common obstretrics & pediatric practices

[chaibaby]

I was unsure as to what "twilight sleep" (mentioned in post below about "What Some Women Went Through...) was so I googled it. Scary! The last line of the article fascinated me though:

"Twilight sleep has, therefore, fallen entirely out of favor and is now merely a chapter in the past history of obstetrics."

Doesn't it make you wonder what we look at as "common" practices in both obstetrics and pediatric health right now and what will have "fallen out of favor" in another 20, 30, 50, or 100 years?

I know there are lots of things that they do now that I personally roll my eyes at, and so I often wonder what will change in the future.

[Kelly1101]

I think very recently, episiotomies have fallen out of favor, and they'll be pretty much gone soon.


The same could be said for pushing flat on your back.

[CookAMH]

Originally Posted by chaibaby

I was unsure as to what "twilight sleep" (mentioned in post below about "What Some Women Went Through...) was so I googled it. Scary! The last line of the article fascinated me though:

"Twilight sleep has, therefore, fallen entirely out of favor and is now merely a chapter in the past history of obstetrics."

Doesn't it make you wonder what we look at as "common" practices in both obstetrics and pediatric health right now and what will have "fallen out of favor" in another 20, 30, 50, or 100 years?

I know there are lots of things that they do now that I personally roll my eyes at, and so I often wonder what will change in the future.

There are also many things that should have fallen out of favor that haven't, like no eating or drinking, for one.

[Kelly1101]

Originally Posted by CookAMH

There are also many things that should have fallen out of favor that haven't, like no eating or drinking, for one.

I think the "no drinking" will go before the "no eating" will.

Funnily enough, I had always heard that the rule for that would be in case of aspiration during an emergency situation requiring a gen anaesthesia-- but now apparently I hear that this is a non-concern, that aspirating stomach acid is just as dangerous as food or water and that it's so rare it's not worth making a policy about it. But I'm not sure about this.


My lamaze teacher (who is associated with the hospital, but not quite "company line"-- kept saying "don't tell them that *I* said this, but really you know...") said that the rule is absolutely ridiculous and the only reason that doctors want it, is because drinking and eating can make you nauseated.

The funny thing is, as she was talking and glancing around the room, she happened to be glancing at me as she said that and I had just given this ENORMOUS eye-roll expression (if I get sick, I get sick. I'm not going to dehydrate or starve myself to save the doctor's sensibilities by being offended by a little throw-up). And she burst out laughing, nodded at me and said "Yeah, my feelings exactly."

[kriket]

Originally Posted by Kelly1101

The same could be said for pushing flat on your back.

yeah, how is that productive? I was trying to tell DH about this the other day and I told him to try to take a crap flat on his back. He said "you can't properly engage your squinting muscles like that" I know he was trying to be funny, but EXACTLY!

[Full Heart]

The flat on your back thing came from a royal who was a sexual deviant who liked to watch women give birth and couldn't see when they squated. Then I guess drs got wind of how easy it was to see when they were interfering...err I mean attending births. I don't know how easy it will be to have them give that up.

The food and drink thing is pretty stupid. You would think with such a high rate of c/s already you would be seeing aspiration more often if it was really a concern. Digestion slows during pg so you are bound to have women in labor who have food in their stomachs probably a good portion of the time. I can't imagine being hungry and having to push, talk about torture. No wonder so many women loose energy.

[Kelly1101]

I am pretty sure that pushing flat on your back isn't encouraged anywhere anymore (I'd be shocked if it was). When I toured my hospital, the nurse made a point to say "when you push, we have a squatting bar that goes over the bed *here*, or if you don't want to do that, we can take off the bottom of the bed so that you can sit up like *this*".

[Full Heart]

When I had my hospital birth - granted 10 years ago now (that makes me feel old lol), they had women on their backs. There was no squating bars either. Its was the whole in stirups thing. If you watched the birth shows on tv lots of them are on their backs too.

[CookAMH]

Originally Posted by Kelly1101

I am pretty sure that pushing flat on your back isn't encouraged anywhere anymore (I'd be shocked if it was). When I toured my hospital, the nurse made a point to say "when you push, we have a squatting bar that goes over the bed *here*, or if you don't want to do that, we can take off the bottom of the bed so that you can sit up like *this*".

From my understanding, it's still pretty common, especially when hooked up to a bazillion things with a medicated birth. It's convenient for the docs to catch the baby too, and yes the practice was started by a male.

[nigellas]

I am pretty sure that pushing flat on your back isn't encouraged anywhere anymore (I'd be shocked if it was).

Unmediated hospital birth last time (2 1/2 years ago) - Had to deliver on my back.

[annettemarie]

Moving to Birth and Beyond.

[jeliphish]

My first birth they encouraged me to lie on my side, not on my back, during the pushing stage....the doctor had mentioned that if I hadn't have had the epi he thought my pushing would have been more beneficial in other positions.

[murphysaangel]

I was in childbirth ed class with a woman who had to deliver on her back for her 1st. They wouldn't even let he get up when she had to pee - they handed her a bedpan. This was only 3 or so years ago. Needless to say I am avoiding that hospital.

[snowmom5]

It might be important to distinguish between pushing flat on one's back vs. pushing semi-reclined on one's back. My understanding is that there may be a significant difference between the two, that the flat way opens up the pelvis more than the reclined way. But I'm no expert. Perhaps someone else who has heard of this can shed some light.

Also, FWIW, I labored on my side and began pushing that way (well, my body did anyway, lol; fetal ejection reflex) but the OB (who generally is very natural-minded) thought I needed to open up the pelvis more and turned me, which put me flat on my back in the final moments and then he came flying out (sorry, it was an out of body experience, long story). Knees were back, kind of like a horizontal squat. Honestly, I could not have been vertical even if I had wanted to during any of that labor, which was med-free.

I don't mean to turn this thread into a debate on pushing positions, but I don't think that any position should be categorically ruled out as somehow passe.

Ah, here it is, I knew I read about it someplace here before. It's called McRoberts
https://www.mothering.com/discussion....php?p=1816316 .

[herbanmama]

Originally Posted by Kelly1101

I am pretty sure that pushing flat on your back isn't encouraged anywhere anymore (I'd be shocked if it was). When I toured my hospital, the nurse made a point to say "when you push, we have a squatting bar that goes over the bed *here*, or if you don't want to do that, we can take off the bottom of the bed so that you can sit up like *this*".

I am a doula in your city (haven't done a ton of births, but enough to get an idea of how things tend to flow around here)and it may surprise you to hear that I have yet to see one of these squatting bars utilized, so prepare to go in with absolute determination. Same with episiotomy. I see more than I'd like, and know of more than one OB who performs them routinely.

If I am intuiting properly, I think I may know who your Lamaze instructor is.

PM me if you'd like, if you wish to remain anon, I understand as well. I could give you a bit of an inside scoop on what to expect from the hospital from a doula's perspective.

[kriket]

Originally Posted by snowmom5

It might be important to distinguish between pushing flat on one's back vs. pushing semi-reclined on one's back.

I don't know.... I've never birthed, but I would imagine semi reclined is 'better' then flat. Even if you were flat, you would pull yourself up with your abs while pushing.

I think I'm going to stick with squatting, kneeling of on my knees. I'm just not comfortable on my back when I'm not labouring!


Oh, and to contribute to the conversations I was reading "sign with your baby" and he mentioned that until the 30s parents were instructed NOT to hold/cuddle their babies. Germs and being fragile and such.

What kind of biological sence does that make? Leave your young laying around in the open!

[battymama]

Originally Posted by kriket

I don't know.... I've never birthed, but I would imagine semi reclined is 'better' then flat. Even if you were flat, you would pull yourself up with your abs while pushing.

I think I'm going to stick with squatting, kneeling of on my knees. I'm just not comfortable on my back when I'm not labouring!


Oh, and to contribute to the conversations I was reading "sign with your baby" and he mentioned that until the 30s parents were instructed NOT to hold/cuddle their babies. Germs and being fragile and such.

What kind of biological sence does that make? Leave your young laying around in the open!

no she is right, reclining closes your pelvis more, it has to do with the position of your tailbone/spine i believe. If you are comfortable on your back then i think its fine, my understanding is its more about being directed and forced to do so.

[the_lissa]

Yes reclining closes your pelvis and is worse than laying flat. With my second, I pushed flat on my back because I was too exhausted to move even though I had planned to kneel or squat, and I still pushed him out in less than 5 minutes.

[MegBoz]

Well, enemas & shaving the pubic hair are no longer done, so we can hope that things will continue to improve.
Episiotomy is definitely on the decline, but not nearly as low as it needs to be. I think I saw an MDC Mama post that in her area in Texas, the rate was 30%.

Of course, "No drinking" needs to be out the door NOW! My baby-friendly hospital allowed drinking, but not eating. Although when I asked one of my MWs if I could eat, she said, "Well, just don't ask."

I'm hoping continuous fetal monitoring for all births will be gone. As well as routine administration of the eye goop. I've read of nurses doing it for C/s. Seems to me that should be an "opt-in" thing (request if you want it) rather than "opt out" (every baby gets it unless you speak up to decline!)

But most importantly, midwives should be the primary attendant for all normal, healthy pregnancies & births, not OBs. Not only is this very likely to improve outcomes, such as reducing CS rates, it will save a lot of money too.

[Full Heart]

Well flat on your back might be better than reclining both can also be incredibly painful and difficult to push in. The worst positions I have ever been in during labor was laying down. Only one labor out of 7 was I able to lay down at all. Sure some women are gonna want it but why force all women to do it? Its not for the womans benefit thats for sure.