Nurses pushing on stomach after birth - help. - Page 9

[womenswisdom]

Originally Posted by holly6737 



Of course you shouldn't be denied all care during your pregnancy. You have the right to find another health care provider to provide you care. You have agency to do so. If you are "fired" from one practice, what is to prohibit you from finding another that might be more in line with your philosophy?

Originally Posted by holly6737 



Who has advocated that women should be forced to accept care? I haven't seen that advocated anywhere in this thread.

These two statement can be diametrically opposed.

Let me describe a circumstance that would prevent a woman from finding another practice - one that happens every day in this country.

Women who live in areas, especially rural areas, where there are no hospitals that allow vbacs are forced to either accept medical care as dictated by the care provider or go without it altogether. There are no practices that will accept a patient who will not consent to a cesarean at 39 weeks. How do you reconcile the two statements above? What is a woman supposed to do in that situation? I'm literally asking you and would love to hear your answer.

[holly6737]

The woman has a choice to make. She can either birth unassisted or she can consent to the c-section at 39 weeks. Women do not have a right to force a provider to offer a service that they do not feel comfortable providing. That's the bottom line of it. You hire your hcp, but you do not own them. And neither do they own you. You can walk at any time.
 

Originally Posted by womenswisdom 


These two statement can be diametrically opposed.
Let me describe a circumstance that would prevent a woman from finding another practice - one that happens every day in this country.
Women who live in areas, especially rural areas, where there are no hospitals that allow vbacs are forced to either accept medical care as dictated by the care provider or go without it altogether. There are no practices that will accept a patient who will not consent to a cesarean at 39 weeks. How do you reconcile the two statements above? What is a woman supposed to do in that situation? I'm literally asking you and would love to hear your answer.

[Storm Bride]

Originally Posted by holly6737 

Not true. You can choose anyone you'd like to attend your birth. You are not doing anything illegal by birthing at home with a lay midwife. However, you do not have the right to have whomever you wish to attend your birth be licensed by the state. And the lay midwife that attends your birth does not have a right to advertise and practice as a midwife, when in fact she is not, according to the state. For example, Storm Bride, for you full term loss during an attempted HBA4(or3?)C's, you used Gloria Lemay, correct? You had a right to choose to birth at home, despite your risk factors. No one arrested you. You had a right to ask Gloria Lemay to be present at your birth, despite her history. No one arrested you for asking Gloria Lemay to be at your birth. However, you did not have the right to force the state to endorse or license Gloria Lemay, considering she doesn't meet any criteria for licensing. And, you did not have the right to ask the state not to bring up charges against Gloria Lemay for practicing midwifery without a license, considering she was acting as a midwife when in fact she was not one. But no one said you weren't allowed to birth at home with anyone you wish in attendance. No one wants to get the laboring woman in trouble. The laboring woman can do whatever she wants. It's the dangerous "provider" that should be regulated and fined for pretending to be something they are not.

 

I had an unlicensed midwife. I don't discuss her identity, for a variety of reasons. My provider in that pregnancy didn't ever pretend to be anything she isn't - not once, not ever. The state may or may not have had the legal ability to charge my provider, but they don't have a moral right to do so. There was police involvement, and the basis of it was that the poor labouring woman must have been led astray. Because, once again - it couldn't possibly be the actions of the licensed medical professionals that pushed me into a decision that the medical establishment doesn't approve of. I obviously must have been led astray by some kind of Kool Aid. Incorrect. I was desperate to avoid the involvement of medpros. Period. (I was desperate enough to disregard my chosen provider's advice to transfer, and it was my call t put off that decision too long. If my provider were proved to have waited too long to advise me to transfer, they'd have howled for her blood. But, I'm just a stupid labouring woman who couldn't have made any decision on my own, so I'm not responsible. There are various factors that contributed to my decisions during that labour. But, if one person deserves the blame for my son's death, it's me, not my provider. The fact that it's the provider people want to go after is just more evidence of the underlying arrogance of the "health" care profession. All the decisions must have been hers, right? After all, the patient/client/pregnant woman has no responsibility for, or authority over, herself.)

I have no interest in forcing the state to license or endorse anybody. I don't give a crap about the state's licensing.

[Storm Bride]

Originally Posted by holly6737 

The woman has a choice to make. She can either birth unassisted or she can consent to the c-section at 39 weeks. Women do not have a right to force a provider to offer a service that they do not feel comfortable providing. That's the bottom line of it. You hire your hcp, but you do not own them. And neither do they own you. You can walk at any time.
 

Got it. Care providers can't be forced to provide actual care. That makes things very clear. (You're also full of it. Women have been taken to court to try to force them into doing what the doctor wants them to do.)

[slmommy]

Quote:

Originally Posted by thegoodearth 

I've been following this thread for quite awhile... And I have to say that never have I wished more for a thumbs down sign than when reading some of your posts Holly, not just the one below. You come across as very pompous. I would never choose a hcp with your attitude: OB, CNM, CPM or whatever.  Maybe you don't realize it but you have a "holier-than-thou" air that comes across your posts and makes you seem like a "know-it-all" that can't consider things from another perspective. Not even for a second. Your dogma (or pride) won't allow it - not sure which.

I kinda think Holly is just having fun making really insulting statements and watching us fall over in frenzy. 

All of this WHOLE thread... over whether or not women should ALWAYS, in every scenario, have fundal massage. 

[holly6737]

Originally Posted by Storm Bride 

Got it. Care providers can't be forced to provide actual care. That makes things very clear. (You're also full of it. Women have been taken to court to try to force them into doing what the doctor wants them to do.)

That's right. That's absolutely correct. You do not have a right to force a care provider to give you care that he/she feels is unsafe. You don't have that right. We have agency. We have rights ourselves. You don't own us. Like it or not, that's the way it is (and thank God for that!). For example, you can't walk into a general surgeons office and say, "I want an appendectomy." and have the right to force that general surgeon to perform an appendectomy. Don't you see how that would be crazy? I would not longer be the captain of my own ship. I would no longer have control over my own actions, my own practice. That's insane.

[thegoodearth]

Totally agree. I'm thinking the same thing now.
 

Originally Posted by slmommy 

Quote:

I kinda think Holly is just having fun making really insulting statements and watching us fall over in frenzy. 

All of this WHOLE thread... over whether or not women should ALWAYS, in every scenario, have fundal massage. 

[holly6737]

Originally Posted by slmommy 

Quote:

I kinda think Holly is just having fun making really insulting statements and watching us fall over in frenzy. 

All of this WHOLE thread... over whether or not women should ALWAYS, in every scenario, have fundal massage. 

I"m just procrastinating studying for boards to be honest with you. I"m not here to have fun. I really should be going actually....

I do think every woman should have fundal massage. I mean, if I do fundal massage a couple of times after delivery of the placenta and your uterus is clamping down nicely and the pit is going in, then I don't have to sit there and knead it. But some fundal massage, yeah. That's evidence based practice, as per the WHO, the ACNM and the ICM, as I've said repeatedly.

[Just1More]

Storm Bride, I am so impressed with your take on such a hard situation. 

*hugs*

Originally Posted by Storm Bride 

I had an unlicensed midwife. I don't discuss her identity, for a variety of reasons. My provider in that pregnancy didn't ever pretend to be anything she isn't - not once, not ever. The state may or may not have had the legal ability to charge my provider, but they don't have a moral right to do so. There was police involvement, and the basis of it was that the poor labouring woman must have been led astray. Because, once again - it couldn't possibly be the actions of the licensed medical professionals that pushed me into a decision that the medical establishment doesn't approve of. I obviously must have been led astray by some kind of Kool Aid. Incorrect. I was desperate to avoid the involvement of medpros. Period. (I was desperate enough to disregard my chosen provider's advice to transfer, and it was my call t put off that decision too long. If my provider were proved to have waited too long to advise me to transfer, they'd have howled for her blood. But, I'm just a stupid labouring woman who couldn't have made any decision on my own, so I'm not responsible. There are various factors that contributed to my decisions during that labour. But, if one person deserves the blame for my son's death, it's me, not my provider. The fact that it's the provider people want to go after is just more evidence of the underlying arrogance of the "health" care profession. All the decisions must have been hers, right? After all, the patient/client/pregnant woman has no responsibility for, or authority over, herself.)

I have no interest in forcing the state to license or endorse anybody. I don't give a crap about the state's licensing.

Edited by Just1More - 4/16/12 at 7:16pm

[stik]

Fundal massage is a low-risk method of treating pph that has a long history of working and has few side effects.  If you gave birth with any kind of care provider, someone checked your fundus after the placenta was delivered.  If it felt huge and floppy, that person probably proceeded to pummel you in the stomach for a while, because that it what care providers do to encourage the uterus to clamp down so that bleeding stops faster, really no matter what their philosophy is on active management of the third stage.  If you had a c-section, they probably did it before stitching you up.  Fundal massage is described as a treatment for PPH in all the UC materials I have seen.  I'm kind of boggled that fundal massage has been viewed with such skepticism in this thread.

Personally, I am not a fan of cord traction, and my experience with fundal massage was pretty unpleasant.  I asked my hcps about their philosophy on managing the third stage, and we were able to communicate in a mutually respectful way that allowed all of us to voice our concerns and decide on an approach that addressed everyone's priorities.  

I think Holly is being very honest about her protocols, and I think that kind of honesty is needed.  I would much rather have an OB or CNM who is transparent in her intentions than one who lies to me during pre-natals and then acts unilaterally while I'm in labor.

[SimonMom]

Originally Posted by holly6737 

Originally Posted by SimonMom 

I'm still interested in your evidence for your evidence based practices. :p I'm a scientist, I am capable of reading the literature. Show it to me. :) You totally glossed over any of the studies I pointed you in the direction of. You want to be believable? :p Then show us the evidence. That should be easy. 

Any true scientist would work at an institution that has access to UpToDate. Log in. Look up anything you want. Otherwise, I would refer you to all of the position statements of the ACNM, the complete Varney's midwifery, the complete Williams Obstetrics, the complete William's Gynecology and the complete Gabe's Normal and Problem Pregnancies. The Green and the Gray journal are also good reads, and you should also have access to these journals through your institution.

i'm asking you you are debating this. are you incapable of finding these studies? i could be convinced if you find them and show them to us. the onus is on you, my dear.

[SimonMom]

i remember fundal massage in at least 2 of my 3 births, however i'm more questioning holly's insistence on cord traction and pit for everyone. i bet she didn't even bother to look at the studies i posted. which just shows to me that she has one view, and that's all. she's not willing to inform herself past what she already believes. 

[Just1More]

Especially when it gets into the sticky arena of parental vs. child rights.  Does the mother get to choose care for herself AND her child?  Or just herself?  Or how about only her unborn child?  Or maybe only her unborn child up to x weeks pregnant?  When does the state get to make these decisions?  Should it ever get to?  Who gets to define "imminent danger"?
 

Honestly, I don't have answers.  I find the topic quite disturbing, mostly because I can only see an all or nothing approach.  And, I neither wish the state to have all authority, nor for children to be unprotected. 

But, yes, it's totally not true that a person, once they have submitted to standard care, can always just walk away.

Originally Posted by Storm Bride 

 (Women have been taken to court to try to force them into doing what the doctor wants them to do.)

Back on topic...no, routine fundal massage is not necessary.  A fundal check?  Sure.  Painful massage.  No.
 

[slmommy]

Quote:

Originally Posted by stik 

I'm kind of boggled that fundal massage has been viewed with such skepticism in this thread.

It was her original assertion that fundal massage is absolutely.necessary.in.every.single.birth or the mother will always lose an "uncommon amount" of blood.

Like I said, Holly can practice however she wants, but speaking in these absolute terms is simply not true. 

[holly6737]

Oh please. Get on UpToDate yourself. You are perfectly capable of doing so. I'm not going to spoon feed material to anyone claiming to be a scientist. If you are a scientist, it is within your abilities to both look up the protocols for yourself and understand them.

Quote:

Originally Posted by SimonMom 



i'm asking you you are debating this. are you incapable of finding these studies? i could be convinced if you find them and show them to us. the onus is on you, my dear.

[holly6737]

Originally Posted by slmommy 

Quote:

It was her original assertion that fundal massage is absolutely.necessary.in.every.single.birth or the mother will always lose an "uncommon amount" of blood.

Like I said, Holly can practice however she wants, but speaking in these absolute terms is simply not true. 

Fundal massage isn't this 20 minute procedure. It can last 10 seconds if the uterus clamps down appropriately and lochia begins to decrease or it can be 5 minutes or more if bleeding persists. It's a feel thing. The duration of fundal massage depends on the situation- and yes, I maintain that my philosophy includes some fundal massage as a part of every birth.

[stik]

ACOG has issued a statement opposing using court orders to force women into specific treatment protocols.  It has happened anyway in a few cases, but I think it's worth noting that the broad medical consensus is that it's poor practice, it reflects horrible doctor/patient relationships, and doctors who do that are asshats.  

Holly has a protocol.  She's been taught it.  It's evidence-based.  It has good results.  She's comfortable with it.  She's honest about it, so if you don't like it you can easily not hire her.  There are other CNMs and OBs who don't automatically use cord traction or pit, and the fact that a bunch of people here are shocked by the existence of fundal massage is clear evidence that not everyone does that either.  

[Storm Bride]

Originally Posted by holly6737 

That's right. That's absolutely correct. You do not have a right to force a care provider to give you care that he/she feels is unsafe. You don't have that right. We have agency. We have rights ourselves. You don't own us. Like it or not, that's the way it is (and thank God for that!). For example, you can't walk into a general surgeons office and say, "I want an appendectomy." and have the right to force that general surgeon to perform an appendectomy. Don't you see how that would be crazy? I would not longer be the captain of my own ship. I would no longer have control over my own actions, my own practice. That's insane.

But, care providers can - and do - have that power over women. Do you not see how that's insane? You're talking about people having no power over their own practice, while women are deprived of power over our own bodies. You talk a good game about how we can make the choices we want, but you're all for the only providers who will support those choices being pursued legally. Is it crazy that doctors can be banned from performing procedures that they feel are safe, or lose hospital privileges or face disciplinary action? Care providers do have their hands tied, and their decisions made for them, on a regular basis, just not by their patients, who are the ones most profoundly affected by those decisions.

I'm so, so glad I'm through my reproductive life and out the other side.

[holly6737]

Originally Posted by Storm Bride 

But, care providers can - and do - have that power over women. Do you not see how that's insane? You're talking about people having no power over their own practice, while women are deprived of power over our own bodies. You talk a good game about how we can make the choices we want, but you're all for the only providers who will support those choices being pursued legally. Is it crazy that doctors can be banned from performing procedures that they feel are safe, or lose hospital privileges or face disciplinary action? Care providers do have their hands tied, and their decisions made for them, on a regular basis, just not by their patients, who are the ones most profoundly affected by those decisions.

I'm so, so glad I'm through my reproductive life and out the other side.

But why should I be forced to provide for you a service that I feel is dangerous just because you wish to pursue it? Why should the state be obligated to make legal a dangerous medical practice just because you wish to participate in it?

[Plummeting]

Originally Posted by holly6737 

The woman has a choice to make. She can either birth unassisted or she can consent to the c-section at 39 weeks. Women do not have a right to force a provider to offer a service that they do not feel comfortable providing. That's the bottom line of it. You hire your hcp, but you do not own them. And neither do they own you. You can walk at any time.
 

That's not "consent". In order to give informed consent, you cannot be coerced. If a doctor is threatening to drop you as a patient in your 39th week if you don't do what (s)he wants, then you no longer have the ability to give "consent". All you can do is either refuse or give in to her/his demands. That's not consent.