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PROM @ 33w4d, breech presentation, currently home AMA--support please - Page 3

post #41 of 220
Oh, good luck and stay strong!

I have never regretted my vaginal breech birth, though he wasn't premature. Don't let those doctors put you at risk for their own convenience!

I've heard stories where people have gone several weeks with broken water and no labor (or problems because of the broken water). Even though you say you seem to be gearing up for labor, maybe you can go a little bit longer - even 35 weeks isn't so early, right?

Anyway, I hope everything goes well for you. *good birthing thoughts*

post #42 of 220
I had an OB tell me the other day that they just won't do it. I asked her whether there was a spare corner in the parking lot they were going to dump me when I refused.
Ruefully LMAO
post #43 of 220
Sending good vibes your way....
post #44 of 220
This has probably already been discussed, but couldn't your midwife be in charge for the labour, and the preemie docs in charge of the baby?? My midwife does something similar if you end up with a c-section - the mother's care is transferred to the doc, but the midwife gets the baby as soon as it is born. Midwives here (alberta) can admit to hospital, I suppose that is key.
That way it doesn't matter if they don't agree with a breech birth. I would still want a midwife instead of an ob with me during labour even if baby was premature.

Hope all goes well. Stay Strong!

post #45 of 220
Don't let them sway you! This is your child and your choice. I hate how in this country you can easily "choose" to abort your baby but you have a hard time choosing how to birth your baby.:

Since you said you don't have much NICU experience I thought I would send you this link. I don't have any NICU experience either but it is my biggest fear. It seems that the parents really can loose control of their babe once they get admitted, especially if they are not informed on how some wonderful NICU's around the world operate (and how really horrible ones can basically restrict parental access). This link talks directly about how to care for preemies in a very gentle touch related manner. It might help you vocalize the care you want your babe to receive after the birth if they have to be admitted.

I think this quote below is especially important to the premee BFing relationship since many NICU's seem to basically force the parents to bottle feed or else the babe can never go home and many will never even allow the babe to BF. It is horrible that they won't even allow the parents to try. Never mind that they don't even care that bottle feeding brings on a HUGE risk at that age of nipple preference leading many times to totally failed BFing. (I would say skip the bottles and all costs, stay a longer in the NICU if you have to just avoid them, use other devices if necessary, cups, syringe what ever it takes to get your babe fed without a bottle. Also pump like crazy if your babe does not bf right away, have it lined up at the birth just incase it is needed, I have heard stories where it took HOURS for the docs to even locate one within the hospital

"While it was observed that ability to suck on a bottle only started at 34 weeks post-conceptional age, recent research has shown that suckling from the breast is possible at 28 weeks. Suckling is a myographically distinct behavior from sucking, and research on sucking on bottles of premature infants shows it clearly to be stressful. Premature infants are unable to coordinate their breathing and their swallowing. "

HUGS!!!: Good vibes for a Safe and happy birth & BFing relationship.
post #46 of 220
Hugs and happy vibes! Praying for some resealing! Hang in there, I know you can do it!
post #47 of 220
Originally Posted by g&a View Post
This has probably already been discussed, but couldn't your midwife be in charge for the labour, and the preemie docs in charge of the baby?? My midwife does something similar if you end up with a c-section - the mother's care is transferred to the doc, but the midwife gets the baby as soon as it is born. Midwives here (alberta) can admit to hospital, I suppose that is key.
That way it doesn't matter if they don't agree with a breech birth. I would still want a midwife instead of an ob with me during labour even if baby was premature.

Hope all goes well. Stay Strong!

That's *supposed* to be the case in Ontario too, but there's a disconnect between the Midwifery guidelines and what the hospitals will allow. Although breech, vbac etc are within the scope of Ontario Midwifery practice, hospital policy dictates that these are "high risk" and obliges MWs to transfer clients to OB care upon arrival. MWs who don't cooperate are at risk of losing their priviledges... you see the problem. I don't know what happens if the mama flat-out refuses OB care in the hospital and insists on being attended by her MW. In theory, the MW can't get in trouble if she dotted & crossed all of her i's and t's, but since MW priviledges are granted by the OBs at the hospital... hmmm... conflict of interest, a little? I would not be surprised if you were to run into the same problem iwth AB hospitals. It's a snobbery thing.

The MW in question (I know her too) is VERY qualified to catch a breech. But the hospital with the neonatal wing isn't "her" hospital and has only "courtesy" priviledges with MWs (ie if they come in with their transported/transferred client, they can stay and are counted as staff not as a client's "guest", but they are there only on the grace of the head OB). In fact, this hospital, because it has recently gone into nearly exclusively "high risk" birth, actually revoked previously existing MW priviledges late last year.

The whole thing is so freakin' stupid.

Sorry for highjacking hon!!!

xo Robin
post #48 of 220
to you, mama. I would focus on becoming well-educated about 34 wkers (there have already been a couple of great links and info posted earlier in the thread), so that you are armed w/ info.

The whole breech situation has gotten out of control, and your case is a perfect example. Stay hydrated, load up on vitamin C and echinacea, and let your mw do what she can to help you. Meanwhile, you focus on your baby.
post #49 of 220
Thread Starter 
Thank you!

I went in today for a non-stress test, as the resident told me to do when I told her I was leaving. She showed me where to register and which desk to go to for the NST. She said I could come regularly to check up on the baby.

Today I arrived and they did the NST then the OB came in and said that I would no longer be eligible for any outpatient services. I must be readmitted or I get nothing. No follow up NSTs or ultrasounds. I am calling the College of Physicians and Surgeons just to make a fuss about such poor ethics. Obviously he is trying to coerce me into staying.

He did admit that they cannot make me have a c-section, and that of course they would be forced to allow me to proceed with a vaginal birth if I insisted. He then tried to point out that things can change during labour and a c-section might become necessary, and that I need to trust the OB so that if something like that happens and a c-section becomes necessary I will accept it. I did tell him that I understand that cesarian delivery can save lives, and that sometimes they are necessary, but how am I supposed to trust the opinion of a random OB I've never met whose mindframe was from the beginning that the c-section was necessary just because the baby was presenting breech? : I pointed out that my midwife would be in attendance and that I would be considering her perspective. He made a bunch of rude comments about how she shouldn't be involved etc. He said she can't make decisions for me. I told him that I was making my own decisions, and that I would consider the opinion of the care provider I've had and trust in addition to the opinion of the man who already thinks I'm supposed to have a c-section.

Someone mentioned priveleges....yes, technically she should have assisting priveleges now, and attending priveleges at 35 weeks with a physician present. The OB brought up (and the one who is mine is the head OB) the fact that a c-section becomes more dangerous with the lower comfort levels of the attending physician. I pointed out that there would be a perfectly qualified, capable and willing attendant at the birth and how convenient for them!

I called him out on the literature, asking him what he thought of particular studies on vaginal breech births, including the term breech trial and the follow-up, and he really didn't have a good answer for me. He just went into a spiel about how most doctors won't do vaginal breech deliveries in Canada and it's not just him, etc. What he didn't tell me is that he has at least one OB on his own staff perfectly willing to do so, and not thinking it such a big deal. My midwife spoke to this man this morning, and while he's not willing to come in for me off-call, he would be happy to proceed with my planned vag breech when he's in on his 2 days a week.

I gave him specific reasons why I did not feel I should be sitting in the hospital indefinitely waiting for this baby. He noted that there had been several conversations between me and others (nurses, OBs, residents) about the topic, and I told him that yes, there have. And they've been abusive and disconnected. The first day I was told I wouldn't stay if I was stable. That I would have outpatient care, even a nurse coming to my home to monitor occasionally. Then I was told I had to stay. I never met this OB that I met today, nor did I ever know my care had been transfered to him. I was in for a full two-and-a-half days. I was told I would meet with neonatology on a certain day. I didn't that day or the next. What benefit of my being there? He tried to tell me there was an increased risk of cord prolapse; I told him I had a frank breech and the risk is much lower. He stopped that argument. Then he had the infection argument. I pointed out I had sat through their IV antibiotics and continued oral antibiotics as prescribed (even though yeah, I'm only partly convinced this is necessary--which I didn't say). He left that alone. Finally it came down to "you should realize how lucky you are to have an antenatal bed...they're hard to get and blah blah blah). In reality, I could be sitting there indefinitely. I've been fine. No bleeding. Baby moving. All NSTs good. BPP good. I just hate that I'm being bullied like this. And now with refusing to do any outpatient monitoring...well, it's obviously manipulative and meant to be a threat. I cannot stay in that environment for potentially a couple weeks.

Just had to get some of that conversation out with people who might understand. I'm glad DP was there. I couldn't have faced the staunchest, most conservative head of obstetrics on my own with a nurse literally laughing out loud at me for being so obviously silly when I pointed out that the practice of an automatic c-section for breech presentation is not in keeping up with current literature.

Okay, enough venting.

If I make 36 weeks, I mosey on down to the hospital where my midwife does have priveleges and we birth the baby. That would be ideal at this point, though I'm getting so mad I almost want to go to their hostile hospital and scream at them while I push a baby out of my vagina bum-first. :

I do fear that there will be backlash against me and the baby because when the baby is born they will have a way of regaining power over me. Things like threats, unnecessary testing, half-truths, and just not making things easy for us.

post #50 of 220
Do you, at this point, have a written plan in place for care after the baby is born...dos and don'ts, etc? If you don't, I suggest you get one, and have signatures that all the OBs and the hospital have received it. This might put the control back in your corner.

And I am steaming mad for you--so you stop being mad and try to relax enough to keep that baby inside you, girl!
post #51 of 220
I'm absolutely sure you are right about vaginal breech births. I'd do the same thing.

I was born at 32 weeks after PROM in 1964. It happened that my Dad was a med student at the only hospital in the world with an NICU.

I'm not so sure I wouldn't have been better off born at home. I was entubated, and ended up with very serious RSV, and spent the first three years of my life in and out of the hospital. I think the entubating introduced the infections.

This was 1964, and a lot of stuff they have now hadn't even been thought of. Mom did get steroids, but they induced right away instead of letting me bake a little longer like you're doing. After that, I had an extremely healthy childhood and life. I hardly ever get sick.

At that time I think they were entubating the way they c/s for breech. They assume it's somehow good for the baby, and I'm not so sure it is in every case or even most cases.

Anyway, I hope you get what you want. I think you are doing really well. I'm so glad you've got a good MW fighting for you.

post #52 of 220
I'm so proud of you for standing up to the sOB!

Like forestrymom said, you should make a birth plan. Also you shouldn't sign the general consent for care for yourself or your baby. Tell them that you must approve of each individual thing they want to do.
post #53 of 220
OMG mama, I am so steaming mad for you. I can not believe how crappy yhe care is, and how can they deny you outpatient care!?!? Isn't there a law or something about that? Grrr...

You stand your ground mama, what an amazing woman you are. I think I would have been a blubbering mess trying to have a conversation with such a jerk off.
post #54 of 220
You're amazing and an inspiration. I hope you have a good outcome to all of this, and are respected by the hospital.
post #55 of 220
Thread Starter 
Thanks again mamas for your support. I have been having some contractions and I'm a little concerned this might be it soon. I'll keep you updated and I truly truly appreciate your kind words.
post #56 of 220
I think someone mentioned it already, but I've heard really great things too about the Dr. Sears Preemie book, if you have access to a library, or bookstore... I'm still praying!
post #57 of 220
Can they really deny you outpatient care? Can BA get it for you at the Mft? That is absolutely unacceptable, paternalistic patronizing CRAP.

I totally get what you mean - wanting to SHOW them.

You are so strong. You are truly an inspiration.

xo Robin
post #58 of 220
: for you and the babe! So glad you are standing up for what you believe in!
post #59 of 220
Originally Posted by sanguine_speed View Post
Thank you mamas; your support means so much. I don't have a lot of friends or family IRL who understand; I get the impression that while they want to be supportive they mostly think medical professionals do always know best and should always be listened to.

My twin sister and my husband were the only ones in my family who truly supported my vbac. I relied heavily on the support of MDC and my midwife. It made such a difference to me. During my labor, I thought of all the kind words from MDC mamas and the successful vbac stories they shared, despite the opposition they faced. It helped me tremendously. You CAN get through this too!

Keep strong mama, and trust your intuition.

Thinking of you,

post #60 of 220
Thinking of youand hoping all goes well.
You are a strong mama for standing up for yourself and your baby at this time.
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