The Silent Mother

Esoteric & Historical Gravidity & Parturition

On Schoolwork and Writing, A Preface to a New Project

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Hello my long neglected readers! I have missed you and I have missed writing for you. It’s been a transition time in my personal life and I’ve had to re-prioritize certain things. Now that I’m more settled, I have the ability to get back into my passion project, The Silent Mother. I feel that you deserve a bit of an explanation as to what’s been going on and what’s coming up next.

Back in August of this year, I did a thing that I should have done twenty-some years ago. I went back to school to finish my undergraduate degree. I failed to complete it because I burned out. Burned out on what? Research and writing, believe it or not. Twenty years ago, I didn’t have the skills to speak up and ask for help or to know how to take a break. So, I quit.

As it turns out, I kind of dig this research and writing thing. I have one more semester to go, with only two classes left to finish. From there, my hope is to go to graduate school. I’m in the midst of my application process now. My plan, should it come to fruition, is to study maternal child health, specifically in two arenas: the efficacy of childbirth education and the historical influences on maternity care.

I do love the smell of an old book. Sometimes that smell is called biblichor”.

What does this mean? It means that if we don’t know the history, we don’t know the “why” of how we engage in maternity care. If we don’t know the “why”, we can’t make improvements. The improvements I seek to make are in patient education, physician and nursing education with the results being more effective communication between patients and staff. To do this, moving into graduate school so I have the ability to do research properly, would allow me to help many more families than I do currently with my work at Shining Light.

Wish me luck on my applications! I’m optimistic, but could use all the luck and support I can get.

On Thursday, January 3rd, I’ll begin my new series on Dr. Grantly Dick-Read. For those who don’t know, he is the author of Childbirth Without Fear (1942). He is the doctor who coined the term “natural childbirth”.

What you’ll be reading in the next few months is the senior Capstone paper I wrote while finishing this BA in Religious Studies, entitled The Revealed Obstetrics of Dr. Grantly Dick-Read and the Entanglement of Faith and Medicine. In this serialized release, I’ll explore questions of faith vs. evidence based science in the context of pregnancy and childbirth. By the end of the series, I’ll look to questions on implications for current practices in childbirth education.

I do hope you stay tuned with me every Thursday for a new installment. If you’d like to support my graduate school endeavors, please do consider becoming a patron.

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Me too, sexual harassment / assault

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There is a meme going around these here internets called “Me too”. It asks women to speak out and say something about sexual harassment and assault they’ve experienced. The meme asks for no details, only and acknowledgement that these things have happened to show the sheer numbers of women who’ve experienced such things.

I think, at least for some of us, we need to share the details. How can change happen if people aren’t aware of the aberrant behavior? If they don’t hear what actually happens and how it happens, how can it end? How can we teach others to do better if we don’t at a minimum, show them what not to do? If you have a better answer, I am listening.

Without a doubt, this happens to men too. Men tend to be even more silent then women are because they are believed even less often than women are. It happens to everyone, often, and it needs to stop.

My #metoo story:

In elementary school, the boy who chased me on the playground and grabbed me inappropriately multiple times. When I told a teacher and my mom, I was told “oh, it’s how little boys show they like a girl.”

In elementary school when the boy in my 3rd grade class asked me to “give him a blow job” with gestures to illustrate what he meant. My teacher wouldn’t move my seat away from him and the principal didn’t care.

In junior high, the unwanted “hugs” from a boy, who when I told him to stop, told me he was being friendly and I should get over it.

At overnight camp when we had “kissing parties” because that’s what you did whether you wanted to or not.

When I was 15 and I met my soon to be stepmother’s father for the first time and he invited me to “sit in grandpa’s lap” while wiggling his eyebrows and leering.

A multitude of gropings at college parties and bars. Too many to count. This still happens.

My sophomore year of college, the man in the car, in broad daylight, outside the college library, who pulled over to ask me “how much” because he thought I was a prostitute. I was wearing an APhiO sweatshirt, jeans and had my backpack. No, it doesn’t matter what I was wearing, but the fact that I feel I have to tell you how I was dressed speaks volumes about rape culture.

All the men who catcall me while I run. All the men who have ever catcalled me.

“Hey, are you still wit dat baby’s daddy? I hope not, ’cause I’d do you!” in the grocery store parking lot with my infant son.

The guy at the club last year in West Palm Beach who was holding my arm, grinding on me and bit the back of my neck. Even the “I have a boyfriend” line wasn’t enough. I shouldn’t have to say “I have a boyfriend” to try to get someone to stop. No, or stop, should be enough. My 40 something adult female friends who thought it was awesome that a younger guy was hitting on me and who I had to convince to leave the club because they were having fun and didn’t want to go.

Sex with an intimate partner out of obligation, rather then desire. Sex with an intimate partner of a type I did not enjoy, but he did.

The landlord who called me “honey” and “baby” while I was trying to negotiate a commercial lease as he sat on the table and looked down at me in the chair, smiling because I couldn’t possibly negotiate a lease. Needless to say, I didn’t rent the space from him.

There are more, but these are the incidents that spring to mind right off the bat.

Point blank – our society still sees women’s bodies as property and objects and we are treated as such. #metoo shows that in terrifying, depressing, angering detail.

Know that I believe you. Know that you never have to tell me the details and I will believe you if you say #metoo. Know that we can make it better for others by behaving better ourselves and by teaching our children to behave better. Know that we can make it better if we intervene if we see it happening.

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Care Denied, Autonomy Ignored, IUD Left Intact

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Note: This is the follow-up from the previous post regarding the scheduling of my IUD removal appointment at Planned Parenthood.

I had my appointment at the local Planned Parenthood for an annual gyne exam and for my IUD removal. Given my broad experience with women’s healthcare providers, both personally and professionally, I found the appointment was divergent from that of my past experience.

I entered the building past two rather polite protesters and encountered the security guard. Upstairs, the receptionist was sweet, caring and inclusive. She had a pleasant demeanor, was polite and helpful. Not only did she ask for my insurance info, but she also asked for my preferred pronoun (it’s “she”, if you are wondering).

This shirt was for a march in DC attended a few years back in support of Planned Parenthood, NARAL Pro-choice and other women’s healthcare advocacy groups. Yes, I’m a firm believer in a woman’s right to choose and safe access to abortion services.

I did bring up the issue I had when scheduling my appointment. She was appalled, and rightfully so. She let me know that what was said was off-message and inappropriate and that’s she’s let my clinician know. A+ for customer service!

I was called back for my exam. This started out as a pretty typical interaction with the nurse… until it wasn’t. She took my vitals, had me pee in a cup and began asking me about my medical history. All good. Then she asked about any symptoms or problems I may be having or have had recently. We proceeded accordingly until I mentioned a minor breast issue and that I still make milk even after having weaned four years ago.

This set off alarm bells for her. After an additional series of questions, she tells me that today’s appointment will be a breast exam and that my annual gyne and IUD removal will be pushed to a later date.

I inquired as to why both couldn’t be done today since I was there anyway and a manual palpitation of my breasts takes all of two to three minutes to complete, if that. She explained that it was about time and prioritization. Since cancer is a *bad* thing, they needed to do the breast exam today and would need to push the IUD removal till a later appointment. (Note: there is no mammography on site, that is to be scheduled for a later date as well.)

I asked again as to why both couldn’t be done since I had an appointment for the IUD removal. The receptionist had mentioned that there was no appointment immediately after me, so any extra time shouldn’t have been an issue.

I explained that since my intention was to get pregnant at 41, that I need to start trying with the next ovulation cycle. Hence, my need to get the IUD out today rather than later.

She insisted that due to time constraints, they couldn’t do both on the same day. I find this to be illogical and not in line with what I know of breast exams and how long they take. Eventually, I relented and grudgingly set a future appointment.

I put my boots on the ground during March for Women’s Lives in DC in April 2003

She then asked if I was using condoms in addition to my IUD. I said “no” and reminded her that I intended to get pregnant and she launched into a “condoms prevent STD’s” speech. This is yet another example of a lack of active listening skills. It felt like she was going through a rote script, rather than hearing what I was saying. It’s awfully tough to get pregnant if you are using condoms.

The physician then comes into the room. She and the nurse discuss my situation. I reiterate to the doctor my need to have the IUD removed and my relative lack of concern over still making breastmilk and the atypical breast swelling before my menstrual cycle. She repeats what the nurse said about time constraints and insists that I schedule a future appointment.

I’m then taken to another room where I’m given a paper half – gown for the breast exam. It is, as I suspected, a manual breast exam taking all of 2-3 minutes. She asked me to express breastmilk, which I did. We talked for a brief moment. I asked, yet again, about my IUD, explaining the inconvenience of having to return a second time and the timeline with regards to ovulation. I expressed my disappointment and my dissatisfaction. I was again told “no”.

We discussed the interaction during the scheduling of the appointment and the doctor apologized for the non-mission statement based conversation which had taken place.

I then was moved on to a blood draw for STD testing for which I had given consent. All told, this took 90 minutes, including multiple wait times and room transfers.

I am left feeling unheard and ignored.

My autonomy was not respected in these interactions with the nurse and the doctor.

Regardless of what issue may or may not be going on with my breast, I was there for a valid purpose – IUD removal, which they did not do.

The delay costs me additional time and money and possibly means that I miss my next ovulation cycle to boot. At 41, I can’t afford to miss a cycle to try to conceive.

I have many thoughts and speculate as to why I may have been denied my IUD removal. None of them make me particularly happy, though I do often wax in negative thought cycles.

If I make a return visit, then they get additional money from both my health insurance company and me with my copay. I’d rather not assume the case is financially motivated, even with the understanding that the government is threatening to cut their funding.

So, let’s assume it’s because they wish to make sure I truly wish my IUD to be removed. They did ask questions about domestic abuse, including whether or not I’d had or a have a partner who coerced me into getting pregnant. My response was “no”.

Rolling this around in my head, I do wonder if this is an imposed waiting period to be sure that I’m not being coerced into a pregnancy.

There is some merit to this method, however, it assumes I am not telling the truth and that I need to be protected. I understand that abused women often protect their abusive partner and deny abuse until they are fully ready to leave the relationship. I also understand that PP works with a population with a high domestic abuse rate and with rape victims.

That said, the nurse and physician with whom I interacted, intentionally chose not to actively listen to my words. When I explained my age and my knowledge of my ovulation cycles, etc. and repeatedly politely asked for my IUD to be removed, they should have been able to ascertain the truth in my words. Or, at least to have better explained the rationale behind not removing my IUD.

The other thing I roll around regarding their decision to delay the IUD removal is my personal life. The staff did inquire as to my relationship status over the course of the visit. I informed them about my separation from my husband and my dating new partners in the last year.

Did this influence their decision not to remove my IUD? I hope not. My personal life is, well, personal and it is not up to the care provider to determine if my personal life is settled and appropriate for having a baby.

Alternatively, maybe, it’s a fluke, a one-time issue with this provider and this office. Maybe, they usually pull out an IUD upon request and something about me or our interaction triggered this response. However, my conversation with the receptionist on the phone at the time of scheduling the appointment indicates otherwise. What if the receptionist at the initial phone call was trying to give me a heads up as to how these IUD removal appointments usually go down?

What if I had only told them I want my IUD out due to excessively heavy periods with anemia, headaches and dizziness accompanying my cycle? Would they have removed it due to that reason alone? I believe in telling the full truth to my care providers. I don’t love my IUD, but I do kind of want to see if I can get pregnant. I don’t believe I should withhold information just to get what I want. There is potential physical harm in that and there is real harm to the provider – patient relationship.

Lastly, what if they told me the truth, with no negligence or malice behind it? What if they really only budget a very short time for visits and even a few minutes over time is a real hardship with regards to other patients? What if the insurance companies only pay for visits of a limited length and PP would be out that money if the visit went too long? This does the patient a great disservice, as sometimes, it is necessary to provide more time to adequately address issues. My body, my choice, except for when it’s inconvenient for others.

I bite back at their prioritization of my breasts over my IUD removal. I am well aware of the risks of breast cancer and I appreciate their concern. However, every gyne visit I’ve had since I was 15, we addressed both breast and uterine issues. The visit at PP was atypical in their focus on only one aspect of my health.

Point in fact – there was NO medical reason to leave the IUD intact. The logistical reason of inadequate time for the appointment, doesn’t hold water given that I was in the office for an hour and a half, at least an hour of that was interacting with the doctor and/or nurse.

I’m still mulling over the rationale regarding the postponement of my IUD removal and as of yet, I have not uncovered a satisfactory reason why my IUD not have been removed at this visit. I will always assume negligence or ignorance over malice. However, the assumption that someone else knows best about my health and my life is erroneous and authoritarian. It is infantilizing to assume that I do not speak the truth or know my mind. Infantilizing to tell me that you, as my provider, know best about my life and my lifestyle.

I live in this body. My values and beliefs govern this body. I do not, nor shall, I cede control to another. My body neither belongs to my care provider, nor my partner. I own my decisions and the consequences thereof.

Planned Parenthood, I will always support you. I will continue to donate to you and I will continue to march for you. I will vote accordingly to support you. Access to safe abortion and birth control is an imperative for women’s health. However, it is unlikely I will be a patient at this office again.

Tell me, readers, of your experiences with care providers who denied you the care you requested. Tell me your stories of needs denied in the comments below.

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