Internal fetal monitoring for VBAC

[SkylarVT]

I am, (was?), planning a hospital VBAC in December, but I have just been informed that the hospital requires internal fetal monitoring for VBAC clients. My OB told me that intermittent external monitoring would be fine, but the head nurse just told me that the internal monitoring was hospital policy and that the OB could not get around that. Am I correct in assuming that they would do an AROM when I get to the hospital if my waters were still intact, (they want the monitor in as soon as you are admitted)? Would they make me stay in bed on my back for the entire labor? Between the risk of infection and risk of a stuck baby from pushing on my back, plus the labor time limit thanks to the AROM this sounds like a recipe for a second c-section right? I have actually been considering switching to a home birth midwife and after this homebirth is looking better and better.
Thanks.

[ckhagen]

Oh no way. There's no way I would submit to internal monitoring (and the required AROM). You're exactly right... the AROM, risk of infection, and time limits on labor that will come along with it are far too much for my personal preference and I would be homebirthing (or hospital shopping) immediately!!
The idea of internal montioring (ie, a small spring being screwed into my baby's scalp, increasing all sorts of risks), with no emergent reason would send me running from that place.

[SuzymomofLaura]

Oh no, don't consent! Studies have shown that the benefits of internal monitoring are quite controversial, and as for the disadvantages, you seem to be very much aware of them already. I had internal monitoring with my first birth, which indeed ended up being a C section, and yes, I got an infection. I found this resource very helpful. Internal monitoring is listed as something you'd want to avoid here too.

[Mama2E&O]

ITA with the others~ do not consent to this! Whether it is hospital policy or not, they cannot make you do that.
There is no reason why you cannot do external fetal monitoring. I chose to do that off and on for my VBAC.

[mom3b1?]

I'd change plans. The more hinderance, the more risk, IMO. I tried to VBAC in the hospital, but couldn't do it with all those machines hooked up to me. At home I was able do it without a hitch, no complications whatsoever. I think it's amazing that some women actually can get a baby out vaginally in the hospital, an absolute miracle. I maybe could if I were at one of those rare facilities that doesn't attach lots of machines, lets you eat, move around, and birth in the water without a huge audience, but I"m not sure. Having strangers around when I'm birthing creeps me out in a way I can't get past, which works against me. So far the only place I've found that I can safely birth is my own home. I think I'm more sensitive to intrusion than some women are, but I think sensitivity isn't all that unusual.

Kiley

[AngelaB]

I agree with the others. I would deeply consider home birth for your next birth.

It is scary the whole unknown part(Im planning one too) but considering the opions, homebirth seems to be the one with the most likely successful outcome.
Angela

[Emma's_Mommy]

there is no way in hell i would go to that hospital to have a baby.....they are setting you up for FTP and a repeat c-section

[ollineeba]

I completely agree with the others. I wouldn't agree to that! I would either fight it tooth and nail or change plans altogether.

[JWhite31]

I had internal monitoring and a IUPC w/ my VBAC, but I was 8cm before they put it in and my water had already broken on its own. Before that I had intermittent external monitoring and was out of bed moving around most of my labor. However, even after the internal monitor was put in, I still moved around in bed and got up on my hands & knees, etc.

I definitely wouldn't agree to it before your water breaks on its own. I mean, I don't know, its hard tosay no when they are insisting on it, but being immobile puts you at higher risk for complications.

Anyway, I just wanted to share my experience with you since I did have one in my VBAC labor.

Good luck.

[grumpyshoegirl]

I wouldn't consent. If you MUST stick with this hospital (and I am aware that there are plenty of reasons why this might be the case), remember that the nurses are NOT the ones who make the decisions, just implement them. First of all, do NOT consent to a vaginal exam from ANYONE that you don't already know and trust. Don't let the nurses up there at all! Second, if they start trying to pull interventions that you don't want, tell them (or better yet, have your partner or a doula tell them) firmly that the intervention is not part of your birth plan, you don't care about hospital policy and you will not consent without meeting with YOUR doctor first. And then keep your legs shut!

[summer99]

I probably should have updated this sooner : I spoke to my very pro-VBAC OB, and he told me that it would be best for me to go in and refuse everything, (internal monitoring, vaginal exams, etc.), and just go with the intermittent monitoring that we discussed. He said to just keep telling the nurses that I was HIS patient, as he is known at that hospital for being the weirdo doctor that refuses all of the "hospital policy" stuff for his patients. I am sort of stuck with this hospital since we decided against a homebirth, and all of the other hospitals in the area won't do VBAC. So, I am really hoping that this will work out.

[meatloafkend]

Well, I would stay at home as long as possible if you are planning to go to that hospital still. I don't know when they would want to do internal fetal monitoring. It could be right away, it could be once you reach active labor. However, I do know that you can refuse the internal fetal monitoring AND the AROM. It's your labor. You may have some pressure and flack for it though.

[hapersmion]

I was going to post another vote for homebirth, but I see in your update that you decided against it. I agree with meatloafkend that you should probably stay home as long as you possibly can, if you go to the hospital. If you aren't there, they can't disrupt your labor.

It's good that your OB sounds supportive, that will probably help a whole bunch. But I agree with another PP that you should watch the nurses, especially if they're already disagreeing with the doctor. They broke my friend's water and put an internal monitor in her baby's poor little head without asking - without even telling her they'd done it, she had to deduce it later on. :

Good luck!

hapersmion

[HappyMommy2]

Run away, run away fast

[MilkTrance]

Summer, I am so happy your doctor is on your side. I had an internal fetal monitor and I absolutely hated it. I felt like an *expletive* cow, or an animal, lying there on the table with them shoving it in me. I hated, hated, hated that P@)$* internal monitor.

[Jenlaana]

You are very lucky that you have your doctor on your side. His word is the law, in the end. That gives you a LOT of leverage. Just decline decline decline, like he told you. You probably shouldn't trust nurses to do or not do anything in particular as PP's mentioned, but I really feel that if you have supportive people with you to "watch your back" when you're busy handling labor, I think you could very likely have a fantastic birth.

Your OB should be commended if he's as great as you say. Very few doctors have the guts to go against the system.

[kltroy]

Originally Posted by summer99

I probably should have updated this sooner : I spoke to my very pro-VBAC OB, and he told me that it would be best for me to go in and refuse everything, (internal monitoring, vaginal exams, etc.), and just go with the intermittent monitoring that we discussed. He said to just keep telling the nurses that I was HIS patient, as he is known at that hospital for being the weirdo doctor that refuses all of the "hospital policy" stuff for his patients. I am sort of stuck with this hospital since we decided against a homebirth, and all of the other hospitals in the area won't do VBAC. So, I am really hoping that this will work out.

Good for him (and you)! I suggest you have him WRITE THIS DOWN ON A PRESCRIPTION PAD and post it on your door and on your bed. Then whenever a nurse tries to do anything you can wave the scrip in their face and they can't violate that.

[gossamer]

Not to scare you, but I have a friend who had an internal monitor screwed into her babies head. The problem was that the monitor was contaminated with staph and her baby died immediately after birth due to staph infection. I have another friend whose baby died because the hook they used to break her waters with (against her persmission) was contaminated with a virus that killed her baby 3 weeks later.
Gossamer

[ericswifey27]

Originally Posted by gossamer

Not to scare you, but I have a friend who had an internal monitor screwed into her babies head. The problem was that the monitor was contaminated with staph and her baby died immediately after birth due to staph infection. I have another friend whose baby died because the hook they used to break her waters with (against her persmission) was contaminated with a virus that killed her baby 3 weeks later.
Gossamer

: and :

A nurse screwed an internal monitor in to my baby's scalp too. I didn't know about it until I got my medical records... 3 years later. That little mark on his head that I asked about that they called a "stork bite"... was where they screwed it in. It is exactly that kind of violation that has made me scared to death of hospitals.

To the OP, be very, very careful. Don't think it can't happen to you. I was really naive and thought that because I wanted a natural birth I would get one. It's almost always not that simple these days, with the procedures and obstacles in place today.

Just be on your toes, you can (and should) refuse any routine procedures/regulations including monitoring, vaginal exams, laying on your back, no eating or drinking, no walking or bathing. I would go in at the last possible moment and fudge on when my water broke, if it did. All of those things can be very detrimental to a healthy labor.

Oh, and edited to say GET A DOULA! (I wish I had the first time around)

[peapiebaby]

Originally Posted by ericswifey27

: and :

A nurse screwed an internal monitor in to my baby's scalp too. I didn't know about it until I got my medical records... 3 years later. That little mark on his head that I asked about that they called a "stork bite"... was where they screwed it in. It is exactly that kind of violation that has made me scared to death of hospitals.
Oh, and edited to say GET A DOULA! (I wish I had the first time around)

Um, ditto. I realized about a year later that's what happened to me. But it was my CNM. And she knew I didn't want that at all.

Ditto the doula, too. I wish I had had one. Perhaps they could have kept pushing for someone to help attempt to move my OP baby who wouldn't turn instead of setting me up for failure.

That is so scary, gossamer, about those deaths! I would be beyond livid.

(On a side note, the hospital in the town where I live [I will NOT ever go to that hospital. I drove an hour north to a better one.] did a c-sec on a teacher at a school I covered as a reporter. Hers was 2 months after mine. I was healed and visiting the people to tell them goodbye when I had quit and let them meet my daughter. Her incision STILL hadn't healed and she was about 3 months post-op then. It was still open. She had a reaction to something they used on her......)