So upset after reading my birth notes-could use some validation

[baybemama]

I am 20 weeks with my second and seriously considering leaving my OB practice and getting prenatal care from my family doc who is very supportive of me attempting at VBAC.  I had a doula last time and she prepared notes for me about my first labor experience and I'm getting angry reading them.  I didn't think much about it before but now that I've been reflecting about how my c-section may have been avoided, it seems so obvious!  But I would like some opinions from the wonderful ladies here to see if my thinking is correct.  My notes are in purple.

April 21 - arrived at hospital at 7:00pm was examined 3 ½ cm 80% 0

Started induction at 8:00pm Pitocin set at 2-I asked the nurse if she could stop turning up pitocin if I was contracting well enough on my own.  She said she would.

Called Karen at 8:20

Karen arrived at 8:52pm Pitocin set at 4

10:20pm increased Pitocin to 6

Vaginal exam at 10:35pm 4 ½ -5 90% 0

11:05 increased Pitocin to 8-I told the nurse my contractions felt incredibly strong (but had nothing to compare it to so what did I know) but she told me I wasn't in active labor yet and that the contractions weren't strong enough.

Jen very uncomfortable, asked for epidural at midnight

12:20am changed her mind wanted to try Nubane-I actually never wanted to try nubane.  I agreed to try it before the epi but then deicded I wanted the hard stuff.

Decided on epidural at 12:30 given with Fenten to slow contractions-I know I don't have to explain how awful contractions felt.  I wanted that epi BAD!  Not sure I understand the Fenten, don't even know what it is excactly except that they did it to stop my labor...why did they keep upping the pitocin so quickly?

Henry’s heart rate dropped shortly after epidural was in, Pitocin was turned off

12:50 vaginal exam 8cm 90% 0

12:50am artificial rupture of membranes and internal fetal scalp electrode
inserted

1:00am catheter inserted to empty bladder

3:20 Pitocin turned back on at 2

3:47 Henry had dips in heart rate; turned Pitocin back to 1 and inserted an
intrauterine pressure catheter to measure contractions

4:40 Aminio-infusion through catheter because of dips in baby’s heart rate.
Turned Pitocin to 2

4:45am increased Pitocin to 3

7:10 turned to other side

7:20am vaginal exam 8cm 90% 0 decided on cesarean delivery, reason: Failure to
Progress

8:20 took Jen back to OR

 

[~Amy~]

What was the reason for the pitocin in the first place?  Membranes were intact at that point, correct?  So you weren't on the clock in that regard.  Why did they only wait an hour to start the pit?  Was there some reason that it was important to get the baby out ASAP?  Seems like your body & baby just weren't ready.  

I would be upset too, mama (((hugs))).  Hope you get your VBAC.

[baybemama]

I was being induded for being overdue and they suspected he was getting too large.  (He was born at 8 lbs 8oz)  I was naive and didn't fully understand my options here.  Nobody forced me to be induced, it was suggestedand I was eager. 

I think what bugs me about this though, is that my current OB said it had nothing to do with being induced and that I would most likely not be succesful with a VBAC because I went four hours without dilating.  She stressed that was a long time.  It doesn't seem like a long to me now, although then it did.  I don't know know much about levels of pitocin but it seems like they pumped me up only to have to halt everything and then nothing happened.  If things were allowed to happen naturally this time around, no induction and meds then it seems to me that I would have a decent chance instead of a "probably not successful" chance. 

[CookAMH]

Originally Posted by baybemama 

I think what bugs me about this though, is that my current OB said it had nothing to do with being induced and that I would most likely not be succesful with a VBAC because I went four hours without dilating.  She stressed that was a long time.  It doesn't seem like a long to me now, although then it did.  I don't know know much about levels of pitocin but it seems like they pumped me up only to have to halt everything and then nothing happened.  If things were allowed to happen naturally this time around, no induction and meds then it seems to me that I would have a decent chance instead of a "probably not successful" chance. 

I could not disagree with your OB more. I think you are an excellent candidate. Pitocin screws with everything so much that it's impossible to justifiably say that your body should have taken over when it was turned off. YOUR BODY might have needed until the next day to really get going, and that wouldn't have been abnormal or unhealthy.  The pitocin took control and took the power of birth away from your body.  Your OB is wrong, I personally think it had everything to do with being induced. I am confident your LO's heartrate would have been fine without the interventions. Your OB has a very incorrect view of the process of dilation - she likely has the standard of 1cm an hour which is very inappropriately expected of most women.

Take heart, and your thoughts of leaving your OB are justified, and I recommend you shop around or go with the family doc you mentioned who is supportive. Have you contacted your local ICAN chapter?  That would be THE best resource for looking for a different care provider. http://ican-online.org/ Find your local chapter, see if they have a chat group anywhere or just go to one of the meetings.

One piece of advice for next time, unless you strongly feel your labor is progressing very quickly, wait longer to go to the hospital, no matter who your doc is or what hospital policy is. Become familiar with the natural stages of labor and the possible variations (ie pick up Natural Childbirth the Bradley Way), be familiar with the "emotional signposts" of labor to know when you are in active labor vs early labor, and try your best to stay home through early labor until you are well established in active labor (ie aim to be 5-6cm when you are admitted, some women aim for even later depending on what their hosp environment is like).  The benefit of that is it can take some women all day or longer to get to active labor, and for some women, that early labor peters out and picks up another day to then proceed to active labor and childbirth. You don't want to be in that hospital until you know the baby is coming that day and you need someone there to catch :).

Also, will you be at the same hospital? Do you have any other hospital or birthing options?
 

[~Amy~]

Okay, that makes sense...sorry, I missed that it was an induction.  I thought you meant you showed up in labor and they started pit that quickly.

I completely agree with the PP...your story has "failed induction" written all over it.  I can't imagine how your OB would be able to know that it wasn't related to the induction.  This was your first birth, correct?  So your OB had no basis on which to say that you won't dilate on your own because your body has never been given a chance to do it.  I would absolutely switch care providers if you can.  It really doesn't sound like your chances for a VBAC are very good with this OB.

[neveraim]

Inductions don't work half the time.  It has nothing to do with you or your baby.  They just don't work.  You got really far so you are a really good candidate for VBAC.  I'm guessing that the baby was not positioned right and that's why you stalled.  There are things you can do.  www.spinningbabies.com was a wonderful resource for me during pregnancy and while I was in labor.  You need a new provider...who believes in birth and won't induce you in the first place...someone who wants you to have a vaginal birth because it's what you want.  My pelvis is actually malformed but I managed to have a vaginal birth (a VBA3C) because I had an awesome doctor...

[maotmsmi]

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Edited by maotmsmi - 5/21/11 at 3:24pm

[roadfamily6now]

Fentanyl is the medication given in the Epidural cocktail. It should not interfer with labor. However, epidurals themselves have been known to stall labors.

Another thing is that pitocin can be upped to 40. It starts at 2 and they can increase it to 40!!

I agree with the other ladies.

Avoid the Pit and the Epidural.

Get a Doula!

Find a new care provider.

[Melly24]

Your story sounds similar to my DD's c-section birth. I wasn't induced, but my labour was augmented after contractions slowed thanks to the epidural. I dilated to 10 but by then the Pit was turned up really high due to contractions slowing and DD's heartrate was starting to dip. C-section for failure to progress. I was told my she was probably too big for me to push out which is why contractions were inefficient (they were inefficient because they weren't normal natural ones!)

I just had my DS at home in October. He was a whole pound bigger than DD at 10 pounds and was born after 5 hours of active labour. It was amazing!