Cesarean Birth Support Thread April & May 2006 - Page 5

[wombatclay]

Strom Bride- my hat is off to you mama! That takes a HUGE amount of courage and conviction. Please let us know how it goes..

[AnditheBee]

Originally Posted by eastkygal

Also, dd is 9 months, and I still have burning and pain in my scar. Is anyone experiencing similar things? When will it go away?

I had some pain and sharp twinges in my scar off and on for 18 months or so after the surgery. I gather that's not unusual. I guess it depends on how much pain you are having and how often--but if it's not much, I wouldn't worry. Just takes a long time for the nerves to re-grow and such.

[amm0406]

Originally Posted by pumpkinsmama

How did they botch it? I am just curious because without knowing that they (the hospital) were neglectful beyond belief, I am really kind of ticked off at the family for suing and lowering all of our chances for vbac's. $28 million is a huge amount of money, especially when the government only allows payoffs in the hundred thousand range if they kill your child with vaccines.

Apparently something happened and the child ended up with cerebral palsy because they didn't do an emergency C when they should of? I'll try to find an article on it and post the link.

[amm0406]

http://www.commonwealinstitute.org/r...t-Oct20041.pdf
Pg 37 of this PDF - the paragraph that starts with "anecdotal" explains the whole case.

[grumpyshoegirl]

Originally Posted by Storm Bride

I finally gave my doctor (my FP, not my OB...I'm still working on that one) the letter I wrote her about how I felt after being railroaded into a third c-section.

If you don't mind my asking, what did you say? I've been contemplating writing a letter to the group practice that handled my pregnancy and am not quite sure how to word it or whom to address it to. (The induction is a policy of the whole practice and four of the six CPs in the practice were actively involved in my care up to the section.)

[pumpkinsmama]

Anecdotal evidence suggests that a rise in “bad baby” cases has occurred since doctors decided
that it was safe for women who had once had a C-section to deliver a second baby vaginally.
These are called VBAC (Vaginal Birth After Caesarean) cases. But catastrophic injuries to both
mother and baby occur when the doctors ignore birthing problems in their mind-set that VBAC
is safe. A classic example is the 1998 delivery of a baby girl at Lankenau Hospital in
Philadelphia. The mother had been admitted on the basis of a telephone call by the most senior
member of the medical group, but her care was handled by the most junior member, who was a
year out of residency. The baby was shown to be in fetal distress at 5:50 p.m., and a prominent
expert witness for the plaintiffs said the baby should have been delivered by C-section within
twenty or thirty minutes. Instead both the doctor and the chief nurse ignored the mother’s pleas
and the monitoring. The baby was vaginally delivered at 7:14 p.m. and the mother’s uterus had
ruptured sometime before that. The hospital had a written protocol for determining the need for
C-sections in VBAC situations. But neither the doctor nor the nurse had read them, and admitted
such. At least seven of the fifteen written criteria for a C-section were found in the medical
chart, and others were confirmed in deposition. The jury awarded $24 million to the mother and
child, who is profoundly brain damaged and afflicted with cerebral palsy and will never walk,
talk, or eat on its own. During post-trial motions the defendants settled the case – but insisted on
a confidential settlement.110
It is certainly not true that recoveries in bad baby cases are consistently shooting up everywhere.

http://www.commonwealinstitute.org/r...t-Oct20041.pdf

amm0406, thanks! That clears it up a little. It sounds so very different from what I usually hear happens, the mom pleading for montoring and the doctor ignoring her. I haven't heard a story like this before, but the article makes it sound common. After reading that, I no longer feel at all that she shouldn't have sued! What a terrible story.

[Storm Bride]

Originally Posted by grumpyshoegirl

If you don't mind my asking, what did you say? I've been contemplating writing a letter to the group practice that handled my pregnancy and am not quite sure how to word it or whom to address it to. (The induction is a policy of the whole practice and four of the six CPs in the practice were actively involved in my care up to the section.)

I wrote six pages, so obviously I can't repeat it all here. But, I basically told her how upset and angry I was at how my feelings and reactions were ignored. (For example, I'd told both her and the OB that I knew I'd suffer from PPD again if I had to have another section, and was told that I "could have PPD, anyway". That's true, but "could" and "will" aren't the same thing.) I also explained that the "I'm fine" that comes out of my mouth whenever I come to the office is totally meaningless, and has nothing to do with how I really feel. I mentioned that I'm still numb, and still haven't healed properly and my bladder still doesn't feel right, etc. I also talked about how wrong I think it is to threaten me with unspecified risks and put pressure on me to have surgery, without ever discussing any of the risks of that surgery.

I can't really remember it all. If you'd like to read it, PM me your email, and I can send it to you...

[pumpkinsmama]

Wow, that just sounds awful, StormBride. I hope that your letter and discussion really make her think twice next time she is in that position.

[pumpkinsmama]

Just a rant.

Ughhhh. I just got done with my 16wk ob apt. I can't wait to get back to the states so I can start shopping for options and maybe a midwife. I asked out of curiosity if there was any chance that if I had a repeat section with this baby they could cut away the old adhesions and maybe help end some of this pain (which is really getting to me, now it is every time I stand up/cough/sneeze/laugh too hard and achy when I'm not doing anything) and she said most likely not. Which I was expecting, it is scar tissue so cutting again can always cause more scar tissue. What really ticked me off, was that DH (who is totally against me having a homebirth and very against VBAC) apparently heard that while they couldn't garuntee anything it would probably help a lot. Which one of us has selective hearing the worst????

Well it isn't his birth, so he doesn't "really" have any input anyway. I find it odd that someone who so rarely does any research on these things can have such strong opinions on what is best!

ETA: OB apts are much more enjoyable on the whole since I started telling them what to do instead of being told!!! I don't even know if they would have done anything like it at this apt, but after reading a lot here after the birth of my son I found out that you can say NO. I really didn't believe that, I had always been taught to listen to people in authority, police, teachers, doctors. Anyway at the first apt. I didn't let them do a pap smear (they couldn't believe I said No, I couldn't believe it either but didn't back down) and at this one I didn't even have to worry about whether they would be doing something I would be uncomfortable with. If they tried, I would just say no. Fantastic to go through a pregnancy without dreading apts!!!! I love this NO thing!!!

[faeriedreams]

Hello, I have a c-section related question. My sister had planned a homebirth, but discovered that her baby was breech when she was fully dilated. Her midwife recommended she have a c-section, and she was transferred to the hospital and given a spinal. She just left the hospital yesterday, and has had a persistant neck pain for the last few days. The pain alternates between a sharp, very painful pain to a dull ache. Has anybody else experienced this?
Could it be due to the spinal? Any recommendations on natural remedies to relieve the pain? She is still taking pain medications for the c-section, but they do not stop the neck pain at all.

Thanks for your help!

[allycat]

Hey Everyone-

I have been reading many entries here and thought I would share my own.

I did have C-section after labouring for 6 hours (6pm contractions started by 2am I was pushing), got to 10cm, was in a lot of back and hip bone pain with sciatia down to my toes. The doctor did tell me that the baby was well positioned, and asked to break my water earlier but I told her no - and it broke slowly as I started to push.

I did push for 2 hours, and wondered why my DS was not coming out. The doc said his head was slightly rotated to the left and tried to manually turn him with her fingers. This was the beginning of another 3 hours of pushing (it is involuntary at a certain point), 3 epidurals that did not work, and an epidural block, and 2 local anesthetics. Finally went to a C-section after trying forceps (for another 1.5 hours) to get the baby out.

After being in so much pain for sooo long, and seeing the daylight once again after labouring all night I welcomed my C-section, and the meds to relieve my back/hip pain. DS was just not coming out as he was wedged in my pelvis. And at this point I did really want him out.

Having had pelvis pain from 4 months onward, I can understand why I was in so much pain during the delivery.

I thought I would be a bit disappointed in my experience as I really wanted to have a natural birth - which I did up until he was not coming out and I was sooo tired at the end. My body is just not designed to have large children - he was only 8 pounds, 5 ounces - 21.5 inches long (which I hear is normal?).

Maybe on the next child I will spontaneously go into labour before the end of 40 weeks so that this option will be available to me once again.

So, for those of you who had 'no other option' as the kid was just not coming out, I hope you do not continue to be too hard on yourselves. Your baby is here - beautiful, and healthy.

[Storm Bride]

Okay- talked to my doctor yesterday. I left in a good mood (that changed when I got a call from ds1's school - he broke a bone in his hand yesterday, and I spent 6.5 hours in ER. His year-end field trips for his 7th grade "graduation" are completely blown. ).

Basically:

She still won't admit that I didn't need my last cesarean.

She's glad I wrote the letter, and thinks it probably helped me a lot.

She said that "we" (doctors) need to hear these things, and remember that there can be lasting repercussions to the surgery.

She acknowledged that my first section (1993) has had a massive negative effect on reproductive life/health since then.

She asked if there was anything she could do to help now.

She's going to look at my hospital records from my first section, and see if she can figure out why it was done. All I was told is that it was because my son was breech...but our hospital wasn't doing c-sections for breech babies at that time. I may still request my records at a later date, but I do appreciate the offer, which came about when I mentioned my frustration over not even understanding how all this c-section crap started.

She said that she and my OB obviously failed to give me the emotional support that I needed, and apologized for that.

She did mention my healthy children, but only in a "try to look at the positive" way, instead of the "it's all that matters" way. She never once tried to tell me that we got a "healthy mom" out of this...

I wish she's acknowledged that ds2 would probably have been just fine without the section, but aside from that, I feel pretty good about the whole discussion. This certainly doesn't just make it all go away, but it does help that she recognized that I had no feeling that I had any say in what was done to me, and that sucked. At least I can hear her name without my blood pressure going up now!

[pumpkinsmama]

Maybe she can't admit you didn't need the last one because that would mean she was wrong ?

Absolutely doc's need to hear those things and remember that their actions have long lasting effects!!! And it is pretty rare someone like you comes along to remind them. Good going!

It sounds like you really got through! She doesn't get a perfect score, but sounds like she is coming along.

[AnditheBee]

I'm glad it went well, Storm Bride. Maybe someday I'll have the nerve to confront my last OB about my last c-sec, but I doubt it--he'd never listen in a million years. I'm glad yours seemed to at least acknowledge your issues/feelings and not try to convince you you're wrong for feeling that way.

And yeah, I agree with pumpkinsmama--I think in general docs can't admit when they're wrong, partly because they're doctors and partly for the risk of litigation that their admission might bring about. Why does medicine always seem to come back to the topic of litigation these days?? Very sad...

[CountryMom2e]

Hi all - so nice to find a supportive thread for c-section. This has been a hard decision for me but I now know it is the right one for my body and my baby.

I planned a natural hospital birth with DS - terrific doula, CNMs I adored & trusted, but in a major medical center just in case. I developed rapid onset preeclampsia at 39 wks, and my MWs wanted to induce if I did not go into labor, thankfully baby had it all set and the next morning my water broke. I labored at home for awhile, went to the hospital, checked in... and immediately my natural birth plan went out the window. Contrax went from every 7 m to every 3 (90 sec contrax, 90 sec break), and I begged for pain relief. I dialated rapidly, and once I had an epidural, was feeling great and once again in control. I could feel contrax before they hit, but could actually breathe in between. Pushing was great, but after a bit I felt his head *stick* a bit.

We pushed for over 3 hrs, until I noticed a lot of people in the room. DS had decells that were non-reassuring, probably due to my intense and rapid labor. My BP was continuing to climb despite the mag sulfate, so my MWs and their OB recommended we stop pushing for awhile and put me on oxygen for an hr. His numbers did not improve, nor did mine, so the recommendation was for an emergency c-section. After a good cry, we moved into the OR, and my son was born with 9 & 9 apgars. The OB mentioned something about his cord may have been short, my MWs felt that his head was not quite aligned which would cause both the hyper-rapid labor (3 cm to 10 in 3 hrs) and the failure to descend. My doula, who is also a MW, told me that had I been her HB, we would have wound up also with another c-section.

Still it was a difficult recovery (my p-e worsened after birth too, so I spent a week after discharge on bedrest after a harrowing ER visit), and I wept a lot for the birth I never experienced. I wondered if the choices I had made, specifically for pain relief and a hospital birth, had influenced the outcome.

After time to heal, DH and I were happy to TTC our little miracle boy, who is due to be delivered via repeat c-section this Wednesday. I had full plans for a VBAC, but once again things change. I developed preeclampsia again at 27 wks, and have been on full bedrest for the past 3 months. The past two weeks my p-e has worsened to the point that we have been on a daily alert to go and deliver if my pressures creep any higher (currently 145-150/95). I decided that my body could not take an induced, pit-only VBAC on top of the stress that the p-e has caused (not to mention that I am weak from all of the bedrest). So I asked for a scheduled c-section if I had to deliver early, and a VBAC if I go into labor beforehand. Through sheer will, family support, and lots of rest I will make it to almost 39 wks, which is truly amazing for p-e.

While I am scared of major surgery again, and concerned about my DS1 and how he will be while I am away, this has been a long and difficult pregnancy and I am eager for relief and to allow my body to heal. I am focused now on welcoming the baby, spending time with both of my sons, starting slowly the healing process, and looking forward to each day getting better, instead of worse.

Thanks ladies!

[mamabeth]

Hi Mel! Best wishes for a wonderful birth and a healthy baby. Do you have a c/s birth plan? If not the "cesarean goddess" (on the fence) has a wonderful one that was helpful to me with my planned c/s.

Come back and post your birth story in a few days!

[Throkmorton]

Hi all!

I've been lurking on the support threads, while holding out hope that I could avoid a RCS later this week. Since it doesn't look like that will happen, I thought I would ask you knowledgeable ladies for advice while i work on my birth plan.

The big thing that is stressing me out is post-surgery pain relief. I am allergic to tylenol and have weird issues with any opiate narcotics. So, no morphine because it makes me sick as a dog (which they give me anti-nauseants for, which make me sleepy.... etc) unless there isn't a lot of other options.
Does anyone have any suggestions on what to put on my birth plan regarding pain medication post-surgery?

[egoldber]

Originally Posted by Throkmorton

The big thing that is stressing me out is post-surgery pain relief. I am allergic to tylenol and have weird issues with any opiate narcotics. So, no morphine because it makes me sick as a dog (which they give me anti-nauseants for, which make me sleepy.... etc) unless there isn't a lot of other options.
Does anyone have any suggestions on what to put on my birth plan regarding pain medication post-surgery?

For post-op pain, I would talk to your OB ahead of time so that he/she can have the order already in your chart. I have heard good things about Toradol, which is a very strong NSAID (like Motrin but stronger). It can be given via IV.

Have you had other opiates besides morphine? There are many different kinds. Other common ones besides morphine are hydromorphone (Dilaudid) and oxycodone (like in Percodan and Percocet which you would not want of course).

[CountryMom2e]

Curious - why not oxycodone? I was on percocet then vicodin after my IV was removed after birth, and they worked great for me.

Also I would consider for pain relief getting an epidural rather than a spinal for the surgery - I've been told that they can administer some add'l drugs at the end of your surgery to *top you off* on the epi and keep you comfortable longer without IV narcotics. Only thing is that it restricts movement, but since I will likely be on bedrest for 24 hrs after surgery, that's not a huge loss for me.

Also can you have demerol? i think that's what I had initially in my IV after my first birth.

[egoldber]

Originally Posted by CountryMom2e

Curious - why not oxycodone? I was on percocet then vicodin after my IV was removed after birth, and they worked great for me.
....
Also can you have demerol? i think that's what I had initially in my IV after my first birth.

Nothing wrong with oxycodone in general. I meant (although I wasn't clear, sorry) that she wouldn't want Percocet, since Percocet is a combo of oxycodone with Tylenol and she's allergic to Tylenol.

The "standard" protocol around here for post-CS meds is Duramorph (morphine) in the epidural catheter after the CS and then oral Perocet and 600 mg ibuprofen after the first 12-24 hours. But this protocol won't work for the above PP. And at least here, the epidural is removed right after surgery, and as soon as the urine catheter is removed, they encourage you to be up and out of bed as quickly as possible.

I have read that Demerol is no longer in favor because it is excreted into breastmilk at a higher rate than morphine. Although having it in the IV vs via oral meds would reduce the transmission rate significantly.