Weill Cornell Medical Center has delivered over 25,000 babies into this world, making the birth of my twin daughters, Friederike and Raphaela, small contributions to this staggering number. And yet their birth on March 26, 2020 was notable. It was the day New York emergency dispatchers received more than 7,000 calls—more than during the September 11 terrorist attacks. The COVID-19 infection rate nearly surpassed all other countries, and New York had the highest number of cases of any state. In the United States, the COVID-19 death toll was at 1,000.
It was the day I was alone, isolated and masked in hospital triage and then an operating room at the height of New York’s vulnerability and panic. Concerns about my physical state during recovery were met with the “medical shrug,” a dismissive gesture signaling a lack of concern. New York, Weill Cornell, and my doctor expected one thing from me: to be strong and move on.
This medical shrug is more common than you might think, and, according to studies, happens more to women than men. One study found female post-op patients were often prescribed sedatives while men were prescribed pain medication. Based on a review of literature, the study hypothesizes the prescription of sedatives is based on the idea that women’s pain is more psychological—a manifestation of stress, anxiety, or depression, rather than physical. And yet multiple studies have found that the women’s pain sensitivity is greater than that of men in most pain modalities. And this disparate treatment affects women of color disproportionately. Studies have found that even when insurance status, income, age, and severity of conditions are comparable, Black women receive lower quality health care than white women.
Despite all the research and statistics, health-care professionals maintain the stereotype that women complain and exaggerate their pain. In my career as a health coach, I’ve found the opposite to be true. My female clients ignore their pain and keep pushing forward to care for their partners, children, and parents. This can go on for weeks, months, years, even decades. If anything, the stress, anxiety, and depression come from the pain rather than the reverse.
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During my pregnancy, there was one brief moment of fragility when I let my guard down and locked my strength away. I was sleep deprived after a late-night visit to the emergency room. It was my first visit to an emergency room—ever—because I pride myself on being tough. But when my doctor breezed into the room and asked, “How are you today?” it knocked me off my center. She had never asked about my well-being before; our visits were always quick, cold, curt.
I took her question as a moment of connection and showed her my legs, the reason for the ER visit—one leg was three times the size of the other. While it’s common to have swollen legs and feet, my swelling was extreme and—I’d only later learn—an early sign of my preeclampsia. Despite her lack of reaction, I continued with my symptoms, describing my debilitating nausea and constant vomiting. Again, nausea and vomiting can be a standard side effect of pregnancy, but mine was unrelenting. It had been 20 weeks of vomiting, multiple times a day. Every day.
With my heart racing and emotions swirling, I looked to her for something—anything—to help me cope and understand what seemed to be extreme symptoms. She didn’t look at me, not even at my legs. She just shrugged and said, “You’re pregnant.” Yes. Yes, I am pregnant. The connection was severed. Those words reminded me, in a flash, that after six years of infertility—being told by multiple doctors I’d never have children and one embryo that split into two—I should be grateful, stop complaining, and stay quiet. I pulled back the pending tears. It took me mere minutes to find the key. I had my strength back by the time I spread my legs for the exam. I sustained my strength for the last ten weeks of pregnancy—the vomiting, the nausea, the ever-increasing swelling of my legs.
With the coronavirus death toll rapidly increasing, Weill Cornell Medical Center banned partners and labor support from both delivery and postpartum recovery. Research clearly concludes the mental and physical health of the pregnant person and baby is greatly improved by the presence of a support person. And the New York State Department of Health guidelines, written specifically for the pandemic, called a support person “essential to patient care throughout labor, delivery and the immediate postpartum period.”
Despite this, and despite my attempt to persuade the hospital otherwise, I was on my own. When I went in for a routine non-stress test on March 26, I expected to be back home within the hour. I had no history of high blood pressure and no Braxton Hicks contractions. But when I arrived the doctor seemed on edge. “We don’t know how bad things are going to get with this virus.” she said. “You and your children need to get home safely. Rather than tax the system, I recommend we do a cesarean today.”
We deserve care
Two babies, tiny and disoriented, were welcomed into this world by their masked mother, no father, and many, many medical professionals. The birth of my girls was followed by four days alone in my hospital room, sleeping in a chair because I couldn’t get in or out of the bed without assistance. That cut across my belly took me down. And no one was available to help me up. A global pandemic means nurses take classes to train for wherever they may be needed. More training means less time with patients. And, certainly, no time to help me in and out of bed. Understood. The chair was just fine. I survived it all without complaint.
I thought my pain was over when I gave birth, but that’s when the vomiting, weakness, and disorientation started. I inquired about my symptoms before I was discharged. The attending doctor shrugged and said, “You just had a baby.” True. He gave me the green light to go home. A few days later, after hearing a faint cry from my daughter, I attempted to reach her in our nursery down the hall. With one step forward, it was clear my trajectory was toward the floor. After just a few seconds of crawling I stopped; the path ahead seemed insurmountable. I spoke to an army of nurses, but I couldn’t get my doctor, or any doctor, to call me back.
So, on April 3, the day the CDC recommended all Americans wear face masks in public and the official death toll in the United States climbed to 5,784, I walked into an emergency room to ask for help. I was quickly diagnosed with postpartum preeclampsia, a rare condition causing high blood pressure and protein in the urine and treated with a 24-hour magnesium drip to stave off a stroke, brain damage, and death.
A few months into my recovery, I asked myself why I accepted my pain. In truth, I was fine with the medical shrug prior to discharge because I wanted to believe my experience was typical. And by dismissing my symptoms, I could go home. The medical shrug is the equivalent of a doctor saying, “suck it up.” It’s as if this is the unofficial motto for carrying and birthing children: Forget the pain, move on, and keep going. This is what defines you as a mother. We’re strong. But we’re also humans who experience pain and deserve care.
To recover from my postpartum preeclampsia, I needed to redefine my relationship with strength. Instead of a woman taking care of two babies, a husband, and a home while keeping her career afloat, I needed to also be a woman who rests. More than strong, I now want to be resilient—a resilient woman walking, not crawling, on her own two feet. Only when we own our pain and demand that our doctors both acknowledge and treat it can we be that woman.