As both a patient and a nurse, my labor and delivery experience with Dr. Salasche was extremely…read moretraumatic. It has taken me one year to work up the courage to write this.
I arrived in spontaneous labor and was having strong, regular contractions on my own. My labor was progressing normally and was not prolonged. Around 5 cm dilated, my daughter experienced her first heart rate deceleration. Rather than taking a more cautious approach after that change, Dr. Salasche told me she wanted to start Pitocin and manually break my water.
I questioned why these interventions were necessary. As a nurse, I understood that Pitocin would intensify my contractions and that breaking my water would remove the protective cushion of amniotic fluid surrounding my baby. Given that she had already experienced a heart rate deceleration, I was deeply concerned that these interventions could place her under even more stress. My labor was already progressing naturally, and my contractions were strong and effective without augmentation.
I specifically told Dr. Salasche that I did not want my water broken or Pitocin started at that point based on both my clinical knowledge as a nurse and my intuition as a mother. Despite making my wishes clear, she forcefully broke my water and told me I "didn't have a choice." They did not start Pitocin after I repeatedly refused. In that moment, I felt powerless. No one should ever be made to feel that informed consent no longer applies simply because she is in labor.
What happened next was equally disturbing. My labor nurse advocated for me, asking that we respect my wishes and allow my daughter time to recover from her heart rate deceleration before proceeding with additional interventions like breaking my water or starting Pitocin. Rather than engaging in a thoughtful discussion, Dr. Salasche yelled at the nurse in front of me, stating that she had given her an order and instructing her not to undermine her. As both a patient and a nurse, witnessing a physician berate a nurse for advocating for her patient was heartbreaking. Instead of fostering teamwork during a critical moment, it created an atmosphere of fear and intimidation. I will always be grateful to that nurse for having the courage to advocate for me and my daughter when I felt my own voice had been taken away. Nurses truly are the heart of healthcare.
Throughout my labor, my daughter continued to experience episodes of heart rate decelerations, and at the time no one knew why. After delivery, we learned that she had a short and marginally inserted umbilical cord and cord compression. Looking back, I can't help but question whether attempting to augment my labor with Pitocin and manually breaking my water after those initial decelerations could have placed my daughter at even greater risk. While no one can know with certainty what would have happened, those decisions continue to weigh heavily on me given what we later learned. In fact, while under Dr. Norlin's care during my pregnancy our daughter's heart rate had dropped from 150/160 to 120 about a week prior to delivery. I thought it was clinically significant and also mentioned I felt really small being so close to my due date and that my sister had placenta issues so I was concerned. I asked for a scan and she said no.
Now we know this: After delivery, pathology revealed multiple abnormal findings, including an extremely short 14 cm umbilical cord, a significantly small placenta, and circummarginate membranes.
My labor was not prolonged. I received my epidural around 2:00 a.m., and my daughter was born vaginally just after 10:00 a.m - healthy and happy. I was progressing naturally, yet I was repeatedly pushed toward unnecessary interventions.
I never felt heard, respected, or safe in Dr. Salasche's care. Every patient deserves informed consent and respect. I'm incredibly grateful that my daughter is healthy, but I cannot recommend this practice based on my experience. My hope is that no other woman leaves her birth feeling that her voice was taken away.
