I got my first dose of COVID-19 vaccine. It was quite difficult for me to prepare for it – anxiety returned, I had flashbacks, disturbed sleep. I used methods I have learnt in last months to deal with it and being able to get my first dose.

May 2, 2021

I registered for a vaccine soon after registration was open for my age group. And I waited. Decision whether or not to register was not a difficult one for me. I had a hard time with my anxiety before and when numbers of COVID-19 deaths were the highest in the world at the beginning of 2021. I was anxious when meeting someone, even in the street. Therefore, the vaccination was logical and the easiest way out.

May 10, 2021

M. registered for a vaccine.

May 20, 2021

Vaccination appointment was scheduled for M. I started to question the registration system, because he registered later and was scheduled sooner than me. How come? Is it because he is a man? Is it because he commutes to Austria? Or is it because he pays taxes (and I am not as I am on parental leave)? Is it because he is three years older? Is there any other reason?

May 26, 2021

M. got his first dose. At the same time I received an email that vaccination appointment was scheduled for me. In the afternoon I had strange pushing sensation on my neck that worsen towards the evening. It was not very bad, I was just aware something unusual is happening. I woke up in the middle of the night breathing anxiously with a sensation of someone strangling me. Moreover, I had a sensation of a cannula needle stabbing my left elbow pit.

2018

I immediately recalled B.’s birth when I had cannula in my elbow pit for about 48 hours and it restricted my movement and positions at delivery time and obstruct my attempts to handle and breastfeed newborn B. safely. After returning home from maternity hospital I had nightmares with the same cannula-stabbing-my-elbow-pit sensation for weeks.

Kristeller maneuver

This memory helped me to decipher also the strangling sensation. During the pushing stage after almost 48 hours without sleep and about 14 hours of contractions I said to a doctor I was exhausted. Doctor’s reply was: “We can help you.” They told me to lie down on a birthing bed and after a while I found myself in an uncomfortable position under doctor’s forearm pushing on my belly. I could not even breathe and whenever I tried to inhale, it was impossible. This is where the strangling sensation came from. I was out of breath and they told me to push. Kristeller maneuver.

In my birth plan I stated it clearly that I did not want Kristeller maneuver – the doctor read it and agreed. But there I was – lying on the birthing bed and the doctor pushed on my belly. I lost about 1000 ml of blood. Bleeding can be caused by Kristeller maneuver, “strict ban on Kristeller maneuver”¹ is one of the preventative measures of postpartum hemorrhage. And a tear can be caused by Kristeller maneuver.² I had a long tear to my clitoris.

Episiotomy

There is a higher risk for episiotomy when using Kristeller maneuver.^{3, 4} And I had a cut – episiotomy, which I did not want either. It was in my birth plan and the doctor agreed. And still, a midwife offered it to me between contractions and doctor’s pushing on my belly with words: “This is the last chance for me to insert episiotomy scissors in your vagina. Then hopefully we will push it through somehow.” It? We? Being exhausted as I was I hesitantly agreed. But there was a question in my head: “Why did she offer it to me, when I did not want it? Is the situation that serious? Is something wrong?” I was scared.

Episiotomy is indicated in cases when the baby is in danger.⁵ B. was not. Doctor monitored his heartbeat after each contraction and he did not mention any problem with that. Even the midwife’s comment about somehow pushing it through does not signify any problem. I was manipulated, they probably did not want to loose time really helping me, so they were “helping” me. I can see it know but back then I could not. The maternity hospital where this happened is oriented towards natural births (it is stated on the website of the hospital – I am not going to provide a link here) – that is why we chose this one… I am disappointed, I feel deceived and cheated. It caused years of problems…

I needed to face all these memories again “just” because I wanted to get my vaccine. Childbirth is a life-changing event, details of which a woman remembers for the rest of the life. Although she is advised to forget. Which is impossible.

May 27, 2021

A day went as usually, although I was sadder then usually because of all that processing. So I used some of the methods I know help me to deal with difficult memories – exercise, listening to guided relaxation, washing my hair…

May 28, 2021

It was a busy day – Spanish lesson, doing laundry, cleaning up, shopping for groceries, a park walk, preparations for a visit. So there was no time for me to think about vaccination appointment.

May 29, 2021

My vaccine appointment was located in national vaccine center and there were tons of people. I did not have time to think about many things as I was directed from one place to another and went trough procedures step by step. Suddenly I was sitting on the chair and a health care provider was asking me: “Which arm?” “The left one.” I took a deep breath in and out and it was done. I did not feel anything. In the evening my arm was painful but that’s it.

Notes

1. Alves, A. L. – Francisco, A. A. – Osanan, G. C. – Vieira, L. B. 2020. Postpartum hemorrhage: prevention, diagnosis and non-surgical management. In Rev Bras Ginecol Obstet : Gynecology & Obstetrics [online]. 2020, vol. 42, no. 11 [cit. 2021-05-30], pp. 776-784. Access: <https://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1721882.pdf>.
2. Youssef, A. – Salsi, G. – Cataneo, I. – Pacella, G. – Azzarone, C. – Paganotto, M. C. – Krsmanovic, J. – Montaguti, E. – Cariello, L. – Bellussi, F. – Rizzo, N. – Pilu, G. 2019. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion. In Ultrasound in Obstetrics & Gynecology [online]. 2019, vol. 53, no. 1 [cit. 2021-05-30], pp. 95-100. Access: <https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/uog.19085>.
3. Sartore, A. – De Seta, F. – Maso, G. – Ricci, G. – Alberico, S. – Borelli, M. – Guaschino, S. 2012. The effects of uterine fundal pressure (Kristeller maneuver) on pelvic floor function after vaginal delivery. In Arch Gynecol Obstet [online]. 2012, vol. 286, no. 5 [cit. 2021-05-30], pp. 1135-9. Access: <https://pubmed.ncbi.nlm.nih.gov/22752555/>.
4. Zanconato, G. – Cavaliere, E. – Cherubini, G. – Bortolami, O. – Mantovani, E. – Iacovella, C. – Franchi, M. 2014. Fundal pressure (Kristeller maneuver) during labor in current obstetric practice: Assessment of prevalence and feto-maternal effects. In Minerva ginecologica [online]. 2014, vol. 66. [cit. 2021-05-30], pp. 239-41. Access: <https://www.researchgate.net/publication/262530379_Fundal_pressure_Kristeller_maneuver_during_labor_in_current_obstetric_practice_Assessment_of_prevalence_and_feto-maternal_effects>.
5. Aldana, I. – Lišiaková, L. – Pizano, V. 2016. Ešte netlačte : Všetko, čo potrebujete vedieť o rodení na Slovensku. Bratislava: W Press a.s., 2016. .týždeň. ISBN 978-80-89879-00-7.