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“What brings you to the hospital?” asked the triage nurse.

I gripped the counter to remain standing through the contractions. “Labor,” I whispered through gritted teeth.

She typed something without looking at me. “Who is your doctor?”

I saw a rolling stool and sat, trying to get enough breath to answer. At this she looked up in alarm. “You can’t sit there!”

I knew sitting on a rolling stool was a fall risk. I also knew that providing a safe chair was necessary for my comfort, how to codeine but not legally required. Since I often instinctively follow sharp instructions — as many women do — I moved off the stool and sat on the floor. Magically, a chair appeared. Thus began the ordeal that would be my labor and delivery experience.

For days prior to this, I wondered, “Is this labor?” The directions from my OB seemed clear enough: “Come in when your contractions are five minutes apart, lasting one minute, for one hour.” But what did a contraction feel like? The hotline said vaguely, “Labor at home for as long as possible.” But what did that mean? What was as long as possible? How could I know what I did not know — and didn’t even know to ask?

Previously, I wrote about the way people speak to pregnant people — as though they perpetually need boundless advice and unsolicited opinions. To my surprise, my L&D experience was quite the opposite: despite being a physician myself with years of hospital experience, I didn’t know what to expect, yet little was explained.

The judgment I had grown familiar with during pregnancy continued during my hospitalization. I was criticized for drowsiness, despite the fact that I needed a blood transfusion; I was asked why my baby was hungry despite the fact that no one had helped me with breastfeeding or offered formula. As a final insult, the only available pediatrician appointment was at 9 am the day after hospital discharge. How was I supposed to get there, shortly after both a C-section and another sleepless night with a newborn?

Yet in those hazy moments I did not feel angry; I felt impossibly ashamed for not meeting expectations.

I thought my experience was atypical until I spoke to other women. Situations like mine are far more common than I realized. Shame and expectations are placed on women in apparently equal weight during any reproductive experience, whether relating to abortion, pregnancy, miscarriage, or birth.

A newly pregnant friend, for example, had woken up with painful cramping and bleeding. “When was the last time you had sex?” her doctor asked.

“A few weeks ago?” She could barely speak.

“Okay. Well, sex doesn’t cause this, so just know it is not your fault.”

The doctor did not clarify what it was. She left the room after ordering an ultrasound.

“You have to guide this wand in,” the ultrasound technician said.

“What?”

“The doctor didn’t tell you?”

As my friend lost her baby, she guided a probe into her own body despite excruciating pain. No one said the word miscarriage. She was too frightened to ask the only question on her mind: “What is happening to my body?

“But I finally figured it out,” she told me later.

She should not have had to ask the question. Women who are looking for clarity and support, many of whom have never been in this situation before, often do not know what questions to ask. Why are we expected to?

A third friend called her regular practice to schedule an abortion. Her call was transferred three times before someone finally said, “We don’t do those. But congratulations! Would you like to schedule a pregnancy appointment?” She called two other clinics who also denied her after lengthy waits. She finally went to Planned Parenthood.

Women often suffer in silence, often because they are ashamed they did not do better — despite not knowing what to expect. We also shy away from asking questions that may make other people uncomfortable, even if we need answers.

How can one establish breastfeeding having never done it before? Yet there is so much shame and toxicity surrounding not being able to breastfeed successfully. How can you make it to a pediatrician’s appointment the day after a C-section? Yet every woman somehow does. How do you know that you are healing correctly after birth — often the most major medical procedure a woman has experienced thus far — with only a two-week appointment and a six-week follow-up? These increasing demands leave women vulnerable to self-professed experts, tired and desperate for answers. These experts often lack credentials but are happy to provide the clear direction women seek in confused moments. It is isolating at best; psychologically debilitating at worst. What will happen if care becomes less accessible — which is now inevitable given the recent overturning of Roe v Wade?

But I believe there is hope. There is so much I did not know to ask. If we share our experiences, without shame and with compassion, we can start a conversation where women can better advocate for themselves in whatever environment they find themselves in.

In retrospect, here are questions I wish I had asked — and that I hope you ask: When will someone help me breastfeed? Is there formula available? Do you provide a nursery so that I can get some sleep? Asking these questions, and making active choices, would not have made me a worse mother.

Now, I would ask the obvious questions even if I “should” know the answer, or even if the answer might make others uncomfortable: Am I having a miscarriage? Do you provide abortions? I have been in pain for three days, shouldn’t I come to the hospital?

I want to live in a world where pregnancy and birth are celebrated in action instead of at face value. I want pregnancy loss or termination to be treated with respect and compassion. It is a small hope, but a promising one, that by joining together and speaking out loud together we can create this world for ourselves and model the change we wish to see from others – in hospitals, clinics, and in government.

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