and mother and doctor and friend…and I need to not feel guilty about it. I am doing the best I can and I refuse to feel guilty. I have friends and family that support me, and this makes all the difference to me.

PW: What are your concerns for the direction that woman’s health care is taking in the US?

N: People who are practicing medicine are defensive. And can you blame them, with all the things that can go wrong? A baby that is injured through the birth process is our biggest fear, and so many things have been put in place to keep the baby safe. I feel that it has resulted in women becoming not as important as the baby inside her.

We like to pretend that all the monitors keep things safe and give us a good idea of how things are. But it is a false sense of security. As OB’s we have a saying that “The only C-section you ever get sued for is the one you didn’t do.” When you have a negative experience it is so hard to not let it color all your other decisions, there is a lot of life and death on the line. I have noticed that in general, doctors are focused on controlling the whole labor and delivery, rather than letting the mother make decisions. There is a severe lack of confidence in a woman’s ability to make her own decisions about her labor and delivery.

I see the tragedy of woman not being encouraged to be active in their child birth experience. A lack of active care of our own health is being seen in all areas of women’s care now. It is a problem that breeds more problems. Women need to take control of their well being, rather than blindly following what the doctor tells them. I encourage women to find a doctor who supports the patient and has the time to help them make educated choices and listen to them. So many decisions are being based on fear…

PW: What do you think is vital for women to know about taking care of their health?

N: I think that this is so individual, and it’s hard to answer. When thinking about your labor and delivery experience, I would encourage women to take time to reflect and know themselves and their needs. If you are interested in a childbirth experience that is the least stressful as possible, find a class to attend that will support you on that. If you want a natural child birth experience do your research, attend that class, and make your expectations clear to both your doctor and partner.

At this point, most of us know, that you need to live what we know is a generally healthy life style; a well balanced diet, moderate exercise, and an emotionally healthy life. Just do it, move your body. I’m not saying everyone should do Yoga for 60 minutes a day or train for a marathon, that’s foolish. But get out and walk with your kids, dance around the room, take the stairs…move! Really simple things are all you need. Women need to be encouraged to step up and take care of themselves and educated themselves; this will give them the power to work with the doctor to help themselves. Women need to be told the importance of getting back to basics; eat well, exercise, and have strong healthy relationships with loved ones. It sounds so simple but they all add up to help you to be satisfied with your life, no matter what gets thrown at you.

PW: What are your hopes for the future of women’s health care?

N: I would just like to see informed choice respected by the medical field. Woman need to have power and be accepted for it, and not treated badly because of it. There is a general vibe that if a woman goes against the doctor’s recommendation it’s because she is crazy. Educating girls and woman in their options and then supporting their choices would result in better overall care.

PW: Any tips for women looking for a new OB?

N: Your first child birth experience (actually any child birth experience) is a vulnerable place to be. I feel like a lot of times you’re in the doctor’s power, and at such a vulnerable time you can’t expect to be able to make choices. Make sure your OB is on the same page with you and willing to help you fight for the experience you want. They need to listen to you and you need to speak up and defend yourself if you feel like it isn’t working. Don’t be afraid to go somewhere else. Watch for red flags and be aware of what your gut is telling you.

It’s OK to switch your doctor at the last hour if you just don’t have the trust you thought you had, I wish I had realized this during my labor. When a woman is entering childbirth she needs to be open minded, because there are a lot of unknowns. You have to get mentally ready and have preferences and make it clear what you want and why. That way if something changes with you or the baby, you can be prepared to make changes that still give you a positive experience. Sometime a C-section needs to happen, but if you followed your instincts and did everything you could to prevent it, you will have a much more positive experience. You need a support person that knows your fundamental beliefs and can help you, and will fight for you when you can’t. Communicate and keep your perspective.

PW: Any last Prairie Wife words of wisdom?

N: You can’t have it all, life is a balance and we are always changing. Women are predisposed to feeling guilty, not matter what choice we make, and I think it needs to stop. Life is an adventure, keep people close that support you and do the best that you can with what you know.


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3 thoughts on "Prairie Wife of the Week May 23, 2014"

  1. michele says:

    Great interview! Thanks for sharing your insights as both a mother and doctor! I was fortunate that I had a doula to represent me. The ob nurses actually laughed at my birth plan-to my face!

  2. Lizzi says:

    I enjoyed this interview immensely! You have officially inspired me to change the way I have been having babies! The first 2 were very weird experiences, the 3rd was the best so far and I’m hoping that number 4 due in September will be the best yet, always save the best for last right?
    The double perspective that you gave is so refreshing to hear, I think we get so used to being told what we can and cannot do that we forget that we need to stand up and make our own decisions or have someone advocate for us! Thank you for sharing your experiences as a mother and OB!

  3. Erica says:

    Thank you for sharing. It’s very interesting to hear a doctor’s perspective. With my first baby, the doctor did whatever he wanted, including performing a huge episiotomy and using forceps, and didn’t tell me a thing that was going on. My second wonderful doctor told me everything, as it sounds like you do. When she told me she was going to do a small episiotomy, I yelled no! And she said ok! Such a different experience. It makes such a huge difference in the birth of your child to have a great, caring doctor. Your work is so important.

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